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Flashcards in GI 10 - IBD Deck (20):
1

Name some triggers of IBD:

- Infection
- Diet
- Smoking
- Antibiotics

2

What is the typical presentation of ulcerative colitis?

- Young adult
- Urgent diarrhoea
- Mucous/bloody stools

May also have problems with:
- Skin
- Liver/biliary tree
- Eye
- MSK pain

3

What is the typical presentation of Crohn's disease?

- Either 15-30yrs or 60+yrs

If ileum affected:
- Colicky abdominal pain
- Diarrhoea
- Malabsorption
- Weight loss

If colon affected:
- Bloody/mucous diarrhoea
- Malaise
- Anorexia
- Weight loss
- Perianal disease

4

What part of the GI tract is affected by ulcerative colitis?

- Continuous proximally from rectum, can affect whole colon
- Mucosa only

5

What part of the GI tract is affected by Crohn's disease?

- Can affect any part of GI tract (with skip lesions)
- Transmural

6

Is there a higher risk of strictures with UC or Crohn's? Why?

Crohn's
Transmural disease leading to thickening of wall and narrowing of the lumen, whereas UC only affects mucosa

7

What skin conditions are commonly seen with IBD?

- Erythema nodosum
- Pyoderma gangrenosum
- Psoriasis

8

Which of IBD may be managed by dietary changes?

Crohn's

9

What methods are commonly used to investigate IBD?

- Blood test
- Stool cultures
- Abdominal XRay
- CT scan
- MRI scan
- Colonoscopy
- Barium enema

10

Which IBD can cause perianal disease?

Crohn's disease

11

What are the macroscopic changes associated with UC?

- Loss of haustra
- Pseudopolyps
- Loss of typical vascular pattern

12

What are the microscopic changes associated with UC?

- Crypt abscesses/distortion
- Decreased no. goblet cells
- Inflammatory infiltrate into lamina propria

13

What are the macroscopic changes associated with Crohn's disease?

- Cobblestone appearance
- Fistulae of bowel + bowel/bladder/vagina/skin
- Ulcers

14

What are the microscopic changes associated with Crohn's disease?

Granuloma formation

15

Which sign from a barium enema is associated with UC?

Lead pipe sign

16

Which sign from a barium enema is associated with Crohn's disease?

String sign of Kantour

17

Name some medications which are available for IBD:

- Aminosalicylates ie Sulfasalazine
- Corticosteroids ie Prednisolone
- Immune system suppressors ie Azathioprine
- Antibiotics
- Anti-diarrhoea med
- Pain relief
- Iron/vit B12/Ca2+/vit D supplements

18

What is the surgical option for UC? IS it curative?

Proctocolectomy +/- Ileoanal anastamosis

Curative

19

What are the surgical options for Crohn's disease?
Are they curative?

- Strictureplasty
- Resection +/- colostomy
- Abscess drain

Not curative

20

What is toxic megacolon, and with which IBD does it typically appear?

- Dilation of colon due to inflammation extending into smooth muscle layer, causing paralysis
- Neutrophils and macrophages produce NO = dilatation

Usually seen in ulcerative colitis