Crohn's Disease

Question 1

What is Crohn’s disease?

Answer 1

Inflammatory GI disease

Question 2

Where does Crohn’s affect in the body?

Answer 2

Anywhere along the GI tract from the mouth to the anus

Question 3

What is Crohn’s characterised by?

Answer 3

Transmural granulomatous inflammation

Question 4

What is the pneumonic for the features of Crohn’s disease?

Answer 4

NESTS

Question 5

What does NESTS stand for?

Answer 5

N- No blood or mucus 
E- Entire GI tract
S- Skip lesions on endoscopy 
T-Terminal ileum most affected and transmural thickness
S-Smoking is a risk factor

Question 6

How does Crohn’s disease present?

Answer 6

Persistent diarrhoea 
Abdominal pain (RLQ)
Weight loss
Erythema nodosum 
Aphthous ulcers 
Peri-anal crohn's- Skin tags

Question 7

What is the most common feature of crohn’s in children?

Answer 7

Persistent abdominal pain

Question 8

What is short bowel syndrome?

Answer 8

Bile acid malabsorption

Patients present with fatty stools and diarrhoea

Question 9

What is a risk factor of Crohn’s disease?

Answer 9

Smoking

preventative in UC

Question 10

Which 2 age groups are affected by Crohn’s?

Answer 10

20-30

50-60

Question 11

What will be raised in Crohn’s disease?

Answer 11

C-reactive protein

Faecal calprotectin

Question 12

What will be low in Crohn’s disease?

Answer 12

Vitamin B12 and Vitamin D

Question 13

What will be negative in Crohn’s disease?

Answer 13

P-ANCA

Question 14

How is Peri-anal Crohn’s diagnosed?

Answer 14

MRI

Question 15

What is the main diagnosis of Crohn’s?

Answer 15

Colonoscopy

Question 16

What would you find on a colonoscopy of someone with Crohn’s?

Answer 16

Cobblestone appearance
Skip lesions
Granulomas

Question 17

What are possible complications of Crohn’s?

Answer 17

Obstruction- small bowel
Fistulae
Strictures

Question 18

How does small bowel enema present?

Answer 18

• strictures: ‘Kantor’s string sign’
• proximal bowel dilation
• ‘rose thorn’ ulcers
• fistulae

Question 19

How is remission induced with Crohn’s disease?

Answer 19

Oral Prednisolone

IV hydrocortisone

Question 20

How is remission maintained in Crohn’s disease?

Answer 20

Immunosuppressants:

• -Azathioprine
• -Mercaptopurine

Question 21

When would you use surgery in the management of Crohn’s?

Answer 21

When Crohn’s affects the distal ileum

Treat strictures and fistulas (secondary to Crohn’s)