Ulcerative colitis (UC)

Question 1

1) What kind of disorder is UC?
2) Where does the inflammation usually start and end?
3) What causes UC?

Answer 1

1) Relapsing and remitting inflammatory disorder of the colonic mucosa
2) Rectum and doesn’t usually pass the ileocaecal valve
3) Inappropriate response against colonic flora in genetically susceptible patients

Question 2

Name 3 signs or symptoms of UC

Answer 2

• Diarrhoea that may contain blood or mucous
• LLQ pain
• Weight loss
• Arthritis
• Uveitis

Question 3

How is UC diagnosed

Answer 3

Endoscopy + biopsy

Question 4

Name 3 features of UC

Answer 4

• Red, raw mucous that bleeds heavily
• No inflammation beyond the mucosa (superficial only), but continuous distribution
• Ulceration and pseudopolyps
• Formation of crypt abscesses
• Depletion of goblet cells
• Smoking is protective
• Primary sclerosing cholangitis is a feature
• Increased risk of colorectal cancer

Question 5

1) Name an acute complication of UC
2) Name a chronic complication of UC

Answer 5

1) Toxic megacolon, VTE
2) Colon cancer

Question 6

1) What is given in mild-moderate disease to induce remission?
2) What is second line in mild-moderate disease to induce remission?
3) What is first in line in severe disease to induce remission?
4) What is second in line in severe disease to induce remission?

Answer 6

1) Aminosalicylate topical then oral (i.e. mesalazine)
2) Corticosteroid i.e. prednisolone
3) IV corticosteroids (i.e. hydrocortisone)
4) IV ciclosporin

Question 7

What is the most commonly affected area in UC?

Answer 7

Rectum

Question 8

1) Is passing 4-6 stools a day classified as a mild, moderate or severe UC flare up?
2) A HR greater than what is considered a severe flare up of UC?
3) An ESR of greater than what is considered a severe flare up of UC?

Answer 8

1) Moderate
2) 90
3) 30mm/hr