IBD

Question 1

Risk factors - Crohn’s

Answer 1

Smoking, genetic

Question 2

Presentation - Crohn’s

Answer 2

Bloody diarrhoea, malaise, anorexia, fever, joint involvement, eye involvement, skin involvement, perianal abscess

Question 3

Peripheral stigmata - Crohn’s

Answer 3

Clubbing
Erythema nodosum
Pyoderma grangrenosum
Conjunctivitis/iritis/episcleritis
PSC
Sacroiliitis

Question 4

Investigations

Answer 4

Faecal calprotectin
Colonoscopy - Crohn’s - biopsy from terminal ileum

Question 5

Management Crohn’s

Answer 5

Steroids - prednisolone or budesonide
Azathioprine/mercaptopurine
Methotrexate
Adalimumab/infliximab - TNF alpha blockers
Ustekinumab
Upadacitinib

Question 6

Crohn’s

Answer 6

transmural granulomatous inflammation of the whole bowel with skip lesions
Fistulating

Question 7

Presentation - UC

Answer 7

Bloody diarrhoea, abdominal pain, urgency, tenesmus

Question 8

Extra-intestinal disease - UC

Answer 8

erythema nodosum, aphthous ulcers, episcleritis, arthropathy of the large joints, pyoderma gangrenosum, anterior uveitis

Question 9

Severe exacerbation requiring hospital admission

Answer 9

> 6 bloody stools a day
Signs of systemic upset

Question 10

Management - UC

Answer 10

Mesalazine, steroids, azathioprine, ciclosporin
TNF-alpha inhibitors