Gastroenterology & Hepatology — Flashcards

Flashcard 681: What investigation is used for toxic megacolon? _____

Answer: AXR → colonic dilation

Flashcard 682: What is the management for inducing remission in mild-to-moderate ulcerative colitis with extensive disease? First-line: _____

Answer: topical 5-ASA + high-dose oral 5-ASA

Flashcard 683: What is the management for inducing remission in mild-to-moderate ulcerative colitis? 1st-line: _____ Remission not achieved within 4 weeks → add oral 5-ASA

Answer: topical 5-ASA

Flashcard 684: What is the investigation of choice for Crohn's disease? _____

Answer: Colonoscopy + biopsy

Flashcard 685: What is the surgical management of ulcerative colitis? _____

Answer: Total proctocolectomy

Flashcard 686: _____ is characterised by mucosal and submucosal continuous inflammation.

Answer: Ulcerative colitis

Extra: Ulcerative colitis: - Depth: Mucosa and submucosa (superficial) - Progression: Continuous, starting from rectum - Key Features: Crypt abscesses, pseudopolyps, loss of haustra (lead pipe appearance)

Flashcard 687: In a patient with a perianal abscess, _____ may be used to identify an underlying cause (e.g., Crohn's disease).

Answer: colonoscopy and blood tests

Extra: While the acute management of a perianal abscess is incision and drainage, investigations like colonoscopy are focused on identifying underlying causes such as Crohn's disease or malignancy. Blood tests (CRP/ESR) help assess systemic inflammation.

Flashcard 688: What is the most common cause of small bowel obstruction in children? _____

Answer: Intussusception

Extra: Intussusception is the most common cause of bowel obstruction in infants (6 months to 3 years). In adults, the most common cause is post-surgical adhesions.

Flashcard 689: Crohn's disease typically presents in _____

Answer: young adulthood

Extra: Crohn's disease has a bimodal age distribution. The first and largest peak occurs between ages 15 and 35 (adolescence/young adulthood). It does not typically present in childhood (pediatrics), although it can occur there.

Flashcard 690: Acutely thrombosed external haemorrhoids should be managed with _____ if presented within 72 hours of symptom onset.

Answer: excision

Extra: Management of Thrombosed External Hemorrhoids: - < 72 hours: Surgical excision/evacuation. - > 72 hours: Conservative management. Note: Internal hemorrhoids are generally not excised acutely in the same manner unless strangulated.