GI: Inflammatory Bowel Disease Flashcards Preview

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Flashcards in GI: Inflammatory Bowel Disease Deck (12)
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1
Q

What are the causes of inflammatory bowel disease?

A

Begins with a genetic predisposition then there is thought to be an immune trigger
Trigger is idiopathoc but possibly antibiotics, infection, smoking, diet

2
Q

Where in the GI does crohn’s and ulcerative colitis affect?

A

Crohn’s: anywhere from mouth to anus - usually the ileum is involved and usually there is rectal sparing. (skip lesions)
Ulcerative colitis: begins in rectum and extends to involve anywhere in the large bowel (continuous)

3
Q

What problems can pts experience outside of the GI tract?

A

MSK pain such as arthritis (50%)
Skin problems such as tender red lumps, psoriasis (30%)
Eye problems (5%)

4
Q

How does Crohn’s present?

A

Loose non bloody stools - area of absorption inflamed so there is a large osmotic load that draws in water
Weight loss - not absorbing nutrients
Right lower quadrant pain - terminal ileum

5
Q

What is the pathology of Crohn’s?

A

There are discrete superficial ulcers and deeper ulcers - transmural inflammation leads to thickening of the bowel wall and narrowing of the lumen.
There is cobblestone appearance - oedema surrounded by ulceration
Skip lesions
Can get fistulae
Perinal disease

6
Q

What is the microscopic appearance of crohns?

A

There is granuloma formation which is a strong indicator of crohns

7
Q

How would you investigate crohns?

A
  • Bloods to test for anaemia
  • CT and MRI scans to look for bowel wall inflammation, obstruction and extramural problems
  • colonoscopy + biopsy
  • barium enema less used
8
Q

How does ulcerative colitis present?

A

Bloody, mucousy, loose stools
Weight loss
Mild lower abdo pain

9
Q

What is the pathology of UC?

A
Chronic inflammation of lamina propria
Get crypt abscesses
Decreased goblet cells so lose protective mucus
Loss of haustra - lead pipe colon 
Continuous 
Mucosa is friable - bleeds on contact
10
Q

What is the microscopic appearance of UC?

A

Crypt abscesses with lots of inflammatory cells

11
Q

How would you investigate UC?

A
Bloods to test for anaemia 
Stool cultures
Abdo xrays 
CT/MRI (less useful for UC)
Colonoscopy
12
Q

How is inflammatory bowel disease treated?

A

Medical:
Aminosalicylates for flares and remission
Corticosteroids to reduce inflammation - flares only
Immunomodulators to maintain remission

Surgical:
Crohn’s remove very bad areas (not curative)
UC remove total large intestine (curative)

Decks in ESA 3 Class (96):