Steroid Refractory Ulcerative colitis

Q) Not used in steroid refractory severe Ulcerative Colitis ( AIIMS 2020 Nov) 

a) Infliximab
b) Azathioprine
c) Cyclosporine
d) Surgery

Ans b- Azathioprine

Cyclosporine is  immunomodulator indicated for second-line therapy in the case of severe, steroid refractory ulcerative colitis. Treatment is usually initiated after 3 to 5 days of failed steroid response

Tacrolimus is appropriate as second-line therapy in patients with severely active ulcerative colitis unresponsive to steroids.

The use of various anti–tumor necrosis factor-α  (TNF-α) monoclonal antibodies ( infliximab)  is well supported in the case of
severe ulcerative colitis refractory to steroids. 

Rectal Intussusception

Q) Pick the true statement about rectal intussusception

a) It is a rare finding in defecography

b) When found, it is found to be a common cause of refractory constipation

c) Biofeedback therapy and fibre intake is the mainstream treatment of choice

d) Rectopexy has had good long term results