Chrons Disease.pptx

MCQ Crohn's disease – a ) Continous involvement b) Sinus & fistula c) Mesenteric lymphadenitis d ) Stud ulcer

Teaching Point Stud ullcer or collar stud/button ulcer are seen in ulcerative colitis

MCQ 178.In a 27 yr old male most common cause of a colo-vesical fistula would be:--AI 2001 A. Crohns disease B. Ulcerative colitis C . TB D. Cancer colon

MCQ Skip lesions are seen in: AIIMS May 2009 Ulcerative colitis Crohn's disease Typhoid Tuberculosis

MCQ Mouth ulcers are more common in Diverticular disease Coeliac disease Solitary ulcer of rectum Ulcerative colitis Crohn’s disease

MCQ Crohn’s disease affects the lips : Rarely Sometimes Frequently Never Invariably

MCQ True statements about inflammatory bewel disease Surgery is the 1st management Pouch operation is done for fulminant ulcerative colitis 2 % case of chrons disease undergo malignant changes Ulcerative colitis don't undergo malignant Changes e.none

MCQ 1%. String sign of Kantor seen in? Crohn's disease Ulcerative colitis Both None

MCQ A patient with Crohn's disease was opened for and an inflammed appendix found. The treatment of choice is ‑ Appendicectomy (PGI 88) Ileocolic resection and anastamosis Close the abdomen and start medical treatment None of the above

MCQ Skin lesions with tuberculoid granulomas is characteristic of ‑ Hodgkins lymphoma‑ Sarcoidosis Crohns disease Ulcerative colitis

MCQ False regarding invlovement in Crohn's disease ‑ Anorectal area (AIIMS 94) Rectum Small intestine with Rt. colon Large intestine alone without involvement of small intestine

MCQ In a 27 yr old male most common cause of a colovesical fistula would be - ( AI 01, AI 99) Crohns disease Ulcerative colitis TB Cancer colon

MCQ Most common cause of death in Crohn's disease is due to: (AIIMS MAY 09 ) Sepsis Thromboembolic complication Electrolyte disturbance Malignancy

MCQ A patient gives chronic history of diarrhoea and blood in stool presents with multiple fistulae in the perineum and multiple stricture in small intestine. The diagnosis is - (AIIMS JUNE 2000) Crohn's disease Radiation enteritis Ulcerative Colitis Ischemic bowel disease

MCQ In Crohn's disease all are seen except : [PGI DEC 06] Hyperplastic polyps Diverticulosis Fissuring ulcer Epitheloid granuloma Crypt abscess

MCQ Crohn's disease is associated with following (D 96) Stomach not involved No granulomatous + Transmucosal fissures Continuous involvement Through and through involvement of thickness of bowel wall

MCQ Transmular inflammation with skip lesions in colon are characteristric of – (AIIMS NOV 93) Regional ileitis ( crohn’s disease Ischemic colitis Ulcerative colitis Non specific colitis

MCQ Ulcerative colitis involves - (PGI DEC 01) Serosa Lamina propria Mucosa Circularis muscle Submucosa

MCQ In a 27-year-old male most common cause of a colovesical fistula: (LB24th/1169-70) (AI/2001) Crohn's disease Ulcerative colitis TB Cancer colon

MCQ Extraintestinal complication which is in ulcerative colitis than Crohn's disease: ( LB24th / 1166) (PGI 93) Uveitis Pyoderma gangrenosum Cirrhosis Cholangiocarcinoma

MCQ Epitheloid like giant cells are seen in all of the following except Crohn's disease Brucellosis Leprosy Ulcerative colitis (JI P - 1993)

Teaching Point 75/ sn chugh Microscopically, non- caseating granulomas are characteristic of Crohn's disease. These granuloma consists of focal aggregates of histiocytes surrounded by lymphocytes and giant cells. Lymphoid aggregates or microgranulomas are also seen which may ulcerate on the surface of mucosa to form tiny aphthous like ulcers.

MCQ Skip transmural lesions with tuberculoid granuloma seen in: (LB24th/1169) (AIIMS 94) Ulcerative colitis Crohn's Tuberculosis Amoebiasis

Teaching Point Crohn's disease is a chronic transmural inflammatory disease of the Gastrointestinal tract of unknown aetiology . • There are skip areas which are characteristic of Crohn ' s disease (one segment of intestine is normal in between). Microscopically, non- caseating granulomas are characteristic of Crohn's disease. These granuloma consists of focal aggregates of histiocytes surrounded by lymphocytes and giant cells.

MCQ False regarding involvement in Crohn's disease: (LB24th / 1169) (AIIMS 94) Anorectal area Rectum Small intestine with right colon Large intestine alone without involvement of small intestine

Teaching Point 75/SN CHUGH/ common sites of involvement in Crohn's disease are terminal ileum and right side of colon, followed by ileum alone, colon alone or ileum and jejunum.

MCQ A patient with 8 year history of diarrhoea and blood in stool presents with multiple fistulae in perineum,was evaluated and found to have multiple strictures in small intestine, most likely cause is :( LB24Th /1169) (AIIMS 2000) Ulcerative colitis Crohn's disease Ischemic bowel disease Radiation enteritis

MCQ The sulfonamide used for chronic bowel inflammatory disease is: (LB24th/1166) (AIIMS 89) Sulfapyridine Sulfadiazine Sulfasalazine Sulfamethoxazole

MCQ The extra-intestinal complication which is seen more often in Ulcerative colitis than in crohn's disease is Pyoderma gangrenosum Cholangiocarcinoma Uveitis Cirrhosis • (PGI - 1993)

MCQ Skip lesions with tuberculoid granuloma is seen in Sarcoidosis Hodgkins diease Ulcerative colitis Crohn's disease (AIIMS-1991)

MCQ Skip lesions are seen in: aiims pgmee questions — May 2009 / 11page Ulcerative colitis Crohn's disease Typhoid Tuberculosis

MCQ Most common cause of death in Crohn's disease is due to: aiims pgmee questions — May 2009 / 11page Sepsis Thromboembolic complication Electrolyte disturbance Malignancy

MCQ The most frequent indication for surgery in Crohn's disease is Abdominal mass External fistula Intestinal obstruction Internal fistula

MCQ Skip lesions are characteristic of Ulcerative colitis Tropical sprue Crohn's disease Typhoid

MCQ Which of the following is the earliest radiological evidence of Crohn's disease? Straightening of valvulae conniventes Cobblestone.reticulation Hyperperistalsis String sign of kantor

MCQ Hose pipe appearance of small bowel is seen in Ulcerative colitis Lymphoma Crohn's disease All of the above

Teaching Point Manipal 466/ 2 nd ed • There is extensive inflammatory oedema and mucosal ulcers are present. Fibrotic thickening of the intestines results in Hose Pipe Rigidity of the intestine.

MCQ Changes of Crohn's disease are most prominent in Duodenum Jejunum Ileum Caecum

MCQ Following are features of Crohn's disease except Fleshy lymphadenopathy Skip lesions Caseating granulomas Transmural inflammation

Teaching Point Sn chugh /75 Microscopically, non- caseating granulomas are characteristic of Crohn's disease. These granuloma consists of focal aggregates of histiocytes surrounded by lymphocytes and giant cells. Lymphoid aggregates or microgranulomas are also seen which may ulcerate on the surface of mucosa to form tiny aphthous like ulcers.

MCQ Following are more often seen in Crohns disease as compared to Ulcerative colitis except Perianal complications Intestinal obstruction Intestinal perforation Toxic megacolon

MCQ Following conditions mimick linitis plastica of stomach except Syphilis Sarcoidosis Crohn's disease Gardner's syndrome

MCQ Most common cause of colonic fistula in India at age of 27 years: Crohn's disease (UP 08) Ulcerative colitis Tuberculosis Carcinoma rectum

MCQ Parenteral nutrition is not used in: (PGI June 08) Enterocutaneous fistula Burns Crohn's disease ILEUS Pancreatitis

MCQ A patient gives chronic history of Diarrhoea an blood in stool presents with multiple fistulae in the perineum and multiple stricture in small intestine. Th diagnosis is --------9.12 / aiims pgmee questions June, 2000 Crohn's disease Radiation enteritis Ulcerative Colitis Ischemic bowel disease

MCQ Duodenal stricture is caused by ----- 3.55aaaII (PG102) Amoebiasis T.B . Ca pancreas Crohns disease Giardiasis

MCQ Skip lesions with tuberculoid granulomas is characteristic of----- 3.72aaaII (AIIMS 91) Hodgkins lymphoma - Sarcoidosis Crohns disease Ulcerative colitis

MCQ False regarding invlovement in crohn's disease- --3.73aaaII (AIIMS 94) Anorectal area Rectum Small intestine with Rt. colon Large intestine alone without involvement Of small intestine

MCQ Skip transmural lesions with tubercuooid granuloma seen in ---- 3.73aaa II (AIIMS 94) Ulcerative colitis Crohn's Tuberculosis Amoebiasis

MCQ Predisposing factors for colon ca are----3.76aaaII (PG102) Animal fat consumption Familial adenomatous polyposis Ulcerative colitis Crohn's disease TB

MCQ True statements about inflammatory bowel disease (IBD )---- 3.76aaaII (PGI 03) Surgery is the 1st management Pouch operation is done for fulminant ulcerative colitis 2 % case of chrons disease undergo malignant changes Ulcerative colitis don't undergo malignant changes

MCQ "Cobblestone" appearance seen on colonoscope is characteristic of the following disease ----3.77 aaa II (MAHE 05) Crohn's disease Ulcerative colitis TB colitis Irritable bowel syndrome

Teaching Point MANIPAL /467/2ND ED INVESTIGATIONS Cobble stone reticulation because of multiple ulcers and islands of normal mucosa in between.

MCQ Inflammatory bowel disease found in children ----3.79aaaII Ulcerative colitis (PGI June 06) Tropical sprue Crohn's disease Celiac disease Cystic fibrosis

MCQ A patient with Crohn's disease was opened for and an Inflammed appendix found. Treatment of choice is - ---3.82aaaII (PG188) Appendicectomy Ileocolic resection and anastamosis Close adbomen and start medical treatment None of the above

MCQ Epitheloid like giant cells are seen in all following except ----1.5aaaII (JIPMER 93) Leprosy Ulcerative Colitis Crohns disease Brucellosis

MCQ All of following are precancerous except --1.37aaaII(UPSC 88) Ulcerative colitis Pigmentary ciirhosis Polyposis coli Crohns disease None

Teaching Point LOVE BAILEY/ 1168 /24 TH ED As with ulcerative colitis it is now believed that Crohn's disease can predispose to cancer, although the incidence of malignant change is not nearly as high as in ulcerative colitis and is most manifest in ileum.

MCQ Features of crohns disease are all except --1.37aaaII Lymphoid hyperplasia (JIPMER 91) Skip lesion Transmural involvement Crypt Abscess

MCQ Transmural involvement & granuloma are seen in --1.37aaaII (JIPMER 98) Ulcerative coilitis Crohn's disease Tropical sprue Amoebic colitis

MCQ Yellowish exudates at multiple sites seen in colonoscopy indicates ----1.38aaaII (Kerala 03) Crohn's disease Hirshspruing disease Tuberculosiss Lymphoma

MCQ True regarding crohns disease are A/E --- 15.6 / aiims pgmee questions - june , 1997 Scleroderma Transmural infection Cobble stone appearance Skin involvement

MCQ Which of the following is the established biological therapy for Crohns disease- ( AIIMSNov 05) --181 arvind arrora 2/e Anti TNF a-antibody IL-1 antagonist IL-6 antagonist IL-8 antagonist

MCQ Which one of the following drugs is useful in treating Crohn's disease ? -–--- 182 arvind arrora 2/e ( Karn PG MEE 2006) Infliximab Azathioprine Tacrolimus Cyclosporine

MCQ Ulcers appearing like 'knife cuts vulva are seen in Bechets disease Psoriasis Crohns disease Tuberculosis

MCQ Crohn's disease may be caused by which one of following infectious agents: (Al 08) Clostridium difficle Mycobacterium paratuberculosis Cytomegalo virus (CMV) Mycoplasma

MCQ Clubbing of fingers is caused by all except---------182pgmee AT AG Acyanotic heart disease (UPSC 87) Ulcerative colitis Crohns disease Billiarv cirrhosis

MCQ A 25 year old male presents with a history of chronic diarrhea. Pathological examination reveals cryptitis and crypt abscesses. The likely diagnosis is: (Al 08) Crohn's disease Ulcerative colitis Giardiasis Microscipic colitis B>A

MCQ A 25 year old male presents with a history of chronic diarrhea. Pathological examination reveals cryptitis and crypt abscesses. The likely diagnosis is: (Al 08 ) Crohn's disease Ulcerative colitis Giardiasis Microscipic colitis B>A

MCQ Extra intestinal manifestations of crohn disease -----1.119aaa vol III (PGI June 05) Uveitis Sclerosing cholangitis Osteoarthritis Skin nodules

MCQ A 35 years old woman complaints of attacks of breathlessness cyanosis and flushing. Apart from occasional diarrhoea , she has no abdominal symptoms. Abdominal examinations reveals an enlarged nodular liver. If leparotomy is done, one would expect to find - (UPSC 88) ---- 1122aaa vol III An ovarian tumour A multicentric hepatoma An appendicular carcinoid d) Crohn's disease

MCQ Crohn's disease (Regional enteritis)It is a disease of Ileum but can affect any part of gastrointestinal tract, ileocolonic being the most common.10 % of patients have a first degree relative with the disease and an association with ankylosing spondylitis. • Patholotgical features are - Fibrotic thickenign of the intestinal wall with a narrow lumen . Dilated gut just proximal to the stricture Oedemotuos mucosa with a cobble stone appearance Mesenteric thickening with enlarged mesentric lymph nodes . Skip lesions and noncaseating giant cell granulomas.

Teaching Point Presentation may be acute pain with diarrhoea or chronic. In chronic cases there may be transmural fissuring; infra-abdominal abscesses and fistulas ( enteroenteric or enterocutaneous ) Small bowel enema shows a narrow terminal ileum with string sign of Kantor,_ ,"Treatment of Crohn's Disease • Steroids are the mainstay of treatment but surgery is indicated when there is • Recurrent intestinal obstruction • Bleeding Perforation Perianal disease Fulminant colitis Intestinal fistula

Chrons Disease.pptx

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