Gastro

Question 1

Ulcerative colitis

Answer 1

Bloody diarrhoea more common
Abdominal pain left lower quadrant
Tenesmus

rectum and sigmoid

smoking protective factor

Extra-intestinal: Primary sclerosing cholangitis

Risk of colorectal Ca

No inflammation beyond submucosa
crypt abscesses

pseudopolyps

drainpipe colon

Question 2

Chron’s

Answer 2

• Diarrhoea usually non-bloody
• Weight loss more prominent
• Upper gastrointestinal symptoms, mouth ulcers, perianal disease
• Abdominal mass palpable in the right iliac fossa

Gallstones, Oxalate renal stones

Obstruction, fistula, colorectal cancer (lower then UC)

skip lesions, mouth to anus

• Inflammation in all layers from mucosa to serosa
• increased goblet cells
• granulomas

Deep ulcers, skip lesions - ‘cobble-stone’ appearance

strictures: ‘Kantor’s string sign’
proximal bowel dilation
‘rose thorn’ ulcers

Question 3

Ascites

Answer 3

Spironolactone
- aldosterone antagonist, used to counterbalance the secondary hyperaldosteronism that develops in patients with hepatic cirrhosis, causing fluid overload.