Flashcards in Inflammatory Bowel Disease Deck (63):
what are the two idiopathic chronic inflammatory diseases involved in IBD?
what do ulcerative colitis and Crohn's disease have in common?
How do ulcerative colitis and Crohn's disease differ?
what are the 3 main factors involved in the pathogenesis of IBD?
Mucosal Immune system
Is there a genetic link in IBD?
which chromosome is thought to be involved in the genetic link in IBD?
In Crohn's disease what is the section in which a mutated form causes the disease?
How does NOD2 cause Crohn's disease?
encodes for a protein involved in bacterial recognition
What is used in the treatment of peri-anal Crohn's disease?
In which type of Crohn's disease is antimicrobial activity highest?
what was does smoking effect IBD?
Aggravates Crohn's disease
Protects agains ulcerative colitis
What environmental factors can cause IBD?
Sterile environment therapy
what is pancolitis?
Ulcerative colitis which affects the whole colon
what is proctitis?
Ulcerative colitis which affects the anus and anal canal only
what are the symptoms of ulcerative colitis?
Diarrhoea and bleeding
Increased bowel habit
Lower abdominal pain - LIF
to determine sever UC 6 or more bloody stool need to be passed in 24 hours along with what else?
one or more of the following:
what investigations would be used for ulcerative colitis?
Bloods - CRP and albumin
what might an AXR show in ulcerative colitis?
no stool present in inflamed colon
Mucosal oedema - thumb printing
what would be present at endoscopy in a patient with ulcerative colitis?
loss of vessel pattern
what differs in the histology of ulcerative colitis?
abscence of goblet cells
crypt distortion and abscess
which layer does ulcerative colitis effect in the colon?
what determines the risk of cancer in ulcerative colitis?
Severity of inflammation
Duration of disease
what is Primary sclerosing cholangitis?
Chronic inflammatory disease of the biliary tree
How may primary sclerosing colangitis present?
mostly asymptomatic or presents as an itch and rigors
In which IBD does primary sclerosing colangitis present?
Which region of the GI tract does Crohn's affect?
What are the common characteristics of Crohn's?
what is peri-anal disease?
Recurrent abscess formation which can then lead to fistula formation with a persistent leak - damaged sphincters
what are Crohn's symptoms when affecting the small intestine?
what are Crohn's symptoms when affecting the colon?
diarrhoea with blood loss
what are the Crohn's symptoms when affecting the mouth?
Angular chielitis - inflammation at the side of the mouth
what are the Crohn's symptoms when affecting the anus?
what are the investigations for Crohn's disease?
CRP, albumin, platelets
what might be found on examination of a patient with Crohn's disease?
evidence of weight loss
Right iliac fossa mass
In which IBD are granulomas present?
How can the small bowel be assessed in Crohn's disease?
Barium follow through
Small bowel MRI
Technetium-labelled white cell scan
Define Crohn's disease
Chronic inflammatory and ulcerating condition of the GI tract that can affect anywhere from the mouth to the anus
Where does Crohn's disease most commonly present?
Terminal ileum and colon
How does Crohn's disease generally present?
Small bowel obstruction
what is this patient most likely to have:
Bloody diarrhoea for 3/12
Is Crohn's does not respond to medical therapy what can this cause?
A bowel obstruction - leads to surgery
Is Crohn's disease patchy?
Yes - it is a segmented disease
Where does the inflammation occur in Crohn's?
Ileal and or colonic mucosa - includes cryptitis and crypt abscesses
what kind of inflammation occurs in Crohn's?
How can the ulcers be described in Crohn's?
Deep knife-like fissuring
what are the complications of Crohn's disease?
what does iretractable disease cause?
continous diarrhoea or pain
How does the immune system respond in Crohn's?
persistent activation of T-cells - don't switch off
excessive pro inflammatory cytokine production
what is ulcerative colitis?
Chronic inflammatory disorder confined to colon and rectum
which layers are inflamed in ulcerative colitis?
mucosal and submucosal
which part of the body does ulcerative colitis almost always involve?
How can ulcerative colitis present clinically in terms of incidence?
Chronic course with exacerbation and remission
Continuous low grade activity
A single attack
what is this patient most likely suffering from:
Bloody diarrhoea and mucus
Goes to toilet 25 times a day
what might need to be done if a patient doesn't respond to medical therapy?
Are granulomas present in ulcerative colitis?
What are the complications of ulcerative colitis?
Elecrolyte disturbance - hypokalaemia
what is toxic megacolon?
When the colon swells up to a point where it will rupture unless removed
what GI manifestations may present in the eye?
Uveitis - eye redness
what GI manifestations may present in the liver?
Primary clerosing cholangitis
what GI manifestations may present in the joints?
Ank spondylitis (spinal arthritis)
what GI manifestations may be present on the skin?
Pyoderma gangrenosum, erythema nodusum
What genetic factor is ulcerative colitis associated with?