wk 5 4 inlfammatory bowel disease clinical

Question 1

how does ulcerative and crohns differ in clinical presentation (usually)

Answer 1

crohns - ab pain, peri-anal disease

ulcerative - diarrhoea, bleeding

Question 2

4 factors contributing to inflammatory bowel disease

Answer 2

pathogenic bacteria
abnormal microbial
defective containment of commensal bacteria
defective host immunoregulation

Question 3

determine severe ulcerative colitis 5

Answer 3

> 6bloody stools/24hr

1 (or more) 
fever
tachycardia
anaemia (Hb <10.5g/dl) 
elevated ESR (inflam marker blood test)

Question 4

ulcerative colitis would be further assessed by 4

Answer 4

bloods - CRP,albumin
plain axr
endoscopy
histology

Question 5

t/f stool distrubtion is observed in an AXR of ulcerativ

Answer 5

false

absent in inflamed colon

Question 6

other than no stool distributioin, what 2 things may be seen in IBD XR

Answer 6

thumb printing - mucosal odema

toxic megacolon - transvere> 5,5cm, caecum>9cm

Question 7

3 things observed in endoscopy of IBD

Answer 7

loss of vessel pattern
granular mucosa
contact bleeding

Question 8

extensive colitis is when the inflammation expands from rectum to

Answer 8

beyond splenic flexure

Question 9

primary sclerosing cholangitis may arise from IBD, which disease is more likely, which is likely to be seen in an lft

Answer 9

UC > crohns

cholestasis (little/no bile)

Question 10

define PSC

Answer 10

primary sclerosing cholangitis

chronic inflammation of biliary tree

Question 11

peri-anal disease can develop in Crohns, define

Answer 11

recurrent abscess formation in peranal (ass cheeks)

pain, can lead to fistula with persistent leakage and damaged sphincters

Question 12

crohns symptoms are determines by the site of disease. likely symptoms if in small intestine, colon, mouth or anus

Answer 12

small - ab cramps (peri-umbilical)
colon - ab cramps (lower), diarrhoea +blood, wt loss
mouth - painful ulcers, swollen lips angular chielitis (inflam at corners of mouth)
aus - peri-anal pain, abscess

Question 13

what would be looked for in clinical exam to further assess a patient with crohns 3

Answer 13

evidence of wt loss
RIF mass
peri-anal signs

Question 14

if terminal ileum affected, likely defiency to occur

Answer 14

vitb12

follate

Question 15

t/f ulcerative colitis would cause a thickened wall surrounding affected area

Answer 15

false

crohns would

Question 16

t/f loss of haustra in ulcerative

Answer 16

true