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Conditions: GI > Crohn's Disease > Flashcards

Crohn's Disease Flashcards

1
Q

What is the cause of Crohn’s disease?

A

No known cause

- Mutations in certain genes have been linked

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2
Q

What genes have been linked to crohns?

A

NOD2

CARD15

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3
Q

What is crohns disease?

A

Chronic inflammatory disease of the GI tract.

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4
Q

What type of inflammation is Crohns?

A

GRANULOMATOUS inflammation as apposed to the granular inflammation of UC

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5
Q

What is the spread of inflammation in crohns?

A

Skip lesions
- Areas of unaffected bowel between affected bowel

Favours terminal ileum and ileocaecal valve

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6
Q

What are the symptoms of Crohns disease?

A

Diarrhoea

Abdominal pain

Failure to thrive in children

Fever and malaise

Anorexia in active disease

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7
Q

What are the intestinal signs of Crohns?

A

Oral apthous ulcers

Abdo tenderness

RIF mass (favouring ileocaecal valve)

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8
Q

Extraintestinal signs?

A

Clubbing

Erythema nodosum

Pyoderma gangrenosum

Ankylosing spondylitis

PSC

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9
Q

Blood tests?

A

FBC
ESR
CRP
U&Es

Cultures

Iron and B12

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10
Q

What other tests should be performed?

A

Stool MC&S
- C Diff toxin

AxR

Sigmoidoscopy w/ biopsy

Barium enema

Colonoscopy

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11
Q

What will be shown on the AxR in crohns?

A

Mucosal thickening

  • Thumb printing
  • Dilatation
  • Possibly perforation
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12
Q

What will the sigmoidoscopy biopsy show?

A

Inflamed mucosa

  • Granulomatous inflammation
  • > can be microgranulomas
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13
Q

What would a barium enema show?

A

Strictures
Cobblestoning

Is not a preferred investigation

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14
Q

What is a colonoscopy used for?

A

To show extent of disease

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15
Q

Why is B12 importantly checked in crohns?

A

Damage to terminal ileum

- Inability to absorb B12 so B12 def.

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16
Q

What signs indicate a severe attack in crohns?

A

Increased temperature
Tachycardia
ESR, CRP, WCC raised

17
Q

What is the treatment for mild attacks?

A

Prednisolone

- Slowly wean off if symptoms improve

18
Q

What is the pharma treatment for severe attacks?

A 
Hydrocotisone
- If improving after five days transfer to prednisolone
Steroid foams for anal area
Metronidazole 
- Cover infections
19
Q

What surgical treatment can be done for severe attacks?

A

Temporary ileostomy
- Rest the bowel

Resection of perforated areas

20
Q

What other management should be employed in severe disease?

A

Nil by mouth

IV fluids

21
Q

What is the implication for surgery in crohns?

A

Treatment failure

Intestinal obstruction

Haemorrhage/perforation

22
Q

What are the complications of Crohns?

A 
Obstruction
Toxic dilatation
Abscesses 
Fistulae 
Perforation and haemorrhage
23
Q

What steroid sparing treatments can be employed in Crohns?

A

Azothioprine

5-ASA’s

Infliximab

Conditions: GI (36 decks)

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