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Gastroenterology > IBD, IBS and Coeliac > Flashcards

IBD, IBS and Coeliac Flashcards

1
Q

Diagnosis of IBS

A

Considered if patient has one of the following for 6 months (ABC)
Abdo pain
Bloating
Change in bowel habit

Positive if
Abdo pain relieved by defacation
Altered bowel frequency stool form

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2
Q

IBS investigations

A

FBC, ESR/CRP, coeliac screen (tissue transglutimase antibodies)

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3
Q

IBS management

A

First line
pain:mebeverine
constipation: laxatives, avoid lactulose
diarrhoea: loperamide

Second line
low dose tricyclic antidepressant

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4
Q

Risk of relapse of Chrohn’s disease is increased by

A

Smoking

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5
Q

Gold standard for coeliac diagnosis

A

Endoscopic intestinal biopsy (must continue to eat gluten otherwise villous atrophy may not be present)

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6
Q

Endoscopic intestinal biopsy findings in coeliac

A

Villous atrophy
Crypt hyperplasia
Increased intraepithelial lymphocytes
Lamina propria infiltration with lymphocytes

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7
Q

Malnutrition is defined as BMI >

A

18.5 OR
unintentional weight loss >10% over 3-6 months OR
BMI >20 and 5% weightloss over 3-6 months

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8
Q

what is ERCP

A

endoscopic retrograde colangeopancreatrography
uses x ray and an endoscope to treat liver, gallbladder, bile ducts and pancreas

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9
Q

achalasia pathophys

A

ganglion cell degeneration causing failure of relaxation of the lower oesophageal sphincter and loss of peristalsis in distal oesophagus

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10
Q

key X-ray achalasia finding

A

bird beak appearance at lower oesophageal sphincter

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11
Q

achalasia investigations

A

oesophageal manometry: excessive LOS tone doesn’t relax on swallowing
barium swallow: grossly expanded oesophagus and bird beak
xray: bird beak and fluid level

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12
Q

ulcerative colitis symptoms

A

bloody diarrhoea
urgency
tenesmus
LLQ abdo pain

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13
Q

ulcerative colitis age occurence

A

15-25
55-65

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14
Q

ulcerative colitis diagnosis

A

colonoscopy and biopsy finding red, raw mucosa that bleeds easily

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15
Q

about ___ of people with IBD have anaemia

A

2/3rds

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16
Q

risk of colorectal cancer higher in ulcerative colitis or chrons disease?

A

ulcerative colitis

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17
Q

most appropriate investigation for h pylori

A

13c urea breath test

18
Q

deranged LFTs and secondary amenorrhoea

A

autoimmune hepatitis

19
Q

what medication may increase the risk of Chrohn’s disease relapse

A

NSAIDS

20
Q

H Pylori management

A

PPI + amoxicillin (or metronidazole) + clarithomycin

21
Q

What indicates a worse prognosis of Chrohns?

A

perianal disease

22
Q

what percentage of people with Chrohns also have osteoporosis?

A

30%

23
Q

is psoriasis in Chrohns related to disease activity?

A

No

24
Q

What laxative should be avoided in IBS?

A

Lactulose

25
Q

Red flag symptoms in IBS

A

1/ rectal bleeding
2/ unexplained weight loss
3/ family history bowel or ovarian cancer
4/ onset after 60

26
Q

What laxative can be used in IBS if other laxatives have not worked for 12 month?

A

?

27
Q

What foods should be avoided in IBS?

A

Insoluble fibres: bran and wholemeal bread

28
Q

Mild flare of UC criteria

A

> 4 stools daily
no systemic disturbance
normal ERS and CRP

29
Q

Moderate flare of UC criteria

A

4-6 stools a day
miminal systemic disturbance

30
Q

Severe flare of UC criteria

A

> 6 stools a day containing blood
systemic disturbance

31
Q

A family history of Chrohns disease is present in around ___% of all patients

A

25%-40%

32
Q

The risk of Chrohns is increased __x after a bout of gasteroenteritis

A

4

33
Q

what drug is used to maintain remission in left sided or extensive ulcerative colitis

A

Oral and reactal aminosalicylate: mesalazine

34
Q

treatment of severe flare of ulcerative colitis

A

admit to hospital
IV corticosteroids

35
Q

mild/moderate distal (proctitis) UC flare treatment

A

topical (rectal) aminosalicylate

36
Q

mild/moderate extensive UC flare treatment

A

oral and rectal aminosalicylates

36
Q

severe relapse or >2 in past year treatment

A

oral thiopurines: azathioprine or oral mercaptopurine

37
Q

2nd line mild/moderate flare UC treatment

A

add oral corticosteroids (prednisolone)

38
Q

,Chrohns vs UC differences
1. bloody diarrhoea
2. weight loss
3. abdo pain
4. colorectal cancer

A
  1. UC
  2. Chrohns
  3. Chrohns
  4. UC
39
Q

Coeliac investigations

A

low ferritin and folate

40
Q

Oral aminosalycisate side effects

A

acute pancreatitis
diarrhoea
nausea
vomiting

Gastroenterology (6 decks)

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