Crohn's disease Flashcards
1
Q
Location
A
Can affect anywhere in the GI tract from mouth -> anus
Most commonly affects the distal ilium and colon
2
Q
Age group
A
Teenagers
<40
Males
3
Q
Histopathology
A
Patchy inflammation Deep (transmural) inflammation Skip lesions Deep knife like fissures Large non caseating granulomas Cobblestone mucosa Fat wrapping
4
Q
Immunology
A
Mediated by Th1 CD4+ T cells
5
Q
Smoking aggrevates / is protective ?
A
Aggrevates
6
Q
Genetics
A
NOD2 on chromosome 16
7
Q
Clinical presentation
A
Abdominal pain Diarrhoea Fever Weight loss Mouth ulcers, angular chelitis Peri anal disease (stricture, abscess, fistula, incontinence) Extra GI symptoms: rare
8
Q
Investigations
A
Endoscopy - biopsy Barium imaging CT scan MRI scan Colonoscopy Bloods - CRP, albumin, platelets, B12 (terminal ileum)
9
Q
Management
A
Steroids
Immunosuppressants (azathioprine)
Anti TNF
Surgery - if nothing else works
10
Q
Surgery
A
Not satisfying
Aim to minimise resection
Disease not cured post surgery
11
Q
Complications
A
Short bowel syndrome Malabsorption Vit B12 deficiency Fistula Anal disease Obstruction Perforation Malignancy
