Diarrhoea in a Young Man

Question 1

diarrhoea characterization?

Answer 1

what's their normal?
consistency
colour
volume: small bowel: larger volume
mucous? blood? (more large bowel)

Question 2

urgency with diarrhoea important how?

Answer 2

tenaesmus,
proctitis
rectal inflammation
mass in colon?

Question 3

associated features?

Answer 3

vomiting?
abdo pain?
tenaesmus

Question 4

diarrhoea at night means?

Answer 4

infammatory, not osmotic

Question 5

types of diarrhoea presentation?

Answer 5

large vs. small

osmotic vs. secretory

Question 6

why stool loose?

Answer 6

secretion
not absorbing
increasing transit time

Question 7

giardia affects where? presentation?

Answer 7

small bowel

no blood

Question 8

what parasitic infection causes bloody diarrhoea?

Answer 8

entamoeba histolytica

Question 9

hypoalbuminia sign of malnutrition?

Answer 9

not really, need BMI of

Question 10

why do you get hypoalbuminia in inflammatory diarrhoea?

Answer 10

negative acute phase reactant

Question 11

first line treatment for Ulcerative colitis?

Answer 11

5 Amino-slycylic acid and pred

Question 12

long term risks of ulcerative colitis?

Answer 12

bowel cancer

Question 13

risks of ileal pouch?

Answer 13

pouchitis

can still get bowel cancer

Question 14

long term effects of 5ASA

Answer 14

azoospermia

Question 15

azathioprine used in what?

Answer 15

Crohn’s, not UC

Question 16

what biologic for UC?

Answer 16

infliximab

Question 17

reactive arthritis?

Answer 17

immune mediated reaction to joint

Question 18

what can cause reactive arthritis?

Answer 18

gonorrhoea, campylobacter, yersinia

Question 19

what can cause a bad flair of Ulcerative colitis?

Answer 19

CMV/amoebic superinfection on top of UC

Question 20

why do daily x-ray in UC exacerbation?

Answer 20

monitor for toxic megacolon

Question 21

azathioprine works how?

Answer 21

works on T-cells

azathioprine»6MP» active metabolite (6TGN) + toxic metabolite, give allopurinol to shunt pathway to active metabolite

Question 22

what tests to do before starting azathioprine

Answer 22

TB
vaccinations
virals
liver function
pregnancy test?
kidney function

Question 23

rescue therapy for UC?

Answer 23

infliximab (TNF-a)

cyclosporine

Question 24

emergency toxic megacolon treatment?

Answer 24

colectomy

Question 25

diarrhoea definition

Answer 25

increased freq or

reduced consistency