Gastroenterology & Hepatology — Flashcards

Flashcard 701: Small bowel obstruction presents with _____ in complete obstruction

Answer: absolute constipation

Flashcard 702: What is the management of perianal fistulae? First-line: _____ Second-line: Surgical - fistulotomy, seton placement

Answer: Metronidazole

Flashcard 703: Crohn's can present with non-specific symptoms such as _____

Answer: weight loss

Flashcard 704: What is the management for inducing remission in severe ulcerative colitis? _____! 1st-line: IV steroids 72 hours no improvement → Infliximab or Ciclosporin (rescue therapy)

Answer: Admit to hospital

Flashcard 705: ~_____% of patients with Crohn's will eventually have surgery

Answer: 70

Flashcard 706: What is the management for maintaining remission in Crohn's? 1st-line: _____ or mercaptopurine

Answer: Azathioprine

Flashcard 707: Small bowel obstruction presents with _____ abdominal pain

Answer: diffuse, central

Flashcard 708: What is the investigation of choice for severe colitis in ulcerative colitis? _____

Answer: Flexible sigmoidoscopy

Extra: In toxic megacolon (a complication of severe colitis), the initial investigation is an abdominal X-ray.

Flashcard 709: What is the most common surgery for Crohn's disease?

Answer: Ileocecal resection is the most common surgical procedure performed for Crohn's disease, typically indicated for terminal ileitis or complications like strictures and fistulas.

Flashcard 710: What is the initial/first-line investigation for small bowel obstruction? _____ in supine position

Answer: AXR

Extra: Classical AXR findings in Small Bowel Obstruction (SBO): 1. Dilated bowel loops (>3 cm). 2. Valvulae conniventes (plicae circulares) crossing the full width of the bowel. 3. Multiple air-fluid levels (best seen on erect film; supine is better for visualizing loop distribution and gas patterns).