Inflammatory bowel disease Flashcards
features of crohn’s disease on small bowel enema.
proximal small bowel dilatation
strictures - ‘kantor strong sign’
‘rose thorn’ ulcers
fistulae
features of UC on barium enema.
loss of haustrations
colon is thin and short - ‘windpipe colon’
pseudopolyps
features of crohn’s histology.
granulomatous inflammation
deep ulcers and fissures = cobblestone appearance
features of UC histology.
low of goblets cells and mucin from epithelial cells
wide spread inflammation with preservation of adjacent mucousa = pseudopolyps
crypt abscesses
1st line treatment for induction of remission in crohn’s disease?
diet (mild disease in child)
prednisolone + azathioprine
1st line treatment for induction of remission in UC?
Aminosalicylate (5-ASA) i.e. sulfasalazine
2nd line: add prednisolone
is primary sclerosing cholangitis more common in CD or UC or both?
ulcerative colitis
is uveitis more common in CD or UC or both?
CD
Is arthritis more common in CD or UC or both?
equally common (most common extra intestinal manifestation of IBD)
what are extra-intestinal manifestations of IBD?
osteoporosis primary sclerosing cholangitis gallstones uveitis arthritis clubbing pyoderma gangrenous erythema nodosum episcleritis
what extra intestinal manifestations are more common in UC than CD?
primary sclerosing cholangitis
uveitis
what extra intestinal manifestations are more common in CD than UC?
gallstones (due to reduced reabsorpition of bile acid = reduced calcium which binds to oxalate therefore increased oxalate levels)
episcleritis
when does UC most commonly present?
bimodal age distribution
15-25yrs
55-65yrs
indications for surgery in UC?
elective surgery
- requiring maximal therapy
- prolonged course of steroids
dysplastic transformation
emergency presentation of poorly controlled colitis that fails to respond to medical management
toxic megacolon
perforation
