Gastroenterology 2 Flashcards
(42 cards)
Amsterdam criteria is used in which condition?
Name the three criteria
Associated with which other cancer?
Hereditary non polyposis colorectal carcinoma
1. At least three family members
2. At least two generations
3. At least one case <50yo
Endometrial cancer
Crohn’s or UC
Bloody diarrhoea
Skip lesions
All layers
Goblet cells
Crypt abscesses
PSC
AP
Perianal fistulae
Smoking
Bloody diarrhoea UC
Skip lesions Crohn’s
All layers Crohn’s
Goblet cells Crohn’s
Crypt abscesses UC
PSC UC
AP Crohn’s
Perianal fistula Crohn’s
Makes Crohn’s worse but UC better
Name three features associated with UC and Crohn’s
Pyoderma gangrenosum
Arthritis
Erythema nodosum
Ix Crohn’s (3)
Faecal calprotectin
Low B12
Low vitamin D
Inducing remission Crohn’s (2)
Name three add on drugs
- Steroids (PO/topical/IV)
- Mesalazine (5-ASA)
1.AZT
2. Mercaptopurine
3. MTX
Crohn’s: what can be used for isolated peri-anal disease?
Metronidazole
Maintaining remission Crohn’s
1st line (2)
2nd line (1)
What should be assessed prior to starting remission treatment?
- AZT or mercaptopurine
- MTX
TPMT activity
Investigation of choice for perianal fistula seen in Crohn’s?
Mx (2)
MRI
Metronidazole
Anti-TNF
UC features (3)
Bloody diarrhoea
Urgency
Tenesmus (feeling that you need to pass stools)
UC versus Crohn’s layers
Crohn’s through all the layers
UC not beyond submucosa
Barium enema findings for UC (3)
- Loss of haustrations
- Superficial ulceration/ pseudopolyps
- Drainpipe colon
UC flare classification
Mild
Mod
Severe
Hint: stool numbers and systemic disturbance
Mild <4 stools with or without blood, normal ESR and CRP
Moderate four-six stools with minimal systemic disturbance
Severe systemic sx, hypoalbuminaemia, >6 bloody stools
UC mx inducing remission:
Proctitis (3)
- Topical 5-ASA/ mesalazine
- If remission not achieved within 4 weeks add PO 5-ASA
- If still not achieved add topical/ PO steroid
UC mx inducing remission:
Proctosigmoiditis and left sided UC (3)
- Topical/ rectal 5-ASA
- If not resolved within 4 weeks then add a PO 5-ASA high dose OR PO 5ASA +/- topical steroid
- PO 5-ASA and PO steroid
UC mx inducing remission:
Extensive disease (2)
- Topical 5ASA + high dose PO 5-ASA
- If remission not achieved within 4 weeks then PO 5ASA and PO steroid
Severe colitis Mx inducing remission (4)
- Admit to hospital
- IV steroids
If no improvement after 72 hours - add IV ciclosporin
- surgery
Remission mx UC
Proctitis + proctosigmoiditis (3)
- Topical 5ASA OR
- PO 5ASA + topical OR
- PO 5ASA
Remission mx UC
Left sided and extensive UC (1)
Low maintenance dose of a PO 5ASA
UC maintenance mx of a severe relapse/ >=2 exacerbations in 1 year mx (2)
PO AZT or mercaptopurine
UC mx of a severe relapse/ >=2 exacerbations in 1 year mx (2)
PO AZT or mercaptopurine
Prophylaxis of variceal haemorrhage mx (2)
Propranolol
Endoscopic variceal band ligation - should be performed at two weekly intervals until all varices are eradicated
Vitamin A deficiency =
Vitamin A name
Retinal
Night blindness
B1 name
B1 deficiency = (4)
Thiamine
Wernicke’s/ Korsakoff’s
Dry beriberi: peripheral neuropathy
Wet beriberi: dilated cardiomyopathy
Vitamin C name
Deficiency = (5)
Ascorbic acid
Gingivitis, loose teeth, haematuria, epistaxis, poor wound healing
