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Flashcards in Week 8 - IBD Deck (44):
1

Who does crohns predominantly affect?

-15-30 years then 60

2

Who does UC predominantly affect?

-Young adults up to 30

3

Name 3 less common IBD

-Diversion colitis
-Pouchitis
-Microscopic colitis

4

What is diversion colitis?

-Section of bowel has been removed and ileostomy -> remaining bit of bowel with no flow can become inflamed

5

What is microscopic colitis?

-Inflammation on a microscopic level

6

Where does crohn's disease affect?

-Anywhere in GI tract from mouth to anus
-Ileum involved in most cases

7

Where does UC affect?

-Begins in rectum and can extend to involve entire colon

8

Which IBD has skiplesions? What are they?

-Crohns
-The ulceration occurs in patches leaving islands of uninflammed mucosa forming skip lesions

9

Which IBD is transmural? What is meant by this?

-Crohns
-Affects the whole thickness of the bowel wall

10

Which IBD is described as continuous? Why?

-UC
-Ulceration is continuous along the tract

11

Which IBD only has mucosal inflammation?

-UC

12

What is backwash ileitis?

-Complication of UC where ulceration can breach the ileocecal valve and cause inflammation of terminal ileum

13

Describe some of the systemic problems which can occur in conjunction with IBD in order of incidence

-MSK pain eg arthritis (50%)
-Skin eg erythema nodosum, psoariasis
-Liver/biliary tree eg primary sclerosing cholangitis
-Eye eg sceritis

14

Which IBD is more associated with primary sclerosing cholangitis?

-UC

15

What is the main cause of IBD?

-Idiopathic

16

Name some factors which are thought to contribute to the development of IBD

-Genetic
-Immunological
-Gut organisms

17

In which IBD is smoking thought to be protective?

-UC

18

Describe a typical presentation of crohns disease

-Abdo pain (RLQ)
-Weight loss
-Loose stools (non-bloody)

19

Which IBD can involve perianal inflammation and ulceration?

-Crohns

20

Describe the pathological changes which occur in crohns

-Superficial and deep ulcers
-Hyperaemia
-Mucosal oedema
-Inflammation causing thickening of bowel and narrowing of lumen

21

Why is crohn's described as a cobblestone appearance?

-Skip lesions created by criss crossing of linear ulcers leaving islands of non-ulcerating or oedematous tissue gives a cobblestone appearance

22

Which IBD do you get fistulae formation? Why?

-Crohn's
-Due to transmural ulceration

23

Which IBD has the presence of granulomas?

-Crohn's

24

Why is IBD assiciated with anaemia?

-Failure to absorb iron and vitamins

25

Why would you not just do colonoscopy when you had suspicion of crohns?

-Colonoscopys cannot visualise small bowel

26

How does UC typically present?

-Loose bloody stools with mucus
-Weight loss
-Lower abdo pain

27

Describe the pathological changes which occur in UC?

-Chronic inflammation upto lamina propria
-Crypt abscesses
-Decreased goblet cells
-Pseudopolyps
-Loss of haustra

28

Why is there mucus and blood in UC stool?

-Large areas of superficial mucosa affected causing sloughing of cells and mucus

29

What is a crypt abscess? What is the consequence?

-Crypts of lieberkuhn fill with inflammatory cells
-Causes loss of renewal of epithelia

30

Why does anaemia occur in UC?

-Loosing blood in stool

31

Why do you do stool culture if UC is suspected?

-Want to rule out infection because it is bloody and mucus

32

What is indeterminate colitis?

-IBD which cannot be classified into one of crohn's r UC

33

State 3 distinguishing features between crohn's and IBD

-Crohns= anywhere UC=rectum/colon
-Crohns = perianal disease UC=no
-Crohns=fistula formation UC =no

34

State 2 pathological differences between crohns and UC

-Crohns has skip lesions and granulomas
-UC is continuous and no granulomas but crypt abscesses

35

Which IBD has liner ulcers?

-Crohn's

36

Which IBD gets lead pipe colon?

-UC (loss of haustra)

37

What is the stepwise pharmacological approach for treating IBD?

1)Anti-inflammatory
2)Corticosteroids
3)Immunomodulators

38

What are the surgical options for crohn's?

-Not curable so want to remove as little bowel as possible to prevent short bowel syndrome

39

What are the surgical options for UC? What are indications for surgery?

-Curable via colectomy
-Inflammation not settling, precancerous changes, toxic megacolon

40

What imaging is often used in Crohn's?

-CT/MRI

41

Why can crohn's have periods of exacerbations?

-It is a relapse and remitting disease where by the acute inflammation can be treated but the underlying chronic condition is still present

42

What anti-inflammatories are used in UC?

-Amino-salicylates

43

When can crohn's present like UC?

-When only the colon is affected

44

What are the two common types of irritable bowel disease?

-Crohns
-Ulcerative colitis