Crohn's Disease: Activity-Linked Manifestations
Crohn's disease (CD) is an inflammatory bowel disease (IBD) that can affect various parts of the digestive tract. It is also known to cause inflammation in other parts of the body, termed extraintestinal manifestations (EIMs).
This question focuses on identifying which EIM among the choices is most closely related to the current disease activity in Crohn's patients.
Analysis of Extraintestinal Manifestations
- Eye Complications (Iritis/Uveitis): These inflammatory eye conditions are known EIMs of IBD. While often seen during active phases, the correlation isn't always direct or consistent with disease activity levels.
- Renal Calculi: Kidney stones in Crohn's patients are often related to factors like dehydration, altered nutrient absorption (e.g., calcium, oxalate), and changes in urine composition, rather than being a direct marker of intestinal inflammation activity.
- Primary Sclerosing Cholangitis (PSC): PSC is a chronic liver disease strongly associated with IBD, especially ulcerative colitis, but also seen in Crohn's. However, its development and progression are complex and may not always directly mirror the bowel disease's current activity.
- Chronic Active Hepatitis: This form of liver inflammation can be linked to the systemic inflammatory processes associated with active Crohn's disease. The ongoing inflammation in the body may contribute to or correlate with the development or persistence of chronic active hepatitis, making it related to the overall disease activity.
Determining Activity Correlation
Among the given options, Chronic Active Hepatitis is considered to have a more direct relationship with the systemic inflammatory state characteristic of active Crohn's disease compared to the others listed.
Important Questions from Intestines
- An eight month old male child is brought to the emergency with recurrent episodes of screaming and drawing up of legs. The child appears to be listless in between the attacks. Local examination of abdomen reveals feeling of emptiness in the right iliac fossa and blood stained mucus is found on the finger on per rectal examination. The most probable clinical diagnosis in this child is
Which of the following statements regarding Ogilvie's syndrome are correct?
1. It presents as acute large bowel mechanical obstruction
2. Marked caecal dilatation is a common feature on X-ray abdo- men
3. Caecal perforation is a well recog- nized complication of this condi- tion
4. Intravenous Neostigmine is used for the treatment of this condition
Select the correct answer using the code given below :
In familial adenomatous polyposis, which of the following all are true ?
1. Presence of $>100$ colorectal polyps
2. Positive family history
3. Autosomal Recessive inheritance
4. Genetic mutation on Chromo- some 5
Select the correct answer using the code given below :
Which of the following statements with regard to Enteric perforation are correct?
1. Salmonella typhi is the causative organism for Enteric fever
2. Enteric perforation characteristi- cally occurs during third week of illness
3. Typhoid ulcers are placed trans- versely to the long axis of the gut
4. Terminal ileum is the most common site for enteric perfora- tion
Select the correct answer using the code given below :
- A 35 year old male patient with enteric fever presents to the emergency with sudden onset of generalised abdominal pain, abdominal distension, nausea, vomiting and constipation for last 48 hours. On examination, patient is dehydrated with PR = $110/min$ and BP = $100/60$ mm Hg. There is genera- lised tenderness, rebound tenderness present and board like rigidity on per- abdomen examination. The most likely complication of enteric fever in this patient is
