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Flashcards in IBD Deck (30)
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1

Feature that distinguishs Crohns and UC?

UC starts in the rectum and does not spread the ileocaecal valve. It is continuous. Crohn's is discontinuous throughout the GI tract

2

Peak age of onset of UC

15-25 years, 55-65 years

3

Presentations of UC

bloody diarrhoea, urgency, tenesmus, abdominal pain (LLQ), extra-intestinal symptoms

4

Common presentations associated with UC disease process?

arthritis, erythema nodosum, episcelritis, osteoporosis

5

Common presentations not associated with the UC disease process

arthritis, uveitis, clubbing, primary sclerosis cholangitis

6

Inflammation in UC is found where?

not beyond the submucosa

7

Crypt abscesses - crohns or UC?

UC

8

Pseudopolyps - crohns or UC?

UC

9

what causes the formation of crypt abscesses?

neutrophils infiltrating the submucosal wall

10

pathology of the glandular epithelium in UC?

depletion of goblet cells and mucin production

11

If a barium enema was performed on a UC patient (old practice) what would be seen?

lack of haustrations, possible pseudopolyps

12

Tests and Investigations carried out in UC?

Bloods - FBC, U&Es, CRP, ESR, LFTs; Stool culture - to rule out microbial involvement; Colonoscopy - to assess disease extent; AXR and CXR - faecal shadowing, colon dilation, perforation

13

Treatment of UC to maintain remission?

5-ASAs such as mesalazine, sulfasalazine

14

Treatment of UC flair ups - mild to moderate disease

steroids i.e. prednisolone PO, may be used as suppositories if necessary

15

Treatment of severe UC flair ups?

Nil by mouth, IV hydration, steroids rectally and IV;monitor bloods, temp, HR and BP and stool frequency and character; consider blood transfusion if low Hb,

16

Where might surgical intervention occur in UC?

perforation, massive haemorrhage, toxic dilation, last resort due to failed medical therapy

17

Immunemodulation may be used when?

there is no remission of disease or there is prolonged steroid use

18

Examples of immune modulation therapy in UC?

azathioprine, methotrexate, infliximab

19

It is important to monitor ___ while using immune modulation therapies

bloods - FBCs and LFTs particularly

20

Crohn's typically affects...?

the terminal ileum and colon but anywhere mouth to anus

21

Inflammation occurs where in crohn's?

all the way to the serosa

22

Crohn's patients are prone to...?

strictures, fistulas and adhesions

23

Presentation of crohn's may include?

weight loss, lethargy, diarrhoea (bloody or non-bloody), abdominal pain, perianal disease (skin tags and ulcers)

24

Extra-intestinal features of crohn's include?

arthritis, erythema nodosum, pyoderma gangrenosum, clubbing, apthous ulcers

25

Pathology of crohns

goblet cells and granulomas

26

complications associated with crohns?

small bowel obstruction, abscess formation, fistulae, colon cancer, fatty liver disease, primary sclerosing cholangitis

27

Tests involved in Crohn's investigations

Bloods - FBCs, ESR, CRP, U&Es, LFTs, INR, ferritin, VitB12, Folate; Stools - exclude infection; Colonscopy and biopsy; small bowel enema - detects ileal disease; MRI - detects pelvic disease and fistulae

28

Treatment of mild Crohn's?

steroids tapered over time

29

Treatment in severe Crohn's flair up?

steroids, metronidazole, daily bloods and stool, consider transfusion,

30

Additional therapies that may or may not work in Crohn's patients?

Azathioprine, sulfasalazine, TNFa inhibitors - infliximab, methotrexate for inducing remission, surgery