September 22, 2015 - SG - Chronic Diarrhea

Question 1

Iron Deficiency (ID) vs ACD

Answer 1

Ferritin: Low in ID… Normal/High in ACD

TIBC: High in ID… Normal/Low in ACD

Question 2

DDx of Thrombocytosis

Answer 2

Can be either reactive or autonomous.

If reactive, may be due to infection, inflammation, iron deficiency…

Question 3

UC vs Crohn’s

Answer 3

UC

• Continuous
• Involves rectum
• Superficial (not transmural)
• Colon only
• Cured with surgery
• Fistulas are rare

Crohn’s

• Skips patches
• Gums to bum
• Penetrative
• Fistulas are common
• Small bowel involvement
• Not curative with surgery

Question 4

Pyramid of Treatment for UC/Crohn’s

Answer 4

Top is most serious, with bottom being least serious. You typically start in the middle, and move your treatment up or down depending on how the disease is responding. If the disease is well-controlled, you may not need any drugs at all.

Surgery

Biologics

Immune Modulators

Corticosteroids

5-ASA

Question 5

5-ASA

Answer 5

Mesalazine

An anti-inflammatory drug that is used to treat IBD. It is a bowel-specific aminosalicylate drug that acts locally in the gut and has predominant action there, thereby having few systemic side effects.