crohns Flashcards

1
Q

what is main genetic factor

A

NOD2 gene

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2
Q

where is NOD2 located

A

gene 16

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3
Q

factors associated with CD

A
  • smoking increases risk
  • NSAIDS
  • poor hygiene
  • appendectomy increases risk
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4
Q

what pathogen is increased

A

e.coli

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5
Q

where can it affect

A

anywhere in GI tract

  • tendency to be terminal ileum and ascending colon
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6
Q

does it have skip lesions

A

yes

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7
Q

what is it called when affects whole colon

A

total colitis

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8
Q

what is it associated with the development of

A

perianal fistulae

fissures

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9
Q

what is the bowel like

A

thickened and narrowed

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10
Q

what do deep ulcers and fissure cause

A

cobblestoning

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11
Q

what is an early feature

A

apthoid ulceration

seen in colonoscopy

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12
Q

where is the inflammation

A

transmural

= through all layers

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13
Q

what is there an increase of

A

chronic inflammatory cells and lymphoid hyperplasia

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14
Q

is there granulomatous present

A

yes

non-caveating

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15
Q

is there goblet cells present

A

yes

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16
Q

when should crohns always be considered

A

in all patients with vitamin malabsorption

17
Q

symptoms

A
  • diarrhoea
  • abd pain
  • weight loss
  • malaise
  • lethargy
  • anorexia
  • nausea
  • vomiting
  • fewer
18
Q

what is abdominal pain like

A

colicky

19
Q

what is diarrhoea like

A

contains blood

20
Q

what are symptoms when acute

A

right iliac fossa pain

21
Q

examination findings

A
  • weight loss
  • mouth ulcers
  • check anus for tags, fissures
22
Q

investigations

A
  • blood test (anaemia, CRP)
  • LFT
  • stool test
  • colonoscopy
  • endoscopy
  • small bowel imaging
23
Q

what is seen in colonoscopy

A

patchy ulceration

cobblestone appearance

24
Q

endoscopy findings

A

to exclude gasproduodenal disease

25
Q

small bowel imaging findings

A

mandatory

  • deep ulcerations
  • skip lesions
26
Q

treatment

A
  • glucocovrticosteroids
  • azathioprine
  • anti-TNF
27
Q

is onset fast or slow

A

slow over years

28
Q

do NSAIDs alleviate or aggravate pain

A

aggravate

29
Q

does smoking alleviate or aggravate pain

A

aggravate

30
Q

why does strictures form

A

thickening of bowel wall and fat wrapping

31
Q

why does cobble-stoning occur

A

deep fissuring ulceration (transmural) of mucosa

32
Q

complications

A
  • malabsorption
  • gallstones
  • fistulas
  • anal disease
  • bowel obstruction
  • perforation
33
Q

what is seen on endoscopy

A

cobble-stoning