Ulcerative colitis

Question 1

Is smoking good or bad for UC?

Answer 1

Smoking protects against ulcerative colitis

Question 2

Predominant symptoms in the history for UC?

Answer 2

Rectal bleeding +/- PR mucus.

Question 3

Where does the inflammation start in UC?

Answer 3

Starts in the rectum (proctitis)

Question 4

Inflammation in UC?

Answer 4

Superficial ulcers

Goblet ells.

Acute cryptitis and crypt abscess

Question 5

What layers does the inflammation involve?

Answer 5

Superficial, mucosa and submucosa onlu

Question 6

Extra intestinal manifestations?

Answer 6

PSC
Cholangiocarcinoma 
Erythema nodosum 
Finger climbers 
Ulcers 
Stomatitis. 
Seronegative arthritis

Question 7

How do you classify severity?

Answer 7

True love and witts criteria?

Question 8

What is mild severity?

Answer 8

< 4 bowel movements, small amount of PR bleed, apyrexial.

Question 9

Moderate severity?

Answer 9

4-6 bowel movements.

Moderate PR bleed.
Slight temp
Pulse 70-90

Question 10

Severe ?

Answer 10

> 6 bowel movements and signs of systemic upset.

E.g. anaemia, high temp, pulse > 90, ESR > 30.

Question 11

Appearance of colon in UC?

Answer 11

Lead pipe.

Question 12

Diagnostic test for UC?

Answer 12

Flexible sigmoidoscopy

Question 13

Assessing extent?

Answer 13

Colonscopy.

Question 14

Main complication of UC?

Answer 14

Toxic megacolon.

Total but non-obstructive dilatation of colon.

AXR showing colon > 6cm. Thumb printing and loss of Haustra.

Question 15

What is given for a severe flare of UC?

Answer 15

IV methylprednisolone.

Question 16

First line management of UC/

Answer 16

5-ASA = mesalasine.

Question 17

What else can u add on fort treatment of UC?

Answer 17

Predinsolone

+/- immunosuppressive (azathioprine)

+/- anti-TNF (Infiximab)

Question 18

What are indications for surgery in UC?

Answer 18

Perforation
Toxic megacolon
Massive haemorrhage
Non responsive to medical therapy.