Crohn's Flashcards

1
Q

what part of the GI tract can Crohn’s effect?

A

the entire GI tract

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2
Q

What is meant by Crohn’s being transmural?

A

it affect the entire thickness of the mucosa

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3
Q

the most common site of the involvement is the distal ileum, therefore pain may be mistaken for

A

appendicitis

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4
Q

what is the least common site for Crohn’s

A

the mouth and the upper GI tract, a small number will experience this as a part of the disease

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5
Q

what are apthous ulcers?

A

canker sores that may present with Crohn’s

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6
Q

1/3 of Crohn’s patient have and associated perianal disease, what may this present as

A

fistula, fissure, abscess this may be seen on rectal exam along with skin tags
therefore screen those with anal abscesses for Crohn’s

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7
Q

a patient with Crohn’s will complain of what type of pain?

A

a cramping colicky abdominal pain likely in RLQ

a palpable RLQ fullness/mass may be present

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8
Q

how do symptoms develop in patient with Crohn’s?

A

symptoms will develop gradually onset and usually be intermittent with periods of exacerbations & relative remission

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9
Q

which severity of Crohn’s involves only inflammation and strictures?

A

moderate

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10
Q

which severity of Crohn’s involves inflammation, strictures, and fistulae?

A

severe

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11
Q

what symptom is common regardless of of severity in Crohn’s?

A

inflammation

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12
Q

nocturnal diarrhea helps distinguish Crohn’s from what condition?

A

IBS, but up to 10% of those with Crohn’s may not have nocturnal diarrhea

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13
Q

are low grade fever and weight loss often present or not in Crohn’s patients?

A

they are often present

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14
Q

what type of lesion are common in Crohn’?

A

skip lesions, disease free areas between diseased part

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15
Q

string sign is often seen in patients with Crohn’s due to what?

A

inflammation

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16
Q

Arthralgias and arthritis are common in Crohn’s in which joints? and how do they present?

A
large joints (hips, knees) 
present with stiffness in the morning and gets better with activity
17
Q

other clinical presentations with Crohn’s?

A

Erythema nodosum
Eye conditions
Gallstones
Possible sclerosing cholangitis

18
Q

why are gallstones related to Crohn’s?

A

related to bile acid malabsorption in the small intestine

19
Q

most common extra-intestinal manifestation of Crohn’s?

A

Arthralgias and arthritis

20
Q

what skin condition may be present with Crohn’s?

21
Q

a patient present with anemia Janice and weight loss what may you screen for?

A

Crohn’s, however it is every difficult to diagnosis if it is a patients first exacerbation

22
Q

why might a biopsy not work for a first exacerbation of Crohn’s?

A

there must be time for inflammation changes

23
Q

the colonoscopy may reach why part of the colon to diagnosis possible Crohn’s

A

terminal ileum

24
Q

after years of Crohn’s conditions what may develop and present on colonoscopy and biopsy?

A

granulomas in about 30% of patients

25
what may be seen on colonoscopy of a patient with Crohn's?
ulcerations, cobblestoning and possible fistulas
26
CT scan of abdomen and pelvis with contrast may show what in Crohn's patients?
Presence of inflammation (thickened walls), abscess, fistulas
27
a string sign may be seen on
a small bowel follow through
28
complications of Crohn's
Fistula, abscess Obstruction due to inflammation Perforation from abscess Nutrient deficiencies (Fe, B12)due to malabsorption in small intestine
29
what 2 things may make Crohn's worse?
NSAIDs and Smoking
30
Crohn's treatment approach
step-up
31
what may be used for Crohn flares
antibiotics, budesonide and prednisone
32
Crohn's treatment options
5-ASA agents Immunomodulators Biologics / TNF blockers such as adalimumab