Ulcerative Colitis Flashcards Preview

GastroIntestinal (GI) > Ulcerative Colitis > Flashcards

Flashcards in Ulcerative Colitis Deck (26):
1

What are the two disease that are inflammatory bowl disease?

Ulcerative Colitis
Crohn's disease

2

What does Ulcerative colitis affect?

The Colon

3

What is the cytokine profile of Ulcerative colitis?

Th2
IL 5/13

4

What are the genetic factors for Ulcerative colitis?

HLADR2

5

What effect does smoking have on Ulcerative colitis?

Protective effect

6

Describe the pathology of Ulcerative Colitis?

Distortion of the crypts
Infiltration of Monocytes and Neutropphils
Inflammation and Ulceration of Mucosa

7

What layer is affected by Ulcerative colitis inflammation?

Mucosa

8

What cells drive the pathology of Ulcerative colitis?

NK T cells

9

What Inflammation cytokines are produced in Ulcerative colitis?

IL 1
IL6
TNF Alpha

10

What are the symptoms of Ulcerative Colitis?

Episodic/ Chronic Diarrhoea
Blood in stool

11

What is treatment for severe ulcerative colitis?

Hydrocortisone
Prednisolone
Surgery: Ilesostomy

12

What is the pharmacological treatment for Ulcerative colitis?

5- ASA (Mesalazine)
Steroids
Immnosuppressants
Anti-TNF therapy

13

What is the mechanism of action of 5ASA?

Topical effect
Anti-inflamatory properties
Reduces risk of colon cancer

Side effects:
Diarrhoea
Idiosyncratic Nephritis

14

How does an oral 5-asa work for delivery of medication?

It is a prodrug - a side chain needs cleaved off to become active
pH dependent release
Delayed release

15

What topical methods of delivery are there for 5 -ASA?

Suppositories (Coat the rectum only)
Enemas (Coat the rectum and sigmoid colon)

16

What 5-ASA drug that causes side effects and why?

Sulphasalazine

It has a sulphapyridine ring

17

What 5-ASA drug is pH dependent?

Asacol

18

What is the best topical therapy for Ulcerative colitis?

Enema

19

What is given if 5-ASA is not working? - What is the purpose and course of this drug?

Prednisolone (Oral)
Budensonide (Topical)

Induces remission
Short course
High dose initially - reduced over 6-8 weeks.

20

What is the surgical treatment for ulcerative colitis?

Permanent Ileostomy
Restorative proctocoloectomy and pouch

21

What is the therapy pyramid for IBD?

5-ASA
Steroids (for short course)
Immunosupression
Anti-TNF drugs

22

What levels in the blood must be done to see if imunosupressive therapy is appropriate?

TPMF

23

What surgery is done for Ulcerative colitis?

Proctocolectomy with end ileostomy
Proctocolectomy with ileorectal anastomosis
Pouches

24

What are the indications for surgery fro UC?

Medically unresponsive disease
Intolerability
Dysplasia/malignancy
Growth retardation in children
Attempted resolution of extra-intestinal disease

25

What are the complications of a pouch?

Haemorrhage
Impotence

26

How can you assess the severity of UC?

Truelove and Witt Criteria

Factors:
ESR
Haemoglobin
Bloody Stools
Temperature (37.8)
Heart rate