GI medicine - PUD Flashcards
Side effects of proton pump inhibitors?
Hyponatremia, risk of C. Diff
alternative to PPIs?
H2 antagonist
SE of methotrexate?
nausea, mouth sores, myelosuppression, hair loss, etc
what can you insert for someone with a perianal fistula?
seton
medical managemetn for someone with acute severe colitis?
- hydrocortisone 100mg QDS
- DVT prophylaxis
- bone protection (calcichew, vit D)
- surgical consult
what investigations do you need to do when planning treatment for a patient with active acute severe colitis?
-biologic screen - hep B, C, HIV, mantoux or quantiferon, VZV, rubella, CMV, EBV
-signmoidoscopy
-
If someone is steroid refractory when treating acute severe colitis, what do you put them on?
-after 3 days of steroids you put them on infliximab
which HLA types are associated with increased risk of celiac disease?
HLA-DQ2 and HLA-DQ8
Classifications of celiac disease?
- Classic
- Refractory Celiac Disease (type I and II)
- Asymptomatic
What is refractive celiac disease?
celiac disease with persistant symptoms and villous atrophy despite strict adherence to gluten free diet for 6 months
what is refractive celiac disease type I ?
refractive disease that responds to aggressive nutritional support and pharmacotherapy
what is refractive celiac disease type II?
Lack of response to intervention. Clonal lymphocytes in gut may result in celiac associate malignancy
Deficiency of which immunoglobulin is a risk factor for celiac disease?
igA deficiency
what antibodies do you test for in the blood when suspecting celiac disease?
- Anti-tTG igA and igA level
- antiendomysial antibody if igA is low
what may be seen on biopsy / histology of the D2 duodenum in someone with celiac disease?
-macroscopic villous atrophy, scalloping, loss of mucosal fields
