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;
18 Cards in this Set
- Front
- Back
|
Inflammatory Bowel Disease: which conditions?
|
-Ulcerative Colitis
-Crohn's Disease |
|
|
Ulcerative Colitis
|
Mucosal inflammatory condition
limited to rectum and colon |
|
|
Crohn's disease
|
Transmural inflammatory condition from mouth to anus
|
|
|
Stages of Ulcertive Colitis
(acute exacerbations with remissions) |
-Mild: < 4 stools per day
-Moderate: >4 stools, no systemic involvement -Severe: >6 stools with systemic involvement(fever, anemia, tachycardia) and ESR>30 -Fulminant: >10 stools/day, continuous bleeding |
|
|
Typical symptoms of Crohn's Disease
|
Nocturnal and/or chronic diarrhea and abdominal pain
-Ileum and colon mostly involved |
|
|
Diagnosis of Inflammatory Bowel Disease
|
-sigmoidoscopy
-endoscopy/colonoscopy -tissue biopsy |
|
|
Treatment for ulcerative colitis: rectal
|
topical aminosalicylates (enema, suppository),can combine rectal CS, if no response start oral aminosalicylates/CS. CS have no role in maintenance tx.
|
|
|
Treatment for ulcerative colitis: distal colitis
|
-oral aminosalicylates, topical mesalamine or combo with topical CS
-If refractory: use oral CS -Remission: mesalamine enema every 3rd night |
|
|
Treatment for ulcerative colitis: pancolitis (extensive UC)
|
-oral mesalamine
-If refractory: add high dose oral CS -If refractory or cannot wean off CS: azathioprine & 6MP |
|
|
Treatment for ulcerative colitis: moderate to severe refractory to aminosalicylates/CS
|
-Infliximab
|
|
|
Treatment for fulminant ulcerative colitis
|
-Hospitalization
-IV steroids -If no response w/i 7 days: switch to IV cyclosporine -Convert cyclosporine to oral -Azathioprine for maintenance |
|
|
Treatment for Crohn's Disease: mild to moderate
|
-Rectal aminosalicylates
-Cipro and flagyl |
|
|
Treatment of Crohn's Disease: Oral disease
|
-Lidocaine lozenges
-Systemic CS/azathioprine (only 50% of pts respond) |
|
|
Treatment of Crohn's Disease: Moderate ot severe
|
-Oral CS: prednisone or budesonide
-if refractory: azathioprine/6 MP -MTX, infliximab |
|
|
Treatment of Crohn's Disease: Fulminant disease
|
-Hospitalization
-blood transufion (anemia) -Abcess: drain, tx with cipro/flagyl -Fistula:flagyl/cipro, azathioprine, 6MP, infliximab -Maintenance: azathiprine |
|
|
Sulfasalazine counseling
|
-Take after meals
-avoid sun exposure -take folic acid to reduce anemia -Orange discoloration of skin/urine |
|
|
Sulfasalazine Adverse Effects
|
-N/V, anorexia, HA
-Sulfapyridine moeity causes hypersensitivity reactions: rash, fever, pancreatitis, nephritis, hepatitis, altered spermatogenesis -Mesalamine better tolerated |
|
|
Infliximab Adverse Effects
|
-Infeciton
-Infustion reactions -lupus |
