Crohns and UC - peerteaching Flashcards

1
Q

What is Crohns

A

Transmural, granulomatous inflammation affecting any part of the gut

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2
Q

Macroscopic appearances of Crohns

A

Skip lesions
Cobblestone appearance
Thickened and Narrowed

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3
Q

Microscopic appearance of Crohns

A

Transmural
Granulomas (non-caseating)
Goblet cells present

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4
Q

Symptoms of Crohns

A

Diarrhoea
Abdominal pain RLQ weight loss
Lethargy
(Variable depending on region of bowel affected)

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5
Q

Signs of Crohns

A

Mouth ulcers

Tenderness RIF

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6
Q

Risk factors of Crohns

A

Smoking
Female
Mutation on NOD2 gene of chromosome 16
Chronic stress

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7
Q

Investigations of Crohns

A

Diagnostic test - colonoscopy
Stool sample must be done rule out infectious causes
FBC - raised ESR/CRP. Often low Hb due to anaemia

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8
Q

Management of Crohns

A

Oral corticosteroids
IV hydrocortisone in severe flare ups
Add anti-TNF antibodies e.g. Infliximab if no improvement
Consider adding Azathioprine or Methotrexate to remain in remission if frequent exacerbations

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9
Q

What is ulcerative colitis

A

Inflammatory condition of the colon mucosa

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10
Q

Macroscopic appearance of ulcerative colitis

A
Continuous inflammation (no skip lesions)
Ulcers
Pseudo-polyps
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11
Q

Microscopic appearance of ulcerative colitis

A

Mucosal inflammation
No granulomata
Depleted goblet cells
Increased crypt abscesses

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12
Q

Symptoms of ulcerative colitis

A

Pain in the LOWER LEFT QUADRANT

Diarrhoea with blood and mucosa

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13
Q

Signs of ulcerative colitis

A

Fever (in acute UC)
Clubbing
Erythema

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14
Q

Investigations of ulcerative colitis

A

FBC will show raised ESR and CRP
Testing for pANCA
Stool sample must be done to rule out infectious causes

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15
Q

Management of ulcerative colitis

A

Sulfasalazine, add oral prednisolone if no response

Colectomy indicated in patients with severe UC not responding to treatment

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16
Q
Describe each of these for Crohn's:
Location
Skip lesions
Presence of granulomas
Goblet cell depletion
Layers affected
Cobblestone appearance
A
Location - anywhere in gut
Skip lesions - yes
Presence of granulomas - yes
Goblet cell depletion - NO
Layers affected - all
Cobblestone appearance - yes
17
Q
Describe each of these for UC:
Location
Skip lesions
Presence of granulomas
Goblet cell depletion
Layers affected
Cobblestone appearance
A
Locationonly in COLON
Skip lesions - NO
Presence of granulomas - NO
Goblet cell depletion - yes
Layers affected - MUCOSA only
Cobblestone appearance - NO