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BDS2 BAMS > Crohns disease and ulcerative colitis > Flashcards

Crohns disease and ulcerative colitis Flashcards

1
Q

What ages are more susceptible to IBD? (2 points)

A
  • 15-25 years

- 50-80 years

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2
Q

Are males or females more susceptible to Crohn’s disease?

A
  • Males
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3
Q

Are males or females more susceptible to ulcerative colitis?

A
  • Females
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4
Q

What are the possible causes of IBD? (4 points)

A
  • Immunological
  • Psychological
  • Smoking (reduces chances of IBD)
  • Genetic
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5
Q

What are immunological causes of IBD?

A
  • People who seem to be predisposed due to the way they have an immune response
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6
Q

What are psychological causes of IBD?

A
  • IBD could be a consequence of psychological factors nut not very clear
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7
Q

Does smoking increase or decrease the chances of someone getting IBD?

A
  • Decreases
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8
Q

Are there genetic causes of IBD?

A
  • Yes, there is a clear tendency that it runs in families

- You are at a slightly higher risk if your parents have it

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9
Q

What is the histology of Crohn’s disease?

A
  • Histologically there are granulomas inside the tissue (collection of multi-nucleated giant cells that form together in a clump) (granulomatous inflammation)
  • Something is happening in the tissues which is causing immune stimulation which the body is unable to deal with
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10
Q

What can cause Crohn’s disease? (2 causes)

A
  • Food intolerance (something passing through the gut which is causing irritation e.g. benzoic acid)
  • Persisting viral infection/immune activation
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11
Q

What is Johne’s disease?

A
  • Problem which cattle get which is similar to Crohn’s disease
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12
Q

Where in the body can you fins Crohn’s disease?

A
  • Any part of the bowel from the mouth all the way down to the bottom end
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13
Q

Where are 3 common places to find Crohn’s disease?

A
  • Mouth
  • Ileo-caecal region
  • Rectum
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14
Q

Where is ulcerative colitis found and where does it originate from?

A
  • Found ONLY in colon
  • Always starts in rectum and works its way up
  • If starts anywhere else it is not this
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15
Q

In relation to Ulcerative colitis and Crohn’s disease, which is continuous and which is discontinuous?

A
  • UC = continuous

- CD = discontinuous

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16
Q

In relation to Ulcerative colitis and Crohn’s disease, when is the rectum involved?

A

UC = always

CD = 50% of the time

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17
Q

In relation to Ulcerative colitis and Crohn’s disease, when do they have anal fissures?

A

UC = 25% of the time

CD = 75% of the time

18
Q

In relation to Ulcerative colitis and Crohn’s disease, when is the ileum involved?

A

UC = 10%

CD = 30%

19
Q

In relation to Ulcerative colitis and Crohn’s disease, what is the mucosa like?

A

UC = Granulomas and ulcers

CD = Cobbled and fissures

20
Q

In relation to Ulcerative colitis and Crohn’s disease, are they vascular?

A

UC = Vascular

CD = non-vascular

21
Q

In relation to Ulcerative colitis and Crohn’s disease, what is the serosa like?

A

UC = normal

CD = inflamed

22
Q

What are the microscopic features of ulcerative colitis? (3 points)

A
  • Mucosal
  • Vascular
  • Mucosal abscesses
23
Q

What are the microscopic features of Crohn’s disease? (3 points)

A
  • Transmural
  • Oedematous
  • Granulomas (in the gut)
24
Q

In relation to Ulcerative colitis and Crohn’s disease, where are they inflamed?

A

UC = Very superficial

CD = Entire thickness of the bowel wall inflamed (narrows lumen)

25
Q

What is Proctitis ulcerative colitis?

A
  • Involves only the rectum
26
Q

What is Proctosigmoiditis ulcerative colitis?

A

Involves the rectum and the sigmoid colon (the lower segment of the colon before the rectum)

27
Q

What is Distal colitis ulcerative colitis?

A
  • Involves only the left side of the colon
28
Q

What is pancolitis ulcerative colitis?

A
  • Involves the entire colon
29
Q

What is Backwash ileitis ulcerative colitis?

A
  • Involves the distal ileum
30
Q

What are common symptoms of ulcerative colitis? (3 points)

A
  • Diarrhoea
  • Abdominal pain
  • PR bleeding (friable, easily damaged surfaces as they are stripped and will bleed as the bowel contents pass)
31
Q

What are the symptoms of colonic Crohn’s disease? (3 points)

A
  • Diarrhoea
  • Abdominal pain
  • PR bleeding
32
Q

What are the symptoms of small bowel Crohn’s disease? (4 points)

A
  • PAin
  • Malabsorption
  • Obstruction
  • Anal disease
33
Q

What are the symptoms of mouth Crohn’s disease? (1 point)

A
  • Orofacial granulomatosis
34
Q

Orofacial granulomatosis is not a single condition. What does this mean? (2 points)

A
  • Granuloma formation blocks lymphatics
  • Lip & oral swelling then noted from other causes of increased capillary leakage (food preservatives and additives, some have no identifiable trigger)
35
Q

What are the clinical features or orofacial granulomatosis? (6 points)

A
  • Lip swelling
  • Angular cheilitis
  • Cobblestoneing
  • Gingivitis
  • Ulceration
  • Microscopic granulomas
36
Q

What investigations can be carried out for IBD? (6 points)

A
  • Blood tests (anaemia, CRP, ESR)
  • Faecal calprotectin
  • Endoscopy
  • Leukocyte scan
  • Barium studies
  • Bullet endoscopy
37
Q

What are the complications of ulcerative colitis? (2 points)

A
  • Develops into carcinoma
  • Risk increases with time
  • Judgement as to whether colectomy is justified
38
Q

What are the possible medical treatments of IBD (immunosuppressives)? (5 points)

A
  • Systemic steroids (Prednisolone)
  • Local steroids (rectal administered)
  • Anti-inflammatory drugs (5-ASA based drugs - Pentasa, mesalazine, sulphasalazine)
  • Non steroid immunosuppresants (azathioprine, methotrexate)
  • Anti TNF-alpha therapy (Infliximab, adalimumab)
39
Q

What surgery treatments of IBD are there? (3 points)

A
  • Colectomy
  • Crohn’s disease - palliate symptoms (remove obstructive bowel segments, drain abscesses, close fistulae)
  • Usually results in a stoma/bag
40
Q

Can a colectomy cure Ulcerative Colitis?

A
  • Yes
41
Q

What is an oral issue with Ulcerative colitis?

A
  • Oral ulceration

- Ulcers worse when UC is worse

42
Q

Look at the slide IBD for exams

A

:)

BDS2 BAMS (57 decks)

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