Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

gastroenterology > Ulcerative Colitis > Flashcards

Ulcerative Colitis Flashcards

1
Q

what is anterior uveitis?

A

inflammation of the anterior portion of the uvea, which includes the iris and ciliary body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how do patients with anterior uveitis present?

A
  • red and painful eye
  • photophobia
  • blurred vision
  • lacrimation
  • hypopyon (inflammatory cells in the anterior chamber)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what conditions are anterior uveitis associated with?

A

HLA-B27

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the clinical features of cholangiocarcinoma?

A
  • upper abdominal discomfort
  • itching
  • jaundice
  • afebrile
  • non-tender mass palpable in the RUQ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the tumour marker for cholangiocarcinoma?

A

C 19-9 (also elevated in pancreatic cancer and gastric cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what other conditions is UC associated with?

A
  • erythema nodosum
  • pyoderma gangrenosum
  • uveitis
  • scleritis
  • episcleritis
  • primary sclerosing cholangitis (PSC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a cholangiocarcinoma?

A

biliary tract malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is ulcerative colitis?

A

chronic-relapsing-remitting inflammatory granulomatous disease affecting the large bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the acute complications of UC?

A
  • toxic megacolon
  • massive lower GI haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the management of toxic megacolon?

A
  • IV fluids + IV hydrocortisone
  • failure to respond to IV steroids within 48-72 hours is an indication for surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what resource is used to assess severity of UC?

A

truelove and witts severity index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is mild UC on truelove and witt’s criteria?

A
  • bowel movements = <4
  • blood in stools = small amounts
  • pyrexia = no
  • pulse >90 = no
  • anaemia = no
  • erythrocyte sedimentation = <30
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is moderate UC on truelove and witt’s criteria?

A
  • bowel movements = 4-6
  • blood in stools = mild amounts
  • pyrexia = no
  • pulse >90 = no
  • anaemia = no
  • erythrocyte sedimentation = <30
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is severe UC on truelove and witt’s criteria?

A
  • bowel movements = >6 + systemic upset
  • blood in stools = visible blood
  • pyrexia = yes
  • pulse >90 = yes
  • anaemia = yes
  • erythrocyte sedimentation = >30
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what ages does UC typically present at?

A

15-25 and 55-65 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the symptoms of UC?

A
  • diarrhoea containing blood/mucous
  • tenesmus or urgency
  • pain in the left iliac fossa
  • systemic symptoms - weight loss, fever
17
Q

what non-radiological investigations should be carried out in UC?

A
  • blood tests - FBC, ESR/CRP, LFTs
  • microbiology - to exclude infective colitis
  • faecal calprotectin - useful way to distinguish between IBS and IBD
18
Q

what will be see on colonscopy in UC?

A
  • continuous inflammation with an erythematous mucosa
  • loss of haustral markings
  • pseudopolps
19
Q

what will be seen on biopsy in UC?

A
  • goblet cells
  • crypt abscess
  • inflammatory cells (predominantly lymphocytes)
20
Q

what will a barium enema find in UC?

A
  • lead-piping inflammation - secondary to loss of haustral markings
  • thumb-printing (marker of bowel inflammation)
  • pseudopolyps - due to areas of ulcerating mucosa adjacent to areas of regenerating mucosa
21
Q

what images are contraindicated in the acute setting?

A

colonscopy and barium enema due to risk of perforation

22
Q

what imaging should be carried out in an acute setting?

A
  • CT
  • abdominal x-ray
  • erect chest x-ray
23
Q

what is the management of mild/moderate UC?

A
  1. topical aminosalicylate (ASA) or oral ASA
    • oral prednisolone if no improvement within 4 weeks
    • oral tacrolimus if no improvement after 2-4 weeks

proctitis and proctosigmoiditis

24
Q

what is the management of left-sided or extensive disease?

A

high dose oral aminosalicylate

25
Q

what is the medical management of severe UC?

A
  1. IV corticosteroids
    • IV ciclosporin if no improvement in 72 hours
26
Q

what are the indications for emergency surgery?

A
  • acute fulminant UC
  • toxic megacolon with no improvement after 48-72 hours of IV steroids
  • symptoms worsening despite IV steroids
27
Q

what is the surgical management of UC?

A
  • panproctocolectomy with permanent end ilestomy
  • colectomy with temporary end ileostomy
28
Q

what are the indications for elective surgery?

A

failure to induce remission by medical means

29
Q

what are the long-term complications of UC?

A
  • colorectal cancer
  • cholangiocarcinoma
  • colonic strictures
30
Q

what is the diagnostic criteria for toxic megacolon?

A

radiographic evidence of colonic dilatation >6cm + 3 of:
* temperature >38
* heart rate >120bpm
* neutrophilic leucocytosis
* anaemia

+1 of:
* dehydration
* altered consciousness
* electrolyte disturbance
* hypotension

gastroenterology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions