IBD

Question 1

What is the main histological difference between UC and CD?

Answer 1

CD - presence of granulomas

UC - absence of granulomas

Question 2

What type of pattern does inflammation follow in CD?

Answer 2

Skip lesions

In a non-continous way

Question 3

What layers of the gut wall are generally affected in CD?

Answer 3

Generally all the layers

Question 4

What layer/s of the gut wall are affected in UC?

Answer 4

Generally only the mucosa

Question 5

What type of pattern does inflammation follow in UC?

Answer 5

Continous manner

No Skip lesions

Question 6

What part of the GIT does UC affect?

Answer 6

The colon only

Question 7

What part of the GIT does crohn’s affect?

Answer 7

Can affect any part of the gut tube

Question 8

What are the main symptoms in UC?

Answer 8

Rectal bleeding
Blood in stools
Mucus stools

Question 9

What do the symptoms of CD depend on?

Answer 9

The location of the inflammation

Question 10

What would be possible symptom in Crohn’s colitis?

Answer 10

Bloody diarrhoea

Loss of mucus

Question 11

What type of Crohn’s could lead to malabsorption?

Answer 11

Ileal Crohn’s

Question 12

What are the investigations for UC?

Answer 12

Endoscopy
Colonoscopy
Sigmoidoscopy
Tissue biopsy for pathology

Question 13

What are the investigations for CD?

Answer 13

Lab tests
Anaemia 
CRP 
LFTs 
Endoscopy
AXR
Barium studies 
Endoscopy 
Colonoscopy 
Sigmoidoscopy

Question 14

What is the treatment for IBD?

Answer 14

Aminosalicylates – (anti-inflammatory)
Oral or rectal admission depending on where is closer to the site of main inflammation
Corticosteroids Immunosuppressant’s
Biologics 
Infliximab  - form of immune suppressor

Question 15

What is the action of aminosalicylates?

Answer 15

Anti-inflammatory

Question 16

What is infliximab a form of?

Answer 16

Immune suppressor

Question 17

What is the risk with infliximab?

Answer 17

Malignancy 1-2%

Question 18

What is required to put a patient on immunosuppressants?

Answer 18

Specialist care and close monitoring

Question 19

What type of appearance is Crohn’s said to have on endoscopy?

Answer 19

Cobblestone

Question 20

What is IBD?

Answer 20

Chronic relapsing inflammatory

Question 21

What are the two types of IBD?

Answer 21

Ulcerative Colitis

Crohn’s

Question 22

Where does UC affect?

Answer 22

Only the colon

Question 23

Does Crohn’s demonstrate continous or skipping inflammation?

Answer 23

Skipping

Question 24

Does UC demonstrate continous or skipping inflammation?

Answer 24

Continous

Question 25

Which age does UC peak at?

Answer 25

20-40

Question 26

Who is UC more common in M or F?

Answer 26

F

Question 27

What are the symptoms of UC?

Answer 27

Bloody diarrhoea Abdo pain Weight loss

Question 28

Where does inflammation always start in UC?

Answer 28

In the rectum

Question 29

Where does the inflammation in UC spread?

Answer 29

Rectum proximally

Question 30

What is classified as a severe attack of UC?

Answer 30

``` Stool frequency >6 stools a day with blood AND Fever >37.5 >90bp (tachycardia) ESR raised Anaemia Hb <10g/dl Albumin <30g/l ```

Question 31

Are M or F more affected with Crohn's Disease?

Answer 31

Equal

Question 32

Where does Crohn's disease affect?

Answer 32

Anywhere from mouth to anus

Question 33

What type of lesions are present in CD?

Answer 33

Skip lesions

Question 34

What are the clinical features of CD?

Answer 34

Depends on which region is affected

Question 35

What are the signs and symptoms of CD?

Answer 35

``` Diarrhoea Abdo pain Weight loss Malaise Lethargy Anorexia Malabsorption (anemia, vitamin deficient ect..) ```

Question 36

What signs in the blood can suggest IBD?

Answer 36

``` High ESR High CRP High platelet High WCC Low Hb Low albumin ```

Question 37

What can be present in a stool sample suggesting IBD?

Answer 37

Calcprotectin

Question 38

In which IBD are granulomas present?

Answer 38

CD

Question 39

In which IBD are goblet cells depleted?

Answer 39

UC

Question 40

In which IBD can fistulae be present?

Answer 40

CD

Question 41

What are differential diagnoses for IBD?

Answer 41

Chronic diarrhoea Ileo-caecal TB Infective, amoebic and ischaemic colitis

Question 42

What is a potential long term complication of UC?

Answer 42

Colonic carcinoma

Question 43

What are the surgical indications for Crohn's disease?

Answer 43

``` Failure of medical management Relief of obstructive symptoms Management of fistulae Management of intra-abdominal abscess Management of anal conditions Failure to thrive ```

Question 44

Is CD curative?

Answer 44

No

Question 45

Rx for IBD

Answer 45

5ASA Corticosteroids e.g prednisolone Immunosuppressants e.g azathioprine Biologics e.g infliximab Surgery if unable to manage