Chrons disease

Question 1

Location

Answer 1

Any part of GI tract, commonly ileum and colon

Question 2

Chrons inflammation vs. UC

Answer 2

Discontinuous vs. continuous (skip lesions)

Question 3

Layers affected chrons vs. UC

Answer 3

Transmural, can penetrate deep. UC mucosa only

Question 4

Histology

Answer 4

Transmural inflammation

Non-necrotising granulomas (not seen in UC)

Question 5

Granuloma

Answer 5

An area/ nodule of inflammation made up of giant cells, a giant cell is formed by the fusion of activated macrophages.

Question 6

Clinical presentation

Answer 6

Depends on part of GI tract involved and clinical sub-type: Inflammatory, structuring, fistulising, perianal.

Question 7

Inflammatory

Answer 7

Colitis- similar symptoms to UC, diarrhoea
Iletis-Abdo pain, malabsorption
Gastritis- dyspepsia

Question 8

Stricturing

Answer 8

Abdo pain, distension, vomiting, bowels not opening

Question 9

Fistula

Answer 9

Connects bowel to other parts of body e.g. to skin, SI to SI, SI to colon, rectum to vagina.

Question 10

Perianal

Answer 10

Perianal abscess, anal fissure, perianal fistula

Question 11

Labs

Answer 11

Raised inflammatory markers- CRP, ESR, platelets, netrophills, mild anaemia

Question 12

extra intestinal manifestations

Answer 12

Eyes, iritis, Liver steatosis, Join pain, skin infections,

Question 13

Treatment

Answer 13

5-aminosalicylates Mild anti-inflammatory action
Steroids
Immunosuppression
Biologics, (anti tumour necrosis factor) synthesised antibodies target TNF (anti-inflammatory cytokine)
Surgery (UC curable with colectomy, CD no cure)