Acute Colitis

Question 1

what is the main cause of acute colitis ?

Answer 1

INFECTION

Question 2

what are the rare causes of acute colitis ?

Answer 2

drugs, ischaemia, endoscopy prep

Question 3

This is NOT specific for infection as it may rarely herald the onset of ____

Answer 3

IBD

Question 4

how is diagnosis made?

Answer 4

stool culture

Question 5

if Polymorphs seen on smear (then culture), what are the most likely causative organisms

Answer 5

campylobacter, shigella, E.coli

Question 6

if Polymorphs not seen on feacal smear, what are the most likely causative organisms

Answer 6

salmonella, E.coli, C.difficile

Question 7

cause of pseudomembranous colitis

Answer 7

C.difficile

Question 8

what is the presentation like>

Answer 8

• have to have diarrhoea to describe colitis ± blood
• dyhydration
• sepsis

Question 9

what investiagtions are required?

Answer 9

plain X ray

sigmoidoscopy and biopsy

stool cultures

barium enema

Question 10

what may you see on x ray?

Answer 10

• lead piping

- thumb printing

Question 11

what is lead piping?

Answer 11

Lead piping - colon looks smooth because you lose the mucosal folds and normal contours of colon because of the inflammation

Question 12

what is thumbprinting?

Answer 12

Thumbprinting - looks spiky due to mucosal ulceration

Question 13

what may be seen within the crypts histologically?

Answer 13

neutrophils - but no crypt irregularity