crohns Flashcards

(33 cards)

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

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
small bowel imaging findings
mandatory - deep ulcerations - skip lesions
26
treatment
- glucocovrticosteroids - azathioprine - anti-TNF
27
is onset fast or slow
slow over years
28
do NSAIDs alleviate or aggravate pain
aggravate
29
does smoking alleviate or aggravate pain
aggravate
30
why does strictures form
thickening of bowel wall and fat wrapping
31
why does cobble-stoning occur
deep fissuring ulceration (transmural) of mucosa
32
complications
- malabsorption - gallstones - fistulas - anal disease - bowel obstruction - perforation
33
what is seen on endoscopy
cobble-stoning