Term
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Definition
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Term
| What is proctosigmoiditis? |
|
Definition
| UC affecting descending, sigmoid colon and rectum |
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Term
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Definition
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Term
|
Definition
| Chron's disease affecting only terminal ileum |
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Term
| What is regional enteritis? |
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Definition
| CD affecting only regions of small intestine |
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Term
|
Definition
| CD affecting only small intestine and colon |
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Term
| What are the causes of IBD? |
|
Definition
genetic predisposition
proinflammatory antigen triggers
-microbes, milk, sugar, chemicals
environmental: smoking, NSAIDs |
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Term
| How does the pathophysiology of CD and UC differ? |
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Definition
UC=inflammation of mucosa only. Leads to formation of crypt abscesses, pseudopolyps, shortening of colon.
CD=chronic inflammation of all layers of bowel wall --> formation of fissures, fistulas, granulomas, bowel obstruction |
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Term
| What is 'cobblestone pattern' in CD? |
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Definition
| Segments of normal appearing bowel called skip legions |
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Term
| What are extraintestinal manifestations of UC and CD? |
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Definition
Arthritis - joints, hips, knees, ankles
Osteoporosis - due to malnutrition, malabsorption
Thromoboembolic events
Cirrhosis and hepatitis (UC)
Cholelithiasis (CD) |
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Term
|
Definition
acute dilation of tranverse colon to a diameter greater than 6cm with systemic toxicity.
-more common in UC |
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Term
| What are the symptoms of UC? |
|
Definition
bloody diarrhoea -> dehydratioin, anaemia, low BP, weak and febrile
abdominal pain
rectal bleeds |
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Term
| What are the clinical features of CD? |
|
Definition
Depends on location-->
Abdo pain: steady, Low.R.Q, cramps.
Diarrhoea: rectal bleeding in colonic disease
Weight loss
Malnutrition, malabsorption
Lower grade fever
Anaemia associated with blood loss |
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Term
|
Definition
severity of clinical symptoms
endoscopy
histological assessment
colonoscopy/sigmoidoscopy- biopsy
CT/ultrasound - abscess, obstruction |
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Term
| What drugs are used to treat IBD? |
|
Definition
Aminosalicylates: sulphasalazine, etc
Corticosteroids: prednisolone, etc
Immunosuppresants: azathioprine etc
Antibiotics: metronidazole
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Term
| What other drugs may be used in the symptomatic treatment of IBD? |
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Definition
Antidiarrhoeals: loperamide, diphenoxylate, cholestyramine (CD with bilesalt diarrhoea)
Antispasmodics: belladonna tincture, dicyclomine, propantheline
Analgesics |
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Term
| What are the aminosalicylates used in the treatment of IBD? |
|
Definition
sulphasalazine
balsalazide
olsalazine
delayed release 5-ASA
SR 5-ASA (Pentasa)
**5-ASA=mesalazine
|
|
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Term
| What is the propossed mechanism of action for the aminosalicylates |
|
Definition
| interferes with arachidonic acid metabolism and acts as a free radical scavenger |
|
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Term
| What are the dose dependant side effects of sulfasalazine? |
|
Definition
N/V
dyspepsia
anorexia
headache
male infertility
|
|
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Term
| What are the dose-independant side effects of sulphasalazine? |
|
Definition
| hypersensitivity reaction = rashes, aplastic anaemia, agranulocytosis |
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Term
| What should supplement should be taken while on sulphasalazine? |
|
Definition
Folic acid 1-2mg/day
Sulphasalazine inhibits folic acid absorption |
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Term
| What particular type of CD is sulphasalazine particularly effective for? |
|
Definition
| colitis... but not ileaitis |
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Term
| Which aminosalicylate is preferred in those with mild to moderate active distal UC? |
|
Definition
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|
Term
| What medication is reserved for patients who are intolerant or fail to respond to AZA/6-MP? |
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Definition
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|
Term
| Which antibiotic is effective for induction of remission in mild to moderate active CD? |
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Definition
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Term
| What dose form is used in the treatment of distal anorectal UC? |
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Definition
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|
Term
| What preparations are used in the treatment of sigmoiditis? |
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Definition
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Term
| What is used to induce remission in active proctitis or distal colitis? |
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Definition
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Term
| What is the treatment for extensive UC? |
|
Definition
| oral and parenteral corticosteroids + 5-ASA? |
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Term
| What is treatment is used mild to moderate CD? |
|
Definition
| oral/parenteral corticosteroids |
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Term
| What is treatment used in iliocaelal disease? |
|
Definition
| CR budesonide 9mg taper to 0 over 8-12 weeks |
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Term
| What is the treatment for severe CD? |
|
Definition
Initially parenteral corticosteroids - Me.Prednisolone
Shift to oral prednisolone once responded to IV treatment
Also use infliximab |
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