Flashcards in Week 8 - IBD Deck (44):
Who does crohns predominantly affect?
-15-30 years then 60
Who does UC predominantly affect?
-Young adults up to 30
Name 3 less common IBD
What is diversion colitis?
-Section of bowel has been removed and ileostomy -> remaining bit of bowel with no flow can become inflamed
What is microscopic colitis?
-Inflammation on a microscopic level
Where does crohn's disease affect?
-Anywhere in GI tract from mouth to anus
-Ileum involved in most cases
Where does UC affect?
-Begins in rectum and can extend to involve entire colon
Which IBD has skiplesions? What are they?
-The ulceration occurs in patches leaving islands of uninflammed mucosa forming skip lesions
Which IBD is transmural? What is meant by this?
-Affects the whole thickness of the bowel wall
Which IBD is described as continuous? Why?
-Ulceration is continuous along the tract
Which IBD only has mucosal inflammation?
What is backwash ileitis?
-Complication of UC where ulceration can breach the ileocecal valve and cause inflammation of terminal ileum
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
Which IBD is more associated with primary sclerosing cholangitis?
What is the main cause of IBD?
Name some factors which are thought to contribute to the development of IBD
In which IBD is smoking thought to be protective?
Describe a typical presentation of crohns disease
-Abdo pain (RLQ)
-Loose stools (non-bloody)
Which IBD can involve perianal inflammation and ulceration?
Describe the pathological changes which occur in crohns
-Superficial and deep ulcers
-Inflammation causing thickening of bowel and narrowing of lumen
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
Which IBD do you get fistulae formation? Why?
-Due to transmural ulceration
Which IBD has the presence of granulomas?
Why is IBD assiciated with anaemia?
-Failure to absorb iron and vitamins
Why would you not just do colonoscopy when you had suspicion of crohns?
-Colonoscopys cannot visualise small bowel
How does UC typically present?
-Loose bloody stools with mucus
-Lower abdo pain
Describe the pathological changes which occur in UC?
-Chronic inflammation upto lamina propria
-Decreased goblet cells
-Loss of haustra
Why is there mucus and blood in UC stool?
-Large areas of superficial mucosa affected causing sloughing of cells and mucus
What is a crypt abscess? What is the consequence?
-Crypts of lieberkuhn fill with inflammatory cells
-Causes loss of renewal of epithelia
Why does anaemia occur in UC?
-Loosing blood in stool
Why do you do stool culture if UC is suspected?
-Want to rule out infection because it is bloody and mucus
What is indeterminate colitis?
-IBD which cannot be classified into one of crohn's r UC
State 3 distinguishing features between crohn's and IBD
-Crohns= anywhere UC=rectum/colon
-Crohns = perianal disease UC=no
-Crohns=fistula formation UC =no
State 2 pathological differences between crohns and UC
-Crohns has skip lesions and granulomas
-UC is continuous and no granulomas but crypt abscesses
Which IBD has liner ulcers?
Which IBD gets lead pipe colon?
-UC (loss of haustra)
What is the stepwise pharmacological approach for treating IBD?
What are the surgical options for crohn's?
-Not curable so want to remove as little bowel as possible to prevent short bowel syndrome
What are the surgical options for UC? What are indications for surgery?
-Curable via colectomy
-Inflammation not settling, precancerous changes, toxic megacolon
What imaging is often used in Crohn's?
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
What anti-inflammatories are used in UC?
When can crohn's present like UC?
-When only the colon is affected