MSRA: Ulcerative Colitis

Question 1

What are the key symptoms of ulcerative colitis?

Answer 1

Bloody diarrhoea
Urgency
Tenesmus
Abdominal pain

Question 2

What are the features of mild UC flare?

Answer 2

Less than 4 bloody stools per day
Afebrile
Normal HR
Hb >110
ESR less than 20

Question 3

What are the features of moderate UC flare

Answer 3

4-6 bloody stools per day
Intermediate temp
Intermediate bpm
Hb 105-110
ESR 20-30

Question 4

What are the features of severe UC flare?

Answer 4

More than 6 bloody stills per day
Temp >37.8
Bpm >90
Hb less than 105
ESR >30

Question 5

What is the management of severe UC flare?

Answer 5

IV steroids

Question 6

How do we induce remission in UC?

Answer 6

Distal UC: Rectal mesalazine
Extensive disease: add on oral

Question 7

What is the management of a mild to moderate UC flare?

Answer 7

Proctitis/sigmoid/left-sided: topical ASA
Extensive: topical + oral ASA

Question 8

What are the side effects of Mesalazine?

Answer 8

Agranulocytosis
Pancreatitis

Question 9

How do we manage left sided UC?

Answer 9

Induce remission with rectal Mesalazine
Maintain with oral

Question 10

What action is needed for a mild/moderate flare that has not responded to rectal and oral ASA?

Answer 10

Oral steroids