Ulcerative Colitis

Question 1

Ulcerative colitis, an idiopathic chronic inflammatory disorder, is localized to the which part of GIT….?

Answer 1

Colon and spares the upper gastrointestinal (GI) tract

Question 2

UC which part of GIT it will start……?

Answer 2

Begins in the rectum and extends proximally for a variable distance.

Question 3

What is proctitis and pancolitis ?..

Answer 3

When it is localized to the rectum, the disease is ulcerative proctitis,

whereas disease involving the entire colon is pancolitis.

Question 4

Characteristics of ulcerative proctitis ….?

Answer 4

Ulcerative proctitis is less likely to be associated with systemic manifestations,

although it may be less responsive to treatment than more-diffuse disease.

Question 5

Most common disorder in infancy misdiagnosed as Ulcerative colitis …………..?

Answer 5

Dietary protein intolerance

Question 6

Which are the typical presentation of ulcerative colitis…….?

Answer 6

Blood, mucus, and pus in the stool as well as diarrhea

Question 7

Define fulminant colitis. …….?

Answer 7

Fever, severe anemia, hypoalbuminemia, leukocytosis, and more than 5 bloody stools per day for 5 days

Question 8

Chronicity is characteristically seen UC…..? Like

Answer 8

Weight loss

growth failure

Question 9

Etiology for Iron deficiency anemia in IBD…..?

Answer 9

Iron deficiency can result from chronic blood loss as well as decreased intake.

Question 10

Folate deficiency reason in IBD……

Answer 10

Folate deficiency is unusual but may be accentuated in children treated with sulfasalazine, which interferes with folate absorption.

Question 11

Reason for recurrent symptoms in IBD. ?

Answer 11

Enteric infection

Question 12

Drugs is considered by some to predispose to exacerbation. …….?

Answer 12

NSAIDS

Question 13

It is generally believed that the risk of colon cancer begins to increase after…….. yr of disease

Answer 13

8-10

and can then increase by 0.5–1% per yr

Question 14

DIFFERENTIAL DIAGNOSIS for UC……?

Answer 14

Infectious colitis, allergic colitis, and Crohn colitis

Question 15

The most difficult distinction is from Crohn disease because the colitis of Crohn disease How to differentiate clinically……?

Answer 15

The gross appearance of the colitis or development of small bowel disease eventually leads to the correct diagnosis

Question 16

When the diagnosis is suspected in a child ?…….

Answer 16

subacute symptoms, the physician should make a firm diagnosis only when there is evidence of chronicity on colonic biopsy

Question 17

The diagnosis of ulcerative colitis must be confirmed by

Answer 17

endoscopic and histologic examination of the colon

Question 18

Endoscopic findings in UC……..?

Answer 18

Classically, disease starts in the rectum with a gross appearance characterized by erythema, edema, loss of vascular pattern, granularity, and friability

There may be a cutoff demarcating the margin between inflammation and normal colon, or the entire colon may be involved

Question 19

Biopsy of involved bowel demonstrates……?

Answer 19

Evidence of acute and chronic mucosal inflammation.

Typical histologic findings are cryptitis, crypt abscesses, separation of crypts by inflammatory cells, foci of acute inflammatory cells, edema, mucus depletion, and branching of crypts

Question 20

Plain radiographs of the abdomen might demonstrate……

Answer 20

loss of haustral markings in an air-filled colon or marked dilation with toxic megacolon.

Question 21

What is backwash ileitis….?

Answer 21

The colon is featureless, reduced in caliber, and shortened.

Dilation of the terminal ileum (backwash ileitis) is present

Question 22

Goals of medical line of treatment….?

Answer 22

controlling symptoms and reducing the risk of recurrence,

With a secondary goal of minimizing steroid exposure

Question 23

The first drug class to be used with mild or mild-to-moderate colitis is an……

Answer 23

Aminosalicylate

Question 24

Sulfasalazine is composed of a………

Answer 24

sulfur moiety linked to the active ingredient 5-aminosalicylate (5-ASA)

This linkage prevents the premature absorption of the medication in the upper GI tract, allowing it to reach the colon, where the 2 components are separated by bacterial cleavage

Question 25

Which is the major side effect of sulfasalazine ……?

Answer 25

Hypersensitivity to the sulfa component

occurs in 10–20% of patients

Question 26

Better tolerated 5-ASA preparations ……?

Answer 26

mesalamine, 50-100 mg/kg/day;

balsalazide 2.25-6.75 g/day

Question 27

Benefits of sulfasalazine and 5-ASA…….

Answer 27

Effectively treat active ulcerative colitis and prevent recurrence

Modestly decrease the lifetime risk of colon cancer.

Question 28

Best therapy for UC…..?

Answer 28

A combination of oral and rectal 5-ASA as well as monotherapy with rectal preparation has been shown to be more effective than just oral 5-ASA for distal colitis.

Question 29

Role of probiotics……? In UC

Answer 29

Probiotics are effective in adults for maintenance of remission for ulcerative colitis

although they do not induce remission during an active flare

The most promising role for probiotics has been to prevent pouchitis, a common complication following colectomy and ileal–pouch anal anastomosis surgery

Question 30

Indication for corticosteroids in UC….?

Answer 30

Children with moderate to severe pancolitis or colitis that is unresponsive to 5-ASA therapy should be treated with corticosteroids

most commonly prednisone

Question 31

Indication for surgical treatment in UC…?

Answer 31

For a hospitalized patient with persistence of symptoms despite intravenous steroid treatment for 3-5 days, escalation of therapy or surgical options should be considered.

Question 32

With medical management, most children are in remission within———— months

Answer 32

3

Question 33

Vedolizumab

Answer 33

A humanized monoclonal antibody that inhibits adhesion and migration of leukocytes into the GI tract, is approved for the treatment of ulcerative colitis in adults

Question 34

Colectomy is performed for ??????

Answer 34

intractable disease,
complications of therapy, and
fulminant disease that is unresponsive to medical management

Question 35

The major complication of this operation

Answer 35

It is a chronic inflammatory reaction in the pouch, leading to bloody diarrhea, abdominal pain, and, occasionally, low-grade fever