Ulcerative Colitis Flashcards
from where to where does inflammation occur?
rectum to colon
which gene is implicated?
HLA-B27
what age group are risk factors for UC?
when two age groups are effected like this what is it called?
15-25, then 55-65
Bimodal distribution
which ethnicity is a risk factor?
Caucasian
what is seen on histology?
-4
ulceration
crypt abscesses
neutrophil infiltration.
Goblet cell depletion.
anus involved in UC.
true or false
false
UC is a relapsing remitting disease.
true or false
true
why is there LLQ abdo pain?
Rectal sigmoid inflammation
hallmark symptoms of UC
urgent bloody diarrhoea
define tenesmus?
sensation you need to empty your bowel, even if bowel has already been evacuated.
types of colitis?
- 4
UC
Diverticulitis
Pseudomembranous Colitis
Ischaemic Colitis
which WBC is responsible for crypt abscesses?
neutrophils
what is low albumin a sign of in UC?
malnutrition
what blood test can easily be used to rule out IBS and rule in IBD?
FCP
pt with UC history,
but you do stool culture to rule out gastro infection.
what two main infections are you trying to rule out?
gastroenteritis
pseudomembranous colitis
an abrupt very severe flare up with colon dilation and abdo distention is called what?
fulminant disease
How many bowel movements constitutes a severe flare up?
what do you need to give quickly when they come hospital?
> 6 bowel movements
IV steroids
symptoms of UC?
-5
Urgent bloody diarrhoea. Tenesmus. Mucus in stool. Crampy abdo pain (LLQ) Weight loss
most common extra-intestinal manifestation?
arthritis
gold.S Ix?
positive result for UC with this Ix?
-2
Colonoscopy
Ulcers.
Pseudopolyps.
will WBC increase with flare ups?
yes
a Colonoscope might not be used in acute flare up.
why?
what is the equivalent you use instead?
perforate bowel risk
Sigmoidoscopy
on barium enema what normal feature is lost?
haustrations
antibody marker for UC?
pANCA
1st line to induce remission?
-give route
Topical Mesalazine
2nd line drug to induce remission?
- 2 drugs
- one is a drug name and route
- other is just drug class
Oral mesalazine or
corticosteroid
1st line to maintain remission?
- give route
- give drug class
give examples of this drug class?
-2
Topical aminosalicylate
e.g. Sulfasalazine, mesalazine
1st line drug given orally after severe relapse?
- name two drugs
- give route
what else is given IV with a severe flare up?
Oral azathioprine or mercaptopurine
IV steroids
what class is mesalazine?
aminosalicylate
what group of drugs does mesalazine belong to?
anti-inflammatory group
Azathioprine class?
Purine synthesis inhibitor
extra-intestinal manifestations seen at the fingers?
clubbing
extra-intestinal manifestations of the skin?
-2
Erythema nodosum
Pyoderma gangrenosum
extra-intestinal manifestations of the eyes which is especially more common in UC than crohn’s?
uveitis
symptoms of UC?
-5
Urgent bloody diarrhoea.
Tenesmus.
Mucus in stool.
Crampy abdo pain
(LLQ pain especially)
Weight loss
malnutrition occurs in UC.
true or false.
true
Which leukocyte is mainly implicated in:
1) UC
2) coeliac disease
1) neutrophil
2) lymphocytes
Character of the abdo pain in UC?
crampy
what are crypt abscesses?
when crypt of Lieberkühn fills with neutrophils
In normal physiology the crypt of Lieberkün has what cells?
- 2 main ones
function of these cells?
enterocytes - make enzymes
goblet cells - make mucus
