L17: IBD

Question 1

Def of IBD

Answer 1

Question 2

Characters of IBD

Answer 2

 Relapsing and remitting condition.

 Characterized by chronic inflammation at various sites in the GI tract.

Question 3

Types of IBD

Answer 3

Crohn’s disease & Ulcerative colitis (UC).

Question 4

Why is IBD Confused with IBS?

Answer 4

as both Result in diarrhea and abdominal pain.

Question 5

Etiology of IBD

Answer 5

Question 6

Def of Crohn’s disease

Answer 6

Chronic transmural inflammation affecting the gut from mouth to perianal region.

Question 7

Def of UC

Answer 7

Inflammatory disease affecting Colonic mucosa anywhere from rectum to cecum

Question 8

Age in Crohn’s disease

Answer 8

<30 years, second peak age 60.

Question 9

Age in UC

Answer 9

2/3 onset by age 30

Question 10

Sex in Crohn’s disease

Answer 10

Females > males.

Question 11

Sex in UC

Answer 11

Females = males.

Question 12

Smoking & Crohn’s disease

Answer 12

Increases CD

Question 13

Smoking & UC

Answer 13

Risk is less in smokers

Question 14

Site of Crohn’s disease

Answer 14

Any part of GIT, from mouthto anus, but mainly terminal ileum & ascending colon.

Question 15

Site of UC

Answer 15

limited to the colon, but mainly affects the rectosigmoid region

Question 16

Layers affected in Crohn’s disease

Answer 16

all layers

Question 17

Granuloma in UC

Answer 17

no granuloma

Question 17

Layers affected in UC

Answer 17

mucosa

Question 18

Granuloma in Crohn’s disease

Answer 18

non caseating granuloma

Question 19

Crypt Abcess in Crohn’s disease

Answer 19

No

Question 20

Crypt Abscess in UC

Answer 20

Yes

Question 21

Continuity of Lesions in Crohn’s disease

Answer 21

skip lesions

Question 22

Continuity of Lesions in UC

Answer 22

continuous lesions

Question 23

Extra-Intestinal Manifestations in IBD

Answer 23

Question 24

Skin Manifestations in IBD

Answer 24

Erythema nodosum, Pyoderma gangrenosum, (skin tags, Oral Aphthous = Crohn's)

Question 25

Rhematological Manifestations in IBD

Answer 25

ankylosing spondylitis, Sacroiliitis, arthritis (commonest association)

Question 26

Occular Manifestations in IBD

Answer 26

uveitis, scleritis, episcleritis, scleromalacia

Question 27

Hepatic Manifestations in IBD

Answer 27

PSC, fatty liver, gall stones.

Question 28

Other Extra-Intestinal Manifestations in IBD

Answer 28

vasculitis, osteoporosis, Vitamin deficiency, thromboembolism.

Question 29

Compare between Crohn's Disease & UC in terms of: - Age - Sex - Smoking - Rectal Bleeding - Diarrhea - Pain - Urgency - Mass - Fever

Answer 29

Question 30

Compare between Crohn's Disease & UC in terms of: - Complications

Answer 30

Question 31

INVx in IBD

Answer 31

Question 32

Colonoscopy in Crohn's Disease

Answer 32

Question 33

Colonoscopy in UC

Answer 33

Question 34

Bariam Enema in Crohn's Disease

Answer 34

Question 35

Barium Enema in UC

Answer 35

Question 36

CT/MR Colongraphy in IBD

Answer 36

Question 37

Capsule Endoscopy in IBD

Answer 37

Question 38

Serology in IBD

Answer 38

Question 39

Calprotectin & CRP in IBD

Answer 39

Question 40

Diet & Lifestyle Changes in TTT of UC

Answer 40

Question 40

TTT Options in IBD

Answer 40

- Diet / Lifestyle - Antidiarrheal Drugs - Antibiotics - 5-ASA - Corticosteroids - Immunosuppresive Drugs - Biologic Drugs - Surgical TTT

Question 41

Diet & Lifestyle Changes in TTT of Crohn's Disease

Answer 41

Question 42

Anttidiarrheal Drugs in TTT of Crohn's Disease

Answer 42

Question 43

Anttidiarrheal Drugs in TTT of UC

Answer 43

Question 44

Antibiotic in TTT of Crohn's Disease

Answer 44

Question 45

Antiobiotics in TTT of UC

Answer 45

Question 46

5-ASA in TTT of Crohn's Disease

Answer 46

Question 47

5-ASA in TTT of UC

Answer 47

Question 48

Corticosteroides in TTT of Crohn's Disease

Answer 48

Question 49

Corticosteroides in TTT of UC

Answer 49

Question 50

Immunosupressives in TTT of IBD

Answer 50

Question 51

Biological TTT of Crohn's Disease

Answer 51

Question 52

Biological TTT of UC

Answer 52

Question 53

Surgical TTT of Crohn's Disease

Answer 53

Question 54

Surgical TTT of UC

Answer 54

Question 55

Truelove and Witts' classification of clinical severity of ulcerative colitis

Answer 55

Question 56

CP of Toxic or fulminant colitis

Answer 56

 Sudden violent diarrhea.  Fever to 40° C (104° F).  Abdominal pain.  Signs of peritonitis.  Extraintestinal manifestations particularly joint and skin complications

Question 57

Toxic or fulminant colitis is more common with .........

Answer 57

Ulcerative colitis

Question 58

Describe Toxic or fulminant colitis

Answer 58

 Occurs when transmural extension of ulceration results in localized ileus and peritonitis.  The colon loses muscular tone and begins to dilate.

Question 59

Def of Megacolon

Answer 59

Transverse colon 5 – 6 cm diameter during an exacerbation.

Question 60

If fulminant colitis or toxic megacolon is suspected. ,,,,,

Answer 60

Question 61

In UC - The risk of colon cancer is proportional to:

Answer 61

 Duration of disease  Amount of colon affected

Question 62

In UC - Sustained microscopic inflammation is → a risk factor.

Answer 62

...

Question 63

In UC - Cancer begins to appear by ..... from onset of illness in patients with extensive colitis

Answer 63

7 years

Question 64

In UC - Regular colonoscopic surveillance, any grade of definite dysplasia → a strong indication for total colectomy.

Answer 64

...

Question 65

managment of Obstuction in Crohn's Disease

Answer 65

 Nasogastric suction and IV fluids.  Immediate surgery.

Question 66

managment of Fulminant disease or abscess in Crohn's Disease

Answer 66

 Hospitalized for IV fluids and antibiotics.  Abscesses must be drained, either percutaneously or surgically.

Question 67

managment of Fistulas in Crohn's Disease

Answer 67

 Treated initially with metronidazole.  Severe refractory perianal fistulas may require temporary diverting colostomy.  Best adjunct to Anti TNF.

Question 68

Compare between IBD & IBS in terms of: - CP - INVx - TTT

Answer 68

Question 69

Done

Answer 69

✅