Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Phase 2a GI > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

Examples of IBD

A

Ulcerative colitis

Crohn’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is UC

A

Continuous chronic inflammation of only the colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Crohn’s disease

A

Intermittent chronic inflammation of the entire GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Difference between UC and Crohns

A
  • Ulcerative colitis is limited to the colon while Crohn’s disease can occur anywhere along GI tract
  • In Crohn’s disease, there are healthy parts of the intestine mixed in between inflamed areas. Ulcerative colitis, on the other hand, is continuous inflammation of the colon
  • Crohns = skip lesions; UC = continous
  • Ulcerative colitis only affects the inner most lining of the colon (crypt abscesses) while Crohn’s disease can occur in all the layers of the bowel walls (transmural inflammation)
  • Crohns has more genetic component (NOD2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Clinical presentation of UC

A 
5Ps: (signs and symptoms)
Pyrexia
Pseudopolyps
lead Pipe radiological appearances
Poo (bloody diarrhoea)
Proctitis

Recurrent diarrhoea, often with blood and mucus
Some extra gastrointestinal manifestations: arthralgia, fatty liver and gall stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which IBD does smoking protect you against and which does it cause damage to it

A

UC - smoking protects

Crohns - smoking damages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pathophysiology of UC

A

Mucosal inflammation originating in the anus and continuously progressing proximally
No granulomata
Goblet cell depletion and crypt abcesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clinical presentation of Crohns

A

Symptoms depend on the region affected.
Small bowel: Weight loss, abdominal pain.
Terminal ileum: Right iliac fossa pain mimicking appendicitis.
Colonic: Blood and mucus with diarrhoea, with pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pathophysiology of Crohns

A

Transmural inflammation with granulomata in 50% of cases.
Ocurs anywhere in the GI tract with ‘skip lesions’.
Deep ulcers and fissures -> cobblestone appearance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aetiology of IBD

A

Genetics: Mild genetic link (Strong in Crohn’s).
Environmental: Stress and depression -> attacks.
Immune response: Effector T cells predominating over regulatory T cells -> Pro-inflammatory cytokines (IL-12, IL-5, IL-17 and interferon gamma/IFG) -> Stimulate macrophages to produce Tumour Necrosis Factor Alpha, IL-1 and IL-6. Neutrophils, mast cells and eosinophils are also activated. All this causes a wide variety of inflammatory mediators -> Cell damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Epidemiology of IBD

A

Usually presents in teens and 20s. Common In northern europe. 400 per 100,000 in UK. Smoking is a RF.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnosis of IBD

A

Seek to distinguish between UC and Crohns.

Sigmoidoscopy/rectal biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of UC

A

5-Aminoslicylic acid (mesalazine) - drug of choice for remission and relapse prevention
Surgical resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Complications of UC

A 
Psychosocial and sexual problems
Frequent relapse
Colorectal cancer risk doubled
Osteoporosis from steroid use
Toxic megacolon
Primary sclerosing cholangitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of Crohn’s

A

Stop smoking.
Corticosteroids induce remission (but don’t prevent relapse).
Thiopurines maintain remission (but have side effects) Azathioprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Complications of Crohns

A 
Bowel obstruction from strictures
May cause short stature in children
Osteoporosis
Anaemia
Fistula formation
Pyoderma gangrenosum
17
Q

Similarities of UC and Crohns

A
  • Both diseases often develop in teenagers and young adults although the disease can occur at any age
  • Ulcerative colitis and Crohn’s disease affect men and women equally
  • The symptoms of ulcerative colitis and Crohn’s disease are very similar
  • The causes of both UC and Crohn’s disease are not known and both diseases have similar types of contributing factors such as environmental, genetic and an inappropriate response by the body’s immune system
18
Q

Symptoms of Crohns

A 
Diarrhoea
Abdominal pain
Weight loss/failure to thrive
Systemic symptoms:
fatigue, fever, malaise, anorexia
19
Q

Signs of Crohns

A 
Bowel ulceration
Abdominal tenderness/mass
Perianal abscess/fistulae/skin tags
Anal strictures
Beyond gut:Clubbing, Skin, joint and eye problems
(systemic problems also)
20
Q

Symptoms of UC

A 
Episodic or chronic diarrhoea
(with or without blood and mucus) 
Crampy abdominal discomfort
Bowel frequency relates to severity
Systemic symptoms in severe/attacks: fever, malaise, anorexia, decreased weight
21
Q

Signs of UC

A

May be none
In acute UC may be fever, tachycardia and a tender dissented abdomen
Extraintestinal signs = clubbing, aphthous oral ulcers, conjunctivitis, large joint arthritis etc

22
Q

Which IBD is associated with granuloma formation

A

Crohns disease

23
Q

Conservative treatment of ulcerative colitis

A

Patient education; smoking has been shown to be protective but is not advised

24
Q

Medical treatment of ulcerative colitis

A 
1st line: 5-aminosalicylic acid analogues (5-ASA analogues)
2nd line: Corticosteroids
Mesalazine
6-mercaptopurine
Azathioprine
25
Q

Example of 5-aminosalicylic acid analogue

A

Sulfasalazine

26
Q

Surgical treatment of ulcerative colitis

A

Colectomy

27
Q

Conservative treatment of Crohns disease

A

Smoking cessation

Low residue diet may be encouraged, but usually diet is normal

28
Q

Medical treatment of Crohns disease

A
  1. Corticosteroids
  2. Immunosuppressants
    Infliximab (TNF alpha inhibitor and thus immunosuppressant)
    5-ASA analogues (sulfasalazine)
    Azathiopurine (prevents flare up as its an immunosuppressant)
    Methotrexate
    Thiopurine (retains remission)
29
Q

Surgical treatment of Crohns disease

A

Remove strictured or obstructed region of bowel

30
Q

What is ulcerative colitis

A

This is a relapsing remitting autoimmune condition that is NOT associated with granulomas.
It affects the colon and rarely the terminal ileum (backwash ileitis)

31
Q

What is Crohns disease

A

This is a disordered response to intestinal bacteria with transmural inflammation
It may affect any part of the gastrointestinal tract but often targets the terminal ileum
Associated with granuloma formation

32
Q

Investigations of UC or Crohns

A

Bloods - FBC and platelets, U and Es, LFTs and albumin, ESR and CRP
Colonoscopy (DIAGNOSTIC)
Radiology - small bowel follow through (diagnostic) and abdominal X-ray (for toxic megacolon and excluding perforation)

33
Q

Corticosteroid function

A

Stop production of prostaglandins which stops inflammation

34
Q

5-ASA acid fucntion

A

…

Medicine Phase 2a GI (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions