SYMPOSIA II

Question 1

Acute diarrhoea [3]

Answer 1

< 4 weeks

Infectious and self limiting

Investigate after 1 week

Question 2

Acute diarrhoea causes [3]

Answer 2

Viral - norovirus, rotavirus
Bacterial - salmonella, s aureus
Parasitic

Question 3

Chronic diarrhoea [2]

Answer 3

> 4 weeks

Chronic pathology

Always investigate

Question 4

Chronic diarrhoea causes [4]

Answer 4

Colonic
Small bowel
Pancreatic
Endocrine

Question 5

Parasitic examples [3]

Answer 5

cryptosporidium parvum, giardia lambila, entamoeba histolytica

Question 6

IBS

Answer 6

continuous mucosal inflammation of the colon without granulomas on biopsy, affecting the rectum and a variable extent of the colon and characterised by a relapsing and remitting course

Question 7

UC

Answer 7

bloody diarrhoea, rectal bleeding, mucus, faecal urgency, abdominal pain, nocturnal defecation

Any age and gender

Relapsing / remitting course

Ex-smokers 70% increased risk of UC

Smoking/Appendectomy protective

Question 8

UC treatment

Answer 8

Normal - hydrocortisone, heparin, stool chart, AXR, daily CRP

Mild- moderate - mesalazine, prednisolone, azathioprine

Severe - infliximab (TNF inhibitor), cyclosporin, colectomy

Avoid NSAID’s, opiated, anti-motility agents

Question 9

UC treatment - normal

Answer 9

hydrocortisone, heparin, stool chart, AXR, daily CRP

Question 10

UC treatment - moderate

Answer 10

mesalazine, prednisolone, azathioprine

Question 11

UC treatment - severe

Answer 11

infliximab (TNF inhibitor), cyclosporin, colectomy

Question 12

CD

Answer 12

discontinuous and often granulomatous and transmural inflammation affecting any area of the gastrointestinal tract

Chronic diarrhoea, IBS symptoms, abdominal pain, weight loss, anaemia, growth failure, blood and mucus in stool, perianal disease, extraintestinal manifestations

Question 13

CD treatment

Answer 13

prednisolone, azathioprine, methotrexate, nutrition, antibiotics, infliximab, surgery