Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
20 Cards in this Set
- Front
- Back
|
What is a broad overview of management/treatment of chronic IBD?
|
1. Supportive
2. Nutritional 3. Medical Therapy 4. Surgical Therapy |
|
|
Summarize initial supportive therapy for Crohn's disease.
|
1. Control diarrhea
(Imodium, codeine, antibiotics, lactose free diet, low fat diet, etc...) |
|
|
Summarize initial supportive therapy for Ulcerative Colitis.
|
1. Fluids and Electrolytes
2. Blood transfusion if required. 3. Control diarrhea (WITHOUT use of antidiarrheal medications, ie. imodium) |
|
|
Summarize nutritional therapy for Crohn's disease.
|
1. Fluids only during acute exacerbations
2. NPO to 'rest' the gut 3. Electrolyte, mineral and vitamin supplements for those with extensive small bowel involvement |
|
|
Summarize nutritional therapy for Ulcerative Colitis.
|
Special diets may alleviate symptoms but have little value of decreasing inflammation. Ensure fluids and electrolytes are sufficient.
|
|
|
What are some medications used to treat Crohn's disease?
|
1. 5-ASA
2. Steroids 3. Immunosuppressives 4. Antibiotics 5. Antidiarrheal agents 6. Cholestyramine 7. Immunomodulators |
|
|
What are some medications used to treat Ulcerative Colitis?
|
1. 5-ASA
2. Steroids 3. Immunomodulators |
|
|
What are some common immunomodulators?
|
1. Cyclosporin
2. Methotrexate 3. Imuran/6-mercaptopurine 4. Infliximab |
|
|
What is Infliximab?
|
A monoclonal antibody to tumor necrosis factor (TNF-alpha) used to treat Crohn's disease.
|
|
|
What is Cholestyramine?
|
A bile salt binding resin used to treat watery diarrhea with less than 1 metre of terminal ileum diseased or resected from Crohn's disease.
|
|
|
What is 5-ASA?
|
5-ASA stands for sulfasalazine (5-aminosalicylate + sulfipyridine). It comes in both oral and topical preparations. Used for both the induction and maintenance of remission for both UC and Crohn's.
|
|
|
Indicate if the following class of drugs are used for 'Remission,' 'Maintenance' or 'Both' for Tx of IBD?
1. 5-ASA 2. Steroids 3. Immunomodulators |
1. Both
2. Remission only 3. Both |
|
|
What is the goal of medical therapy for IBD Tx?
|
To suppress the inflammatory response (remission). This allows the tissue to heal and relieve the symptoms of IBD. Once the symptoms are undercontrol, medical therapy is used to decrease the frequency of flare-ups (maintenance).
|
|
|
What are some indications for surgical therapy for IBD?
|
1. Failure of medical therapy
2. Cancer risk 3. Perforation 4. Haemorrhage 5. Stricture |
|
|
What is the main difference between surgical therapy between UC and Crohn's?
|
Surgery for UC is curative whereas it is not for Crohn's.
|
|
|
What are the 2 most common surgeries for UC?
|
1. Proctocolectomy (removal of entire colon and rectum) with a creation of an opening in the abdomen to empty feces into a pouch (ileostomy).
2. Creation of an ileoanal anastomosis (with an ileoanal pouch). |
|
|
What is the most common surgery for Crohn's disease?
|
A simple segmental resection of the inflammed/infected part of the intestine.
|
|
|
What is the percent chance of recurrence of Crohn's disease after surgery at 5 years, at 15 years?
|
1. At 5 years, 50%
2. At 15 years, 85% |
|
|
For cancer prevention, surveillance colonoscopy is recommended every _____ years?
|
1-2 years for IBD patients after onset of disease.
|
|
|
What is a general treatment overview for toxic megacolon?
|
1. Replace fluids and electrolytes
2. Blood transfusions if required 3. Nasogastric suction 4. Anti-inflammatory drugs (ie. 5-ASA and steroids) 5. Surgical therapy if no response in 48-72 hrs. |
