5: IBD clinical signs and symptoms Flashcards Preview

Gastrointestinal Week 5 2016/17 > 5: IBD clinical signs and symptoms > Flashcards

Flashcards in 5: IBD clinical signs and symptoms Deck (32)
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1
Q

Normally, the gut acts as a ___ organ for the ___ immune system.

A

surveillance

mucosal

2
Q

What are the two types of inflammatory bowel disease?

A

Crohn’s disease

Ulcerative colitis

3
Q

What symptoms tend to be seen in Crohn’s disease?

A

Abdominal pain

Perianal disease

Watery diarrhoea

4
Q

What symptoms tend to be seen in ulcerative colitis?

A

Bloody diarrhoea

5
Q

What three factors are involved in the pathogenesis of IBD?

A

Genetics

Mucosal immune system

Environmental triggers

6
Q

Which gene predisposes you to develop IBD?

A

NOD2

7
Q

What does the NOD2 gene code for?

A

Proteins involved in bacterial recognition

8
Q

Smoking (aggravates / protects against) Crohn’s disease.

A

aggravates

9
Q

Smoking (aggravates / protects against) ulcerative colitis.

A

protects against

10
Q

Which class of drug aggravates colitis?

A

NSAIDs (ibuprofen, naproxen, diclofenac)

11
Q

Which part of the GI tract does ulcerative colitis start in?

Where does it go after that?

A

Rectum

Proximally

12
Q

If an acute flareup of UC doesn’t clear up with drugs (e.g steroids), what is performed?

A

Colectomy

13
Q

What are the main symptoms of ulcerative colitis?

A

Diarrhoea with blood

Increased bowel frequency

14
Q

Lower abdominal pain in the left iliac fossa is characteristic of which disease?

A

Ulcerative colitis

15
Q

What aspect of the past medical history is important in UC?

A

Antibiotics / NSAID use

Skin, eye, joint problems

16
Q

What is the criteria for diagnosing severe UC?

A

>6 bloody stools within 24 hours

+ 1 or more of:

Fever

Tachycardia

Anaemia

17
Q

What may be seen on the AXR of someone with UC?

A

Absence of stools

Mucosal oedema - thumb print sign

Toxic megacolon

18
Q

What would be seen upon endoscopy of someone with UC?

A

Continous inflammation

Granular mucosa

Pseudopolyps

Absence of goblet cells

Crypt abscesses

19
Q

Does UC affect the whole thickness of the gut?

A

No - mucosa only

20
Q

What does ulcerative colitis increase your risk of?

A

Colorectal cancer

21
Q

What are some extra-intestinal symptoms of UC?

A

Skin - rashes

Joint problems

Eye problems

Mouth ulcers

Oxalate renal stones

22
Q

What gallbladder condition is associated with ulcerative colitis?

A

Primary sclerosing cholangitis

inflammation due to stricture in cystic duct

23
Q

Which areas of the GI tract are affected by Crohn’s disease?

A

Mouth to anus

24
Q

What kind of lesions are seen in Crohn’s disease?

How does this differ from UC?

A

Skip lesions

UC is continous, Crohn’s skips bits of the GI tract

25
Q

What kind of inflammation is seen in Crohn’s disease?

A

Transmural

penetrates the whole gut wall

26
Q

What is perianal disease associated with?

A

Crohn’s disease

27
Q

Give an example of a perianal disease associated with Crohn’s.

A

Rectal abscesses

28
Q

What is a complication of rectal abscesses seen in Crohn’s disease?

A

Fistula formation

29
Q

Why may someone with Crohn’s disease become incontinent?

A

Damage to anal sphincters caused by abscesses

30
Q

What pathology, causing bowel obstruction, is seen in Crohn’s disease?

A

Strictures

31
Q

What kind of mucosa is seen in Crohn’s disease patients?

A

“Cobblestoning”

32
Q

What causes cobblestone mucosa in Crohn’s disease?

A

Omentum wraps round bowel and tries to seal off the injury