IBD clinical Flashcards
Difference between Crohn’s and UC clinical presentation?
Crohn’s: abdominal pain and perianal disease
UC: bleeding and diarrhoea
Best established risk for IBD disease development?
Family history
Gene linked with Crohn’s
NOD2/CARD15
Th cells and Crohn’s/UC
Crohn’s is a Th1 mediated disease
UC is mixed: Th1/Th2 mediated disease/NKTC
Smoking and crohn’s
Smoking aggravates Crohn’s - Andrew should not smoke
Smoking protects againts UC
Inflamamtion is limited to mucosa and submucosa?
UC
Crohn’s is transmural
Proctitis
Proctitis = inflammation of the rectum only
Pancolitis: inflammation of the whole large intestine
Determining severity of UC?
Determined by DISEASE EXTENT + SEVERITY: Diarrhoea + bleeding Increased bowel frequency (HOW OFTEN?) Urgency Tenesmus Incontinence Night rising (this will be why we always have to ask lol) Lower abdo pain (esp. LIF) (proctitis can cause constipation)
Truelove and Witt Criteria for severe ulcerative colitis?
>6 bloody stools/24 hour \+ 1 or more of Fever (>37.8°C) Tachycardia (>90/min) Anaemia (Haemoglobin 30mm/hr)
(FATE)
What will a plain AXR show in UC?
Stool distribution:
Absent in inflammed colon
Mucosal oedema / ‘thumb-printing’
Toxic megacolon:
Transverse >5.5cm
Caecum >9cm
Endoscopy appearance of UC?
Granular mucosa
Contact bleeding
Loss of vessel pattern
Increased chance of which type of cancer in UC?
Increased chance of colo-rectal cancer
What does extensive colitis?
Extensive colitis (to beyond splenic flexure) is risk for colorectal cancer and require surveillance after 10 years of disease
PSC is associated with UC. Give some symptoms?
Most asymptomatic OR itch, rigors
Cancer associated with PSC?
Cholangiocarcinoma