Crohn’s Disease: The Daily PANCE Blueprint

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Crohn's Disease: The Daily PANCE Blueprint

A 27-year-old female with a history of migraines and hypothyroidism presents to your clinic complaining of chronic abdominal pain, diarrhea, intermittent fevers, and fatigue. Which of the following laboratory tests, if positive, would indicate that this patient has Crohn's disease?

A. perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)
B. Carcinoembryonic antigen (CEA)
C. Erythrocyte sedimentation rate (ESR)
D. Antinuclear antibodies (ANA)
E. Anti-Saccharomyces cerevisiae antibodies (ASCA)

Answer and topic summary

The answer is E. Anti-Saccharomyces cerevisiae antibodies (ASCA)

Inflammatory bowel disease (IBD) includes two distinct entities: Ulcerative Colitis and Crohn’s Disease; both are immune-mediated inflammatory responses. Below is a table to help you with the differences between the two.

Characteristics? Ulcerative Colitis Crohn Disease
MC site of origin? Rectum Terminal ileum
Is smoking an RF? No Yes (doubles risk!)
Lab studies? p-ANCA ASCA (87% specific)
Complications? Toxic megacolon Fistula, abscess, stricture
Appearance via scope? Lead-pipe Cobblestoning
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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ Colorectal disorders (PEARLS) ⇒ Inflammatory bowel disease

Also covered as part of the General Surgery, Family Medicine, and Emergency Medicine Rotation PAEA EOR topic list