GI

Question 1

What is the treatment for oesophageal vatical rupture?

Answer 1

Rescue TIPS
Endoscopic banding
Prophylactic antibiotics (as patients are risk of infection)
Vasopressin (Terlipressin) to manage low blood pressure

Question 2

What are the three classes of drugs used in BOTH UC and Crohn’s disease?

Answer 2

Corticosteroids
Thiopurines
Biologics

Question 3

Which drugs are used for UC alone?

Answer 3

5ASA’s (aminosalycates)

Question 4

Which drug is used for Crohn’s disease alone?

Answer 4

Methotrexate

immune modulating diets are also used to treat Crohn’s disease alone

Question 5

Give 3 examples of steroids used for UC and Crohn’s?

Answer 5

IV hydrocortisone
methylprednisolone
prednisolone

Question 6

What should be given with prednisolone to help prevent bone side effects of steroids?

Answer 6

calcium and vitamin D supplementation

Question 7

What are three side effects of steroids?

Answer 7

Immunosuppression
Impaired glucose tolerance (borderline diabetic becomes diabetic)
Osteoporosis
Weight gain
Cushingoid appearances

Question 8

Give an example of a 5ASA?

Answer 8

Sulphasalzine
Mesalazine
Pentasa

Question 9

What is the aim of 5ASA’s?

Answer 9

Induction of remission in mild to moderate ulcerative colitis
Maintenance of remission in UC
Reduce risk of colorectal cancer as they aim to reduce the inflammation

Question 10

Give an example of thiopurines?

Answer 10

Azathioprine and mercaptopurine

steroid sparing drugs - this means less dose of steroid is required when these drugs are also used

Question 11

What is the aim of thiopurines?

Answer 11

Maintenance therapy for UC and Crohn’s

Question 12

What does azathioprine do?

Answer 12

Essentially prevents T cell clonal expansion in response to antigenic stimuli
Allows T cell apoptosis

Question 13

What does TPMT do?

Answer 13

TPMT: Thiopurine methyl transferase metabolises azathioprine to its active agent.