GI, liver, kidney > Ulcerative colitis > Flashcards

Ulcerative colitis Flashcards

(49 cards)

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1
Q

Where is UC?

A

Confined to colon- worst within rectum

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2
Q

Where is inflamamtion in crohns?

A

Confined mycosa + submucosa

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3
Q

Histology UC

A

Crypt abscesses, mucosal ulcers and depleted goblet cells, increased inflammatory cells

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4
Q

UC x ray

A

Thumb printing
Thickening of haustral folds
Often acute inflammation

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5
Q

UC pathology

A
  • Superficial inflammation
  • Lymphoid aggregates and plasma cells
  • Bifid crypts - abscess formation
  • Crypt distance increases
  • loss absorptive surfaces
  • Psurdopolyps (non absorptive)- epithelial regenration
  • Vascular oedema and bleeding
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6
Q

UC symptoms

A
  • Cramping pain - LLQ esp
  • Blood
  • Muscous
  • Tenesmus + urgenyc
  • Classically diarrhoea (bloody)
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7
Q

What is the true love and witts severity index?

A

Rates severity of ulcerative colitis flare

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8
Q

What is severe UC on true love and witts severity index?

A

65+

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9
Q

What does a score of 35-64 mean on true love and witts severity index

A

moderate disease

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10
Q

What is mild disease true love and witts severity index for UC?

A

10-34

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11
Q

When is UC in remission on true love and witts severity index?

A

Under 10

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12
Q

What are the features of true love and witts severity index?

A

Bowel movements
Blood in stools
Pyrexia (37.8 degreees)
Pulse over 90BPM
Anaemia
ESR

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13
Q

Mayo endosocopic grading score 1 UC

A

Midl disease
Erythema, decreased vascular pattern, mild friability

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14
Q

Mayo UC endoscopic score 2

A

Marked erythema, absent vascular pattern, friability, erosions

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15
Q

Mayo UC endoscopic score 3

A

Severe disease
Spontaneous bleeding, ulcerations

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16
Q

Causes of UC

A
  • Infective - enteric, STIs, viral, amoebic
  • Immunological - typhilitis
  • Diverticulae
  • Microscopic
  • Medications
  • Radiation
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17
Q

Manage IBD flare

A
  • IV steriods
  • +/- ciclosporin/infliximab - immunosupression,
  • Optimise - Hb, fluids, infection, nutrition, VTE
  • Gastroenterology
  • Surgeons - colectomy
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18
Q

Severe treatment of UC

A
  • Biologicals
  • Janus kinase inhibitors
  • Infliximab/adalimubab - moncolonal TNF alpha
  • Vedolizumab
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19
Q

What is proctitis?

A

Inflammation of the lining of the rectum

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20
Q

Ischaemic colitis risk factors

Study These Flashcards
A
  • Vasculopathies - stroke and heart attack risk also risk ischaemic bowel
  • Coagulopathic
  • Aneurysmal surgery
  • Hypotension
  • Mesenteric angina - post prandial
  • Mucosa is first thing to die - shed into stool
21
Q

Symptoms of diverticular disease

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A
  • Blood
  • Constipation/haemorrhoids
  • Sigmoid involvement, normal mucose
  • Self limitng - weeks, months
22
Q

What is diverticular UC?

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A

Pouches in bowel wall - heavy strain
Pockets collect faecal matter → inflamamtion and bleeding

23
Q

Causes of diverticular UC

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A
  • Meds
  • Radiation
  • Microscopic
24
Q

UC on X ray

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A

Thumb printing
Thickened haustral folds
Acute inflamamtion
Large bowel continious

25
What meds cause UC
MMF - kindey or liver transplant treated, 1/3 get colitis NSAID induced colitis NSAID flares of IBD Cocaine - smuggling → colitis - stimulant → vasoconstriction ⇒ ischaemic colitis
26
What does radiation cause? How long before can cause?
3 weeks to years - Chronic ischaemia, fibrosis, friable, enarteritis - Bleeds, strictures
27
When escalate IBD management
Escalate if > 2 flares a year
28
What is ciclosporin
- Ciclospin - clainerin inhibitor - T cell
29
L sided colitis vs pancolitis
L sided does not expand beyond spleniic flexure, pancolitis does
30
What is curatice for UC?
Colectomy
31
Extraintestinal symptoms of UC? skin, eye, joints, bones, liver
Erythema nodosum, pyoderma gangronosum Aphtlous ulcers Episcleritis, ant uveitis Arthritis - asymmetric, pauarticular Sacrolitis, ank spond Osteoporosis Clubbibng Primary scleroisng cholangitis
32
What is mild disease parameters for each section Ture love and witts UC?
<4 stools a day Small amounts bloody stool NO anaemia, fever, normal ESR/CRP, pulse <90
33
What is severe UC on true love and witts criteria?
>6 stoos a day Visible bloood in stool At least one systemic upset 0 temp . 37.8, hr > 90, esr > 30
34
Complications of UC
Psychological Toxic megacolon Colorectal cancer VTE Osteoporosis
35
WHy do you get osteoporosis in UC?
Steroid use
36
Ass conditions w UC
Turners syndorme Wiskott Aldrich Glycogen storage IL-10 deficiency (refactory IBD) Primary scleroisng cholangitis
37
What is Wiskott aldrich?
X recessive syndrome -> imunodeficiency + thrombocytopenia
38
What is Primary scleroisng cholangitis
Bile duct fibrosis Autoimmune -> encephalopathy unless liver transplant
39
What gene is ass with IBD?
CARD 15 - crohns 2/3 - HLA B 27 - ank spond
40
What bacteria increases risk of UC
- Salmonella, shingella, campylobacter, Cdiff S
41
1st line treatment UC
5 ASAs - rectal topical or steroids eg rectal mesalazine, oral 5 ASAs
42
When is oral prednisolone used in UC?
2nd line for patients who fail to repsond to aminosalicyclates
43
Maintatining remission
Oral 5 ASA=s Azathioprine/mercaptopurine pROBIOTICS
44
bARIUM enema UC what see
Loss of haustrations, superficial ulceration, psurdopolyps, drainpipe colon 0 narrow and short
45
1st line investigation for diagnosing UC
Colonsocopy with biopsies
46
What is lactoferrin?
Granulocyte iron binding glycoprotein found in stool
47
How often monitor childs growth in UC
Every 3-6 months if active disease, flare near puberty or CCS treat Every 6 monhts near puberty otherwise every 12 months Use tanner staging to assess
48
When add ciclosporin IV to hydrocrotisone for acute severe flare of crohns
Dont improve within 72 hours on IV hydrocort Worsen at any time
49
Biologic approved in children for UC
Etrasimod
GI, liver, kidney
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