Gastroenterology

Question 1

Crohns disease

Induciing remission
1. First line
2. Second and third line
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Maintaining remission
a. first line
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i. Which part usually affected
ii. lifestyle advice
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Surgical management
*refer to passmed
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Complications of crohns?

Answer 1

inducing remission
1. Glucocorticoids
2. Sulfasalazine/mesalazine (5-ASA)
3. Azathioprine/Mercaptopurine/MTX
4. Infliximab
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Maintaining remission
a. azathioprine or mercaptopurine
*MTX is used of +TPMT
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i. terminal ileum and colon; may be see anywhere
ii. stop smoking
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Complications - small bowel cancer, colorectal cancer, osteoporosis

Question 2

GORD

what are the indications for a upper GI endoscopy

Answer 2

-age >55
->4wks of persistent symptoms
-dysphagia
-relapsing symptoms
-weight loss

***if endoscopy is negative consider 24hr esophageal pH monitoring (gold standard)