Inflammatory Bowel Disease

Question 1

what is Inflammatory Bowel disease

Answer 1

Chronic, non specific inflammatory disorder of the gastrointestinal tract

Question 2

what are two examples of inflammatory bowel disease

Answer 2

Crohns disease

Ulcerative colitis

Question 3

when is the peak occurance of IBD

Answer 3

15 - 40 years old

Question 4

do we know the cause of IBD

Answer 4

no but both are described as autoimmune disorders meaning there must be a trigger to hte inflammation

Question 5

what are the risk factors of IBD

Answer 5

Hygiene 
Diet
Sleep
Medications
Microbiome
Genetic susceptibility
physical activity
appendectomy
smoking
stress
vitamin D uv exposure

Question 6

what is the initial evaluation

Answer 6

exclude other diseases

Question 7

what blood test should be taken

Answer 7

general signs of inflammation and for anaemia and vitamin and mineral deficiencies

Question 8

what can stool test be used to do

Answer 8

rule out infections

Question 9

what is crohns disease

Answer 9

chronic inflammatory disease of gastrointestinal tract

Question 10

where does the inflammation extend from in chrons disease

Answer 10

inflammation extends all the way through the intestinal wall from mucous to serosa

Question 11

what are the causative agents of pathogensis

Answer 11

bacteria
virus
dietary

Question 12

what are the modifying factors of pathogenesis

Answer 12

environment

genetic

Question 13

what are the luminal factors of pathogenesis

Answer 13

luminal bacteria
digestive enzymes
bile acids

Question 14

describe pathogenesis in chrons disease

Answer 14

causative agents trigger an immune response which then causes inflammation and amplification leading to a tissue injury

Question 15

what is the best way to define chrons disease

Answer 15

relapsing and remitting of a disease through the GI tract

Question 16

what are symptoms of chrons disease

Answer 16

patients present with diarrhoea and insidious abdominal pain

pain is often exacerbated after feeding

diarrhoea is usually non bloody

patients can frequently have fever and weight loss

Question 17

what can non intestinal manifestation include for crohns disease

Answer 17

mout hulcers
arthritis
erythema nodosum

Question 18

what are the complications of Crohns disease

Answer 18

narrowing of intestine can lead to blockage of obstruction

• severe cramping and abdominal pain, nausea, vomiting and constipation treated surgically

localized collection of pus or infections

• this causes pain and a fever

an abscess may also develop into a fistula

Question 19

how can fistulas be treated

Answer 19

diet , analgesics or with surgery

Question 20

what is proctitis

Answer 20

when only the rectum is affected

Question 21

what is distal colitis

Answer 21

when the descending colon is affected along with the rectum

Question 22

what is total colitis

Answer 22

everything affected in colon

Question 23

what is ulcerative colitis

Answer 23

condition that causes inflammation and ulceration of the inner lining of the rectum and colon

small ulcers develop on the surface of the intestinal lining and these may bleed and produce pus

Question 24

what are the symptoms of ulcerative colitis

Answer 24

loss of appetite and loss of weight

diarrhea often with blood and mucus and pus

cramping pains in the abdomen

tiredness and fatigue

feeling genrally unwell

anaemia

Question 25

from least to most agressive rank the methods IBD interventions from least to most

Answer 25

``` Aminosalicylates Antibiotics Corticosteroids Methotrexate Cyclosporine Infliximab Experimental therapies ```

Question 26

what do aminosalicylates do

Answer 26

inhibit production of reactive oxygen species scavenge of free radicals which inhibit the function of lymphocytes and monocytes and plasma cell production of immunoglobulins

Question 27

what are the side effects of aminosalicylates

Answer 27

``` nausea vomiting watery diarrhoea headache indigestion mild allergic reactions with rash itchiness fever ```

Question 28

what can sulphasalazing cause

Answer 28

male infertility by reducing the sperm count; resolves on stopping

Question 29

what can sulphasalazine reduce

Answer 29

absorption of folates (blood cell formation)

Question 30

what is sulphasalazine

Answer 30

aminosalicylates

Question 31

what do corticosteroid act on

Answer 31

immune system and block release of the substances that trigger allergic and inflammatory responses.

Question 32

what are some examples of corticosteroid

Answer 32

prednisolone, prednisone, hydrocortisone, methylprednisolone

Question 33

what are some common side effect of corticosteroids

Answer 33

``` puffy face excessive facial hair night sweats insomnia hyperactivity ```

Question 34

what are the serious side effects for corticosteroids

Answer 34

``` high blood pressure type 2 diabetes osteoporosis bone fratures cataracts increased susceptibility to infects ```

Question 35

what are the main immunosuppresant drugs

Answer 35

``` azathioprine mercaptopurine methotrexate mycophenolate meofetil ciclosporin tacrolimus ```

Question 36

when should azathioprine be used

Answer 36

when 5 ASAs and steroids have failed to produce results

Question 37

what are the side effects of azathiprine used for

Answer 37

nausea flu like illness fever diarrhoea

Question 38

what are some examples of biologic interventions

Answer 38

anti tumour necrosis factor alpha | humanized monoclonal antibodies