Ulcerative Colitis Flashcards
more common in ____
males
affects the ___ extending proximally
rectum
what are the symtoms
- Diarrhoea and bleeding - may have mucous/pus
- Increased bowel frequency - NEED TO FIND OUT HOW OFTEN
- Urgency, tenesmus and incontinence
- Night rising
- Lower abdo pain (LIF)
- (Proctitis can cause constipation)
what is important in the history?
Recent travel Antibiotics NSAIDS Family history Smoking SKin, eyes, joints
what extraintestinal skin manifestations may you get with UC?
erythema nodosum
pyoderma gangrenosum
clubbing
what extraintestinal joint manifestations may you get with UC?
- spondylitis, sacroileitis, Peripheral arthritis
- Axial, peripheral joints
what extraintestinal eye manifestations may you get with UC?
uveitis
what extraintestinal circulation manifestations may you get with UC?
phlebitis
may have deranged ___
LFTs
may get ____ stones
oxalate renal
____ and ____ are GI problems associated with UC
PSC and gallstones
what may be present on mouth examination
apthous mouth ulcers
what tests would you order to make an exclusion
Stool studies - to exclude campylobacter, c.diff, salmonella, e.coli, amoeba
what tests would you do?
blood: FBC, ESR, CRP, U and E, LFT, blood culture
plain AXR
- colonoscopy
why do a plain AXR
can be used to rule out perforation and toxic megacolon at first presentation
on an AXR you may see -___/____ ___
thumbprinting/ lead piping
colonoscopy may show _____ mucosal ulceration where the ulcers have a ___ base
superficial , broad base
inflammation in UC is confined to the ___ and ____ except in ____ ____
Inflammation confined to the mucosa and submucosa except in toxic megacolon
on colonoscopy may see ___ mucosa and diffuse erythema and may find _______
granular , pseudopolyps
what are pseudopolyps?
The repeated cycle of ulceration, alternating with the deposition of granulation tissue during the healing phase, results in the development of raised areas of inflamed tissue that resemble polyps.
histologically there is the absence of ___ cells and ____ distortion and may even get crypt ___
histologically there is the absence of goblet cells and crypt distortion and may even get crypt abscess
what are the complications of UC?
- colorectal cancer
- also cholangioma - if have PSC
- intractable disease
- toxic megacolon
- blood loss
- electrolyte disturbances
- anal fissures (uncommon)
what electrolyte disturbance may arise with UC?
hypokalaemia
toxic megacolon requires an emergency_____
colectomy
what is the differential diagnosis for UC
- Crohn’s disease
- Indeterminate colitis
- Radiation colitis
- Infectious colitis
- Diverticulitis
- IBS
- Mesenteric ischaemia
- Vasculitis
WHAT WOULD MAKE YOU THINK RADIATION colitis instead of UC?
Radiation colitis - if have a history of receiving radiotherapy especially to pelvic area
what would make you think infectious colitis instead of UC?
Infectious colitis - history of recent exposure or travel
what would make you think diverticulitis instead of UC?
Diverticulitis - older age, fever nausea, diarrhoea or constipation
what would make you think mesenteric ischaemia instead of UC?
history of heart disease
