Inflammatory Bowel Disease Flashcards Preview

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Flashcards in Inflammatory Bowel Disease Deck (23):
1

What are the 2 types of IBD?

Ulcerative Colitis
Chrohn's Disease

2

What causes IBD?

Mostly idiopathic
Environmental trigger or genetically susceptible people

3

Symptoms of UC?

Bloody diarrhoea
Abdominal pain
Weight loss

4

What is ulcerative colitis?

Continous inflammation which only affects the colon. It starts in the rectum and works proximally

5

What are the clinical features of UC?

Temp >37.5
Pulse >90
Albumin <30g/l
>6 stools/day with blood
Hb <10g/l
ESR raised

6

What is Crohn's?

Patchy inflammation affecting mouth to anus with skip lesions. Can cause ulcers, strictures and fibrosis

7

What are the symptoms of Crohn's?

Diarrhoea
Weight loss
Abdominal pain
Malaise
Lethargy

8

What are the clinical features of Crohn's?

High ESR and CRP
High platelet count
High WCC
Low Hb
Low albumin

9

What are the main histological differences between UC and Crohn's?

UC is transmural
Crohn's will have non caveating granulomas
More crypt abscesses in UC
Goblet cells depleted in UC

10

What extra-intestinal manifestations could occur in IBD?

Eyes
Joints
Renal calculi
Liver and biliary tree
Skin

11

What disease can present very similarly to Crohn's?

Ileo-caecal TB

12

What disease is associated with UC?

Sclerosing cholangitis
Colonic carcinoma

13

What method is used to continue surveillance of IBD?

Colonoscopy

14

What drugs are aminosalicylates (5ASA)?

Mesalazine
Pro drugs (Balsalazide, Olzalazide, Sulfasalazide)

15

How are 5ASA used in UC?

>3g/day
Reduces number and severity of relapses
Reduces CRC risk

16

How is 5ASA used in Crohn's

Used for Crohn'd colitis

17

What steroids are used in IBD?

Prednisolone (40mg per day then tapering reduction)
Budenoside

18

What thiopurine is used in IBD?

Azathioprine (Side effects incl leucopenia, pancreatitis and hepatotoxicity)

19

How is methotrexate used in IBD?

Unlicensed use in Crohn's
Requires specialist follow up

20

Name some immunosuppressants used in IBD?

Ciclosporin
Mycophenolate
Tacrolimus

21

What are the Anti-TNF alpha antibodies in IBD treatment called?

Infliximab (8 weekly infusions)
Adulimumab (bi weekly SC injections)

22

What is the alpha4b7 intern blocker used in IBD called?

Vedolizumab

23

What are the surgical indications for Crohn's?

Failure of medical treatment
Relief of obstructive symptoms
Fistulae management
Intra-abdominal abscesses
Anal conditions management