GI Infections

Question 1

What is fulminant colitis

Answer 1

Acute severe inflammation of the colon
associated with toxic megacolon, shock, hypotension and ileus

Question 2

Treatment of non-severe C.diff

Answer 2

AB therapy with oral vancomycin or metronidazole
Faecal microbial transplant

Question 3

Treatment of severe C.diff/ fulminant colitis

Answer 3

AB therapy, supportive care, close monitoring
surgical consult

Question 4

Indications for surgery

Answer 4

• Colonic perforation
• Necrosis or full-thickness ischaemia
• Intra-abdominal hypertension or abdominal compartment syndrome
• Clinical signs of peritonitis or worsening abdominal examination despite adequate medical therapy
• End-organ failure

Question 5

Pseudomembranous colitis

Answer 5

associated with C.Diff
yellow-white plaques form pseudomembranes on the mucosa
Confirmed on endoscopy +/- biopsy

Question 6

Ulcerative colitis management

Answer 6

Steroids
Immunosuppressants (azathioprine)
biologic therapy
5-ASA

Question 7

Features of severe Ulcerative colitis

Answer 7

> 6BMs/day
significant anaemia
weight loss
severe symptoms
raised ESR/CRP