Crohns Flashcards Preview

GI: Inflammatory Bowel Disease > Crohns > Flashcards

Flashcards in Crohns Deck (27)
Loading flashcards...
1

more common in ___

males

2

where in the GI tract can crohns affect and where is it most common?

can affect any region of the GI tract from the mouth to the anus but most common in terminal ileum and colon

3

about 50% of people with crohns get _____ disease

perianal

4

what happens in perianal disease

- get Recurrent abscess formation
- Pain
- Can lead to fistula with persistent leakage
- Damaged sphincters

5

crohns symptoms are determined by the ___ of the disease

site

6

what are the sypmtoms of crohns in the small intestine?

- Abdominal cramps (peri-umbilical)
- Diarrhoea, weight loss

7

what are the sypmtoms of crohns in the colon?

- Abdominal cramps (lower abdomen)
- Diarrhoea with blood
- Weight loss

8

what are the sypmtoms of crohns in the mouth?

- painful ulcers, swollen lips, angular chelitis

9

what are the sypmtoms of crohns in the anus?

perianal pain, abscess

10

what may be found on clinical examination

- Evidence of weight loss
- RIF mass
- Perianal signs - inflammation at or near to the anus, including tags, fissures, fistulas , abscesses

11

what blood tests would you do?

FBC - may show anaemia, leukocytosis

CRP and ESR- high

platelets

iron studies - anaemia

12

what other tests would you do?

serum folate and B12 - may be low

stool testing

Metabolic panel

AXR

CT abdomen

MRI

13

what may be seen on AXR?

small bowel or colonic dilatation, calcification, sacroiliitis, intra abdominal abscess

14

what may be seen on CT

skip lesions, bowel wall thickening, surrounding inflammation, abscess, fistulae

15

get ____ ____ in 30-50% of people pathoogicaly

non-caseating granuloma

16

transmural or mural

transmural inflammtion

17

pathology summary:
- Ileal and/or colonic chronic active mucosal inflammation including - ____, ___ _____
- _____ inflammation
- Fissuring
- -______ 50%

Ileal and/or colonic chronic active mucosal inflammation including - cryptitis, crypt abscesses
Transmural inflammation
Fissuring
Grnaulomas 50%

18

what are the highly likely complications

- small bowel obstruction - due to bowel wall thickening
- anaemia
- malabsorption
- fistulas
- short bowel syndrome

19

what are the moderately likely complications

- perforation
- infective colitis as a result of immunosuppressive therapy
- colorectal cancer
- hepatotoxicity from - methotrxte drug
- pulmonary fibrosis from methotrexate

20

what are the other complications

- toxic megacolon - rarer than in UC
- Anal disease: sinuses, fissures, skin tags, abscesses, perineum falls apart
- PSC - more in UC though

21

what is on the differential diagnosis for crohn's

- Ulcerative colitis
- Infectious colitis
- Pseudomembranous colitis
- Ischaemic colitis
- Radiation colitis
- Yersinia enterocolitica
- Amoebiasis
- Cytomegalovirus colitis
- Colorectal cancer
- Diverticular disease
- Acute appendicitis
- Ectopic pregnancy

22

what would make you think infectious colitis instead of crohns?

Infectious colitis - history of sick contacts and travel to endemic areas

23

what would make you think pseudomembranous colitis instead of crohns?

history of antibiotic use

24

what would make you think CMV colitis instead of crohns?

if they are immunocompromised

25

what would make you think colorectal cancer instead of crohns?

Colorectal cancer - increased risk with increasing age and positive FHx

26

what would make you think diverticular disease instead of crohns?

Diverticular disease - left sided abdo pain commonly

27

what would make you think appendicits instead of crohns?

younger patinets