crohns Flashcards
what is main genetic factor
NOD2 gene
where is NOD2 located
gene 16
factors associated with CD
- smoking increases risk
- NSAIDS
- poor hygiene
- appendectomy increases risk
what pathogen is increased
e.coli
where can it affect
anywhere in GI tract
- tendency to be terminal ileum and ascending colon
does it have skip lesions
yes
what is it called when affects whole colon
total colitis
what is it associated with the development of
perianal fistulae
fissures
what is the bowel like
thickened and narrowed
what do deep ulcers and fissure cause
cobblestoning
what is an early feature
apthoid ulceration
seen in colonoscopy
where is the inflammation
transmural
= through all layers
what is there an increase of
chronic inflammatory cells and lymphoid hyperplasia
is there granulomatous present
yes
non-caveating
is there goblet cells present
yes
when should crohns always be considered
in all patients with vitamin malabsorption
symptoms
- diarrhoea
- abd pain
- weight loss
- malaise
- lethargy
- anorexia
- nausea
- vomiting
- fewer
what is abdominal pain like
colicky
what is diarrhoea like
contains blood
what are symptoms when acute
right iliac fossa pain
examination findings
- weight loss
- mouth ulcers
- check anus for tags, fissures
investigations
- blood test (anaemia, CRP)
- LFT
- stool test
- colonoscopy
- endoscopy
- small bowel imaging
what is seen in colonoscopy
patchy ulceration
cobblestone appearance
endoscopy findings
to exclude gasproduodenal disease
small bowel imaging findings
mandatory
- deep ulcerations
- skip lesions
treatment
- glucocovrticosteroids
- azathioprine
- anti-TNF
is onset fast or slow
slow over years
do NSAIDs alleviate or aggravate pain
aggravate
does smoking alleviate or aggravate pain
aggravate
why does strictures form
thickening of bowel wall and fat wrapping
why does cobble-stoning occur
deep fissuring ulceration (transmural) of mucosa
complications
- malabsorption
- gallstones
- fistulas
- anal disease
- bowel obstruction
- perforation
what is seen on endoscopy
cobble-stoning
