MSRA: Crohn's Disease

Question 1

What are the key symptoms of Crohn’s disease?

Answer 1

Terminal ileum is most commonly affected
Abdominal pain
Non-bloody diarrhoea
Weight loss
Perianal disease: itching, tags, fissures

Question 2

How do we induced remission in Crohn’s disease?

Answer 2

Steroids
Second line = Mesalazine
Can add on 6MP/AZA

Question 3

How do we maintain remission in Crohn’s disease?

Answer 3

Azathioprine/6MP

Question 4

What is the imaging modality of choice for a suspected perianal fistula?

Answer 4

MRI

Question 5

What are the key endoscopy features in Crohn’s disease

Answer 5

Transmural inflammation
Granulomas and goblet cells
Skip lesions
Cobblestone appearance
Rose thorn ulcers

Question 6

What is the association between smoking and Crohn’s disease?

Answer 6

Smoking is a significant risk factor for developing Crohn’s, and is associated with increased disease severity

Question 7

Azathioprine has a serious interaction with which medication?

Answer 7

Allopurinol

Question 8

Which enzyme level needs checking before starting Azathioprine?

Answer 8

TPMT