Diarrhoea in a Young Male Flashcards
Why don’t do ileal pouch on young people?
Risk of infertility
Passing stools 5-6 times per day
What does tenesmus indicate pathophysiologically?
Rectal involvement
What characteristics of diarrhoea reflect an organic (inflammatory) cause?
Nocturnal diarrhoea
Blood
No association with food
What are the long term consequences of UC? How long do you have to have it for?
Bowel cancer
After ~10 years
What does urgency indicate pathophysiologically?
Distal colonitis or proctitis
What is diarrhoea?
Increased frequency
Reduced consistency
Which disease is cryptitis indicative of on histopathology?
IBD more so than infections
What is pouchitis?
Inflammation of the ileal pouch that replaces colon is total colectomy
What is the pANCA status in the each type of IBD?
UC: May be positive
Crohn’s: Usually negative
What is the sensitivity and specificity for giarrdia on stool sample?
Low
What do you test for before commensing azathioprine?
Liver/kidney function
TB statis
Vaccinate - chicken pox, Hep B (the live vaccines)
TPMT phenotype (for metabolism of the azathioprine)
In which type of IBD is azathioprine most effective?
Crohn’s
What are alternatives to prednisolone in UC?
Methatrexate
Azathioprine
Cyclosporin
Infliximab
What is used for treatment of UC?
5 amino-salicylic acid - for 2 years
Prednisolone (wean off around 8 weeks)
What is the most important extraintestinal manifestation of UC?
PSC
