CHRONS DISEASE Flashcards
chrons + ileal resection
symptoms
watery diarrhoea
due to bile acid malabsorption
chrons + ileal resection
rx
CHOLESTYRAMINE
bile acid sequestrant
chrons … no flare =
normal calprotectin and inflammatory markers
no abd pain or disturbance
IF FLARE
rx: ORAL STEROIDS
leocaecal chrons vs ilecaecal tb DD
RISK FACTORS FOR TB
CHRONS INTESTINAL SYMPTOMS
ORAL ULCERS
abd pain
diarrhoea
weight loss also
bloating and nausea particularly after meals
fistulae
chrons EExtra INTESTINAL symptoms
itchy eyes ..uvietis …., episcleritis
tender nodules …. erythema nodosum
pyoderma gangrenosom
vasculitis
abnormal liver enzymes
stone …kidney and gall
FEVER
weight loss
small joint poly arthritis
sacroilitius
clubbing
chrons location m/c
rt side
rt iliac fossa
chrons * vs Uc
mor common in smokers
chrons * vs Uc
chrons happens in small bowel also
UC IS A LARGE BOWEL DISEASE
DIL LOOPS OF SMALL BOWEL in scan
stricture
chrons * vs coeliac
no strictures in coeliac
chrons * vs pancreatitis
small bowel obstruction in crons
chrons ..histology
transmural thickness
patchy inflammation
skip lesions
non caseating granuloma
ulcerative ‘C’olitis ….histo
CRYPTS
distortion, neutophilic distraction and abcesses
chrons* vs uc
stricturing present in chrons on endo
uc* vs chrons
uc present in only colon
chrons endoscopy
assymetry disease
COBBLE STONE
DEEP FISSURES
STRICTUTES
CHRONS * VS SMALL BOWEL LYMPHOMA
NO STICTURES AND ULCERATIONS IN lymphoma
chrons med treatment
sulfasalazine
sulfasalazine side effects
decreareased blood cells individually or
PANCYTOPENIA lead to
bleed bruising, fever sorethroat etc
somatitis parotitis hpersensitivity
sulfasalazine caution
g six pd , renal and hepatic impairement
Pancytopenia causes
sulfasalazine
acute leukaemia
hiv , epstein , hepatitis
chrons
LARGE* bowel vc small bowell
large bowel=
“L”eft side
b’L’eed
no clubbing and vomitting
in large age groups
chrons
SMALL* bowel
right side
no … bleeding ,clubbing and vomitting .. in small age
ulc col* vs chrons
tenesmus in uc
chrons
more than one relapse in one year requiring steroids
rx for maintenace
Azathiprine
stop after years
azathiprine adverse effect
lymphoma
fever ,artralgia ,rash
chrons maintenace M/C
And others
azathioprine m/c
others =
sulfasalazine , mesalazine
tnf agents : adalimumab, infli xi zu mab
chrons + PERIANAL ABCESS
mri to knowextent
or ct
ot then exam under anaesthesisa
chrons big risk facotor
smoking
azathioprine pre check
tmpt
tmpt deficiency=no med
tmpt low =low dose azathioprine
azathioprine complications
myelosuppressive
abnormal LFT
pancreatitis
chrons … early indication for anti TNF therapy
fistulating chrons
Sx in chrons
chrons colitis refractory to meds
terminal ilium
chrons derma compli
pyoderma garenosum
pyoderma gangrenosum
purple ulcer bleeding
epidermal necrosis ,neutrophil infiltrate
rx =anti TNF
normal potassium requirement
1mmol /kg/day…… 90 to 120 mmol
potassium requrement for GI LOSS eg bowel resection
higher end 120 mmol/day
chrons perianal disease
anal tag
chrons* abdomen auscultaion vs UC
tender diffuse inflammatory mass… eg in rt iliac fossa
no mass in UC
