Ulcerative_Colitis_Flashcards
How is severity of ulcerative colitis (UC) in children assessed?
Severity in children is assessed using the Paediatric Ulcerative Colitis Activity Index (PUCAI).
What are the severity levels of UC according to the Paediatric Ulcerative Colitis Activity Index (PUCAI)?
Severe > 65 points, Moderate 35-64 points, Mild 10-34 points, Remission 0-9 points.
What is the first-line treatment for proctitis in UC?
The first-line treatment for proctitis is topical aminosalicylate for 4 weeks.
What is the treatment for mild UC if remission is not achieved within 4 weeks?
If remission is not achieved within 4 weeks, oral aminosalicylate can be added.
How is moderate UC managed initially?
Moderate UC is managed initially with oral prednisolone for 2-4 weeks and then tapered.
What is the treatment for steroid-dependent UC?
Steroid-dependent UC is treated with thiopurine or infliximab. If inadequate, options include colectomy, adalimumab, or vedolizumab.
What is the treatment approach for severe UC?
Severe UC is a medical emergency treated with high dose IV methylprednisolone, stopping oral 5-ASA, and possibly antibiotics for bacteraemia, with parenteral nutrition until improvement or surgery.
What should be assessed in children with UC regarding their daily activities and mental health?
Assess the impact of symptoms on home, school, and leisure activities, and check for associated anxiety and/or depression.
What are some of the recommended support groups for UC patients?
Support groups include Crohn’s and Colitis UK and CICRA.
What nutritional supplements should be considered for children with UC?
Calcium and vitamin D supplementation should be considered to assess the risk of osteoporosis.
What blood tests are needed for monitoring children with UC?
Monitoring should include FBC (for anaemia), folate, B12, calcium, and vitamin D levels, and supplements should be provided as appropriate.
What is the initial supportive care for volvulus?
Initial supportive care for volvulus includes NGT (if obstruction is present), broad-spectrum antibiotics, and IV fluids.
What is the emergency surgical procedure for volvulus?
The emergency surgical procedure for volvulus is the Ladd procedure with open laparotomy.
What steps are taken to stabilize a child with acute liver failure?
To stabilize a child with acute liver failure, steps include maintaining blood glucose with IV dextrose, preventing sepsis with broad-spectrum antibiotics and antifungals, preventing haemorrhage with IV vitamin K and H2 antagonists/PPIs, and preventing cerebral oedema with fluid restriction and mannitol diuresis.
What features indicate a poor prognosis in acute liver failure?
Features of poor prognosis in acute liver failure include shrinking liver, rising bilirubin, and falling transaminases.
