Crohn's Disease Flashcards
What are the most commonly affected parts in CD?
1) Terminal ileum and proximal colon
What are some RFs for CD?
1) White ethnicity
2) Smoking
3) NSAIDs
4) FHx
5) Age: 15-40, 60-80
What are the key features on Hx for CD?
1) Presence of RFs
2) Pain
3) Diarrhoea
4) Mild fever
5) Fatigue
Characterise the pain in CD
1) Crampy abdo pain (generally)
2) RIF
3) Gradual onset
4) Can be present for hrs
5) Not affected by food
Characterise the stool in CD
1) Diarrhoea
2) Non- bloody or intermittently bloody
3) Can be a/w urgency and tenesmus
What causes the fatigue in CD
Malnutrition, inflammation and weight loss
What are features O/E you would find in CD
1) Abdo exam: +/- abdo tenderness, RIF tenderness
2) PR exam: red inflammed anus (proctitis), +/- tender on PR
3) Peri-anal inflammation: abscesses, blueish piles, anal fissures, anal fistulas, skin tags
What are some Ix for CD?
1) Colonoscopy/ sigmoidoscopy
2) Biopsy
3) AXR
4) Stool sample + MCS (x3)
5) FBE
6) ESR
7) LFTs, UECs, B12 and iron studies
What do you expect to see on colonoscopy for CD
1) Skip lesions
2) Cobblestone appearance
3) Ulcers/ fissures
4) Contact bleeding
What do you expect to see on histology for CD
1) Non- caseating granulomas
2) Lymphocytic infiltrate
3) Transmural involvement
What do you expect to see on AXR for CD
Might see obstruction
What do you do a stool sample for?
Rule out infectious agent (salmonella, shigella, amoebia)
What do you expect to see on FBE
1) Anaemia of chronic disease (normochromic and normocytic)
2) Leucocytosis
What will the ESR be?
Raised
What will the UECs and LFTs be?
Abnormal
