Ulcerative Colitis

Question 1

UC

Answer 1

inflammation of GI tract

Question 2

signs

Answer 2

Continuous inflammation
Limited to large colon and rectum
Only superficial mucosa 
Smoking is protective
Excrete blood and mucus

Use of asaclyzine
Primary sclerosing cholangitis - liver transplant

Question 3

investigations

Answer 3

bloods
CRP
faecal calprotectin

Endoscopy
x-ray

Question 4

management

Answer 4

REMISSION:
proctitis, proctosigmoiditis, L side colitis:
topical aminosalicylate
 \+ oral aminosalicylate
 \+ oral/topical steroid (stop topical)

pan colitis:
topical + oral aminosalicylate
oral corticosteroids + oral ASA (stop topical)

MAINTENANCE:
topical/oral aminosalicylate

Question 5

endoscopy findings

Answer 5

crypt abscess
mucosal inflammation
loss of goblet cells
loss of haustral markings

Question 6

when is colonoscopy contraindicated and what is used instead

Answer 6

acute situation

flexible sigmoidoscopy

Question 7

management of acute severe disease

Answer 7

admit and give IV hydrocortisone
no improvement - IV ciclosporin + surgical input
no improvement and not suitable for surgery - biologics

Question 8

what is describes as a severe

Answer 8

>6 stools
frank bloods
temperature, HR>90
anaemia
ESR >30

Question 9

complication and management

Answer 9

toxic megacolon

IV hydrocortisone, infliximab or surgery

Question 10

primary sclerosis cholangitis signs and investigastions

Answer 10

RUQ pain
jaundice
fatigue
pruritus

ERCP/MRCP - beaded look seen

Question 11

how would you maintain remission after a severe relapse

Answer 11

azathioprine