Inflammatory bowel disease? Flashcards
Why is loperamide contraindicated in suspected UC?
May precipitate toxic megacolon
Extra-intestinal manifestations of UC? (5)
Arthritis/enthesitis/tenosyovitis Erythema nodosum Pyoderma gangrenosum Episcleritis Uveitis
Options for management of active UC? (5)
Mesalazine (either topically or orally depending on extent) Tapering corticosteroids AZT Ciclosporin Infliximab
Severity criteria for UC in adults?
Truelove and Witts’
Obstructive jaundice in a UC patient?
Sclerosing cholangitis
Perianal disease in Crohns? (4)
Abscess
Fistula
Skin tags
Anal fissures
Induction of remission in active Crohn’s??
Steroids 1st line
5-ASA drugs second-line
AZT/MTX or mercaptopurine as add-on
Biologics (e.g. infliximab)
Watery diarrhoea + steatorrhoea in a patient with extensive ileal disease/ileal resection?
Suspect bile acid malabsorption
Management of bile acid reabsorption (under specialist advice)?
Bile acid sequestrant e.g. colestyramine
Analgesic contraindicated in IBD?
NSAIDs may precipitate relapse
Why are patients with Crohn’s prone to strictures/adhesions/fistulas?
Inflammation occurs in all layers of the gut
Most prominent symptom of Crohn’s in children?
Abdominal pain
Commonest extra-intestinal manifestation in both UC and CD?
Arthritis- pauci-articular, assymetric
Maintenance treatment in CD?
AZT or mercaptopurine 1st line
MTX second line
Assay which needs to be performed before AZT or mercaptopurine treatment?
TPMT activity
