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Pre-reg Exam 2021 > Chronic Bowel Disorders > Flashcards

Chronic Bowel Disorders Flashcards

1
Q

What is coeliac disease?

A

Autoimmune condition associated with chronic inflammation in small intestine unable to absorb nutrients

Gluten intolerance

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2
Q

What are the symptoms of coeliac disease?

A

Diarrhoea
Abdominal pain
Bloating
Higher risk of malabsorption of key nutrients

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3
Q

How do you treat coeliac disease?

A

Gluten free diet
Osteoporosis treatment
Supplements

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4
Q

What is diverticula disease?

A

Small bulges or pockets develop in the lining of the intestine

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5
Q

What is diverticulitis?

A

When the pockets become inflamed or infected

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6
Q

What are the symptoms of diverticula disease?

A

Lower abdominal pain
Constipation
Diarrhoea

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7
Q

What is the treatment for diverticula disease?

A

High fibre diet
Bulk forming drugs

Antibiotics if diverticulitis

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8
Q

What is ulcerative colitis?

A

Mucosal inflammation and ulcers restricted to colon and rectum

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9
Q

What are the symptoms of ulcerative colitis?

A

Bloody diarrhoea
Abdominal pain, urgent need to defecate

Alternates between acute flare up and remission

Flare up - mouth ulcers, arthritis, sore skin, weight loss, fatigue

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10
Q

What are the long term complications of ulcerative colitis?

A

Colorectal cancer
Secondary osteoporosis
VTE
Toxic megacolon

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11
Q

What is contraindicated in ulcerative colitis?

A

Loperamide/codeine

Paralytic ileus - increased risk of toxic megacolon

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12
Q

What type of colitis is treated orally?

A

Extensive

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13
Q

What type of colitis is treated with enemas?

A

Left sided/distal

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14
Q

What type of colitis is treated with suppositories?

A

Proctitis

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15
Q

What type of colitis is treated with foam preparations?

A

Proctosigmoiditis

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16
Q

What is used to treat mild-moderate exercise ulcerative colitis?

A

Proctitis and proctosigmoiditis first line - rectal aminosalicylate

Extensive colitis or left sided colitis first line - high dose oral aminosalicylate + rectal aminosalicylate or oral beclometasone if necessary

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17
Q

What is used to treat subacute ulcerative colitis?

A

Oral prednisolone or mab

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18
Q

What is used if treatment failure in acute mild-moderate ulcerative colitis?

A

+ oral prednisolone

+ oral tacrolimus

19
Q

What is used for severe acute colitis?

A

IV corticosteroid - assess for surgery

IV corticosteroid + IV ciclosporin

20
Q

What is used to maintain remission in ulcerative colitis?

A

Proctitis + proctosigmoiditis - aminosalicylates

Extensive or left sided - low dose oral aminosalicylate

Oral azathioprine/mercaptopurine if 2+ flare ups in 12 months

Mab

21
Q

What is Crohn’s disease?

A

Inflammation of GI tract from mouth to anus

22
Q

What are the symptoms of chrons disease?

A 
Abdominal pain
Diarrhoea
Rectal bleeding
Weight loss
Low grade fever
Fatigue
23
Q

What are the complications of Crohn’s?

A

Intestinal strictures, abscesses, fistulae

Malnutrition
Anaemia
Colorectal cancer
Growth failure and delayed puberty 
Arthritis
24
Q

What is the lifestyle advice for Crohn’s?

A

High fibre diet
Smoking cessation
Loperamide or codeine phosphate

25
Q

What do you give for 1+ flare up of Crohn’s in 12 months?

A

Corticosteroid

Budesonide/aminosalicylate

26
Q

What do you give for 2+ flare ups of Crohn’s in 12 months?

A

Azathioprine or mercaptopurine

Methotrexate

27
Q

What is used to maintain remission in Crohn’s?

A

Azathioprine

Mercaptopurine

28
Q

What is used to maintain remission in Crohn’s after surgery?

A

Azathioprine or mercaptopurine

Or aminosalicylates

29
Q

What are the aminosalicylates used in IBD?

A

Balsalazide
Mesalazine
Olsalazine
Sulfasalazine

30
Q

What are the corticosteroids used in IBD?

A 
Beclometasone
Budesonide
Hydrocortisone 
Methylprednisolone
Prednisolone
31
Q

What are the drugs that affect the immune system that are used in IBD?

A 
Azathioprine
Ciclosporin
Mercaptopurine
Methotrexate 
Infliximab
32
Q

What is the mechanism of action of aminosalicylates?

A

Reduce cytokine and free radical formation and inhibit prostaglandin synthesis

33
Q

What are the side effects of aminosalicylates?

A

Blood dyscrasias
Nephrotoxicity
Salicylate hypersensitivity
Yellow/orange bodily fluids with sulfasalazine

34
Q

What are the counselling points for aminosalicylates?

A

Report unexplained bleeding, bruising, sore throat, fever

35
Q

What is the interaction between mesalazine and lactulose?

A

Lactulose lowers stool in pH in the intestines

Prevents sufficient release of the active ingredient in EC/MR preparations

36
Q

What are the symptoms of IBS?

A

Lower abdominal pain
Bloating
Alternating constipation and diarrhoea

37
Q

What are the antispasmodics used in IBS?

A

Alverine
Mebeverine
Peppermint oil

38
Q

What are the antimuscarinics used in IBS?

A

Hyoscine butylbromide
Atropine
Dicycloverine
Propantheline bromide

39
Q

What are the laxatives used in IBS?

A

Lactulose not recommended

Linoclotide

40
Q

What antimotility drug is used in IBS?

A

Loperamide

41
Q

Why are antidepressants used in IBS?

A

Abdominal pain/discomfort

TCA
SSRI

42
Q

What is short bowel syndrome?

A

Characterised by malabsorption following extensive resection of the bowel

43
Q

What vitamins are people with short bowel syndrome?

A

ADEK, fatty acids, zinc, selenium, hypomagnesaemia

44
Q

What do you need to give higher doses of in short bowel syndrome?

A

Warfarin
Oral contraceptives
Digoxin

EC/MR not suitable
Liquid formulations may be suitable

Pre-reg Exam 2021 (79 decks)

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