1. Why is she taking mesalamine? 

What adverse effects should Mrs. D be particularly aware of? 

2. What signs and symptoms indicate that she needs to be admitted? 
3. Why does she have a low potassium and a low albumin? 
4. Why is she having an abdominal X-ray and stool cultures done? 

5. How should this flare be managed? 

Several days later you see Mrs. D, who is distressed as she is not responding to treatment and she
desperately wants to avoid surgery. The consultant has suggested that ciclosporin may be an option, and
she asks to talk to you about it. 

6. Why is surgery likely? 

7. What is the evidence for the use of ciclosporin? 
8. What should you discuss with her about the use of ciclosporin? 

9. Mrs. D is now very much recovered and is due to go home. What drugs would you expect her to be
discharged on? 
10. What monitoring would you do? 
11. Do anti-bacterial have a role in ulcerative colitis?