Ulcerative Colitis

Question 1

Define

Answer 1

Relapsing remitting inflammatory disorder of COLONIC muscosa

Question 2

Are they always unwell?

Answer 2

No, they’re well between attacks

Question 3

Most common site that’s affected?

Answer 3

Rectum

Question 4

Is UC continuous or patchy?

Answer 4

Continuous

Question 5

What is seen in the stool?

Answer 5

Blood that’s mixed with mucousy diarrhoea

Question 6

Where is the pain?

Answer 6

Abdo pain

Question 7

Extra intestinal manifestations of IBD mneumonic

Answer 7

A PIE SAC

Aphthous ulcers (CD>UC)
Pyoderma gangrenosum
I - iritis, uveitis, episcleritis (CD>UC)
Erythema nodosum 
Sclerosing cholangitis (UC) 
Arthritis 
Clubbing fingers (CD>UC)

Question 8

Investigations

Answer 8

Stool sample
Blood tests
Abdominal x ray
Colonscopy or flexible sigmoidoscopy and biopsy

Question 9

What signs might you see in IBD?

Answer 9

Lead pipe sign

Thumbprinting sign

Question 10

What is a complication of IBD?

Answer 10

toxic mega colon -> sepsis

Question 11

How does this cause sepsis?

Answer 11

The enlargement of the colon means that it might pop and lead to faeces leaking out, leading to sepsis

Question 12

What else can cause toxic mega colon?

Answer 12

C. diff leads to inflammatory colitis, TMC and sepsis

Question 13

Management

Answer 13

Aminosalicylates

Question 14

What are the different ways in which aminosalicylates can be given?

Answer 14

Topical

Oral

Question 15

What drugs are given to maintain remission?

Answer 15

Azathioprine
Methotrexate
Ciclosporin

Question 16

What is the lead pipe sign?

Answer 16

Loss of colonic folds leading to a smooth appearance of the colon, resembling a pipe

Question 17

What is the name of normal colonic folds?

Answer 17

Haustral folds

Question 18

What is thumbprinting sign?

Answer 18

When the colon looks like it has chunks taken out of it, like a fish bone