Ulcerative Colitis And Chron's Flashcards
Where does UC start and how does it spread?
Rectum, spreads proximally
Symptoms of UC
Bloody watery diarrhoea
Abdo pain
Weight loss
Erythema nodosum
Associated diseases with UC
(anything inflammatory really) Renal calculi Vasculitic diseases Gallstones Uveitis Sacroilitis Sclerosing cholangitis Pyoderma gangrenosum Conjunctivitis Monoarticular arthritis
What would you see in UC colonoscopy?
Crypt abscesses Ulceration Submucosal fibrosis Dysplasia Pseudopolyps
Complications of UC
Heamorrhage
Perforation
Toxic dilatation
Carcinoma
Pathogenesis of UC
Strong immune response to gut flora
9% increased risk if relative affected
Diagnosis of UC
pANCA in 75% Stool calprotectin of over fifty High ESR and CRP Low heamoglobin and albumin Loss of haustra on X-ray
Specific UC treatment and then rest of treatment
Cyclosporin to prevent bacterial overgrowth
Anticoagulation with heparin or warfarin
5 aminosalicylate
Immunosuppressants (Tacrolismus, ciclosporin, mycophenate, metronidazole)
Biologics (IL13+IL13 blockers, anti TNF alpha antibodies (infliximab, adalimumab), vedolicumab
Steroids (prednisolone, budenoside)
Chrons specific treatment then rest of treatment
Methotrexate to induce remission
5 aminosalicylate
Immunosuppressants (Tacrolismus, ciclosporin, mycophenate, metronidazole)
Biologics (IL13+IL13 blockers, anti TNF alpha antibodies (infliximab, adalimumab), vedolicumab
Steroids (prednisolone, budenoside)
What do 5ASAs do?
5 aminosalicylates reduce number and severity of relapses, reduces colorectal cancer risk and maintains remission
What sort of drugs are 5 ASAs?
Prodrugs
Name some 5ASAs
Mesalazine
Balsalazide
Olzalazine
Sulfalazine
What do thiopurines do in inflammatory bowel diseases?
Induce and maintain remission
Azithiopurine complications
Leukopenia
Hepatotoxicity
Pancreatitis
Lymphoma
Chrons presentation
Anorexia Weight loss Diarrhoea Malaise Pyrexia Anemia Vitamin deficiencies Malabsorption Erythema nodosum
Chrons associated diseases
Carcinomas Renal calculi Gallstones Uveitis Sacroilitis Sclerosing cholangitis Pyoderma gangrenosum Conjunctivitis Monoarticular arthritis Episcleritis Biliary disease Pericholangitis Ankylosing spondylosis Clubbing Paneth cell metaplasia Lymphangiectasia
Spread of Chrons disease
Non-ceseating granulomatous spread that gives skip lesions and has systemic effects
Chrons disease colonoscopy and exploration
COBBLESTONE APPEARANCE ON COLONOSCOPY Abscesses Thickened, fibrotic, odematous mesenteries Polyps Atrophy Perforation Stricture Fistulas Transmural inflammation Apthous ulceration Granular serosa
Pathogenesis of Chrobs
Persistent activation of the mucosal immunity driven by intraluminal forces.
Diagnosis of Chrons
Cobblestone appearance on colonoscopy pANCA in 11% Stool has calprotein over fifty High ESR + CRP, platelets and WCC Low heamoglobin and albumin
