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30 Cards in this Set
- Front
- Back
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UC or CD?
1. autoimmune disease 2. inflammatory disease 3. limited to colon 4. anywhere in GI tract 5. majority of cases involve rectum 6. assoc'd w/ cobblestoning 7. goal: remission, improve QOL, limit toxicity 8. assoc'd w/ pseudopolyps |
CD 1. autoimmune disease
UC 2. inflammatory disease UC 3. limited to colon CD 4. anywhere in GI tract UC 5. majority of cases involve rectum CD 6. assoc'd w/ cobblestoning UC & CD 7. goal: remission, improve QOL, limit toxicity UC 8. assoc'd w/ pseudopolyps |
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what do you need to do when Dxing IBD?
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1. colonoscopy
2. C difficile toxin 3. smoker/non smoker 4. stool freq 5. ntr |
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smoking improves ___, but worsens ___. (CD, UC)
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smoking improves UC, but worsens CD.
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common Sx of UC?
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1. bloody diarrhea
2. rectal bleeding 3. ab pain 4. urgency 5. tenesmus (urge to go, but can't) |
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UC classifications?
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1. pancolitis: entire colon
2. L sided colitis: end of transverse colon to rectum 3. proctosigmoid: sigmoid colon to rectum 4. proctitis: rectum |
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UC severity classifications:
1. mild 2. moderate 3. severe |
1. mild < 4 stools/d
2. moderate > 4 stools/d + min toxicity signs 3. severe > 6 bloody stools/d + systemic toxicity |
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what is considered systemic toxicity in UC?
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1. HR > 90
2. T > 37.8C 3. Hb < 10.5 4. dec Hct 5. ESR > 30 |
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what is the inflammation marker?
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ESR > 30
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what age group does CD affect?
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all, but most commonly 20 - 30 yr olds
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Sx of CD:
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1. chronic/nocturnal D
2. ab pain 3. wt loss 4. rectal bleeding 5. inflamm in other parts of the body 6. spondylarthritis 7. peripheral arthritis 8. skin manifestations (rash) |
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UC/CD experiences systemic Sx.
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CD experiences systemic Sx.
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matching:
a. aminosalicylate b. Abx c. corticosteroid d. thiopurine e. methotrexate f. calcinurin inhibitor h. anti-TNF 1. cyclosporine 2. methotrexate 3. infliximab 4. metronidazole 5. mesalamine 6. 6-MP mercaptopurine 7. budesonide 8. tacrolimus 9. adalmumab 10. azathiopurine 11. betamethasone 12. balsalzide 13. sulfasalazine 14. prednisone 15. hydrocortisone |
1. cyclosporine
2. methotrexate 3. infliximab 4. metronidazole 5. mesalamine 6. 6-MP mercaptopurine 7. budesonide 8. tacrolimus 9. adalmumab 10. azathiopurine 11. betamethasone 12. balsalzide 13. sulfasalazine 14. prednisone 15. hydrocortisone |
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matching:
a. aminosalicylate b. Abx c. corticosteroid d. thiopurine e. methotrexate f. calcinurin inhibitor h. anti-TNF 1. SE stevens-johnson 2. not for maintenance 3. gm - coverage 4. slow onset of action 5. must monitor for myelotoxicity 6. folic acid can help w/ GI SE from ____ 7. unlabeled use for UC 8. must screen for TB |
aminosalicylate 1. SE stevens-johnson
steroids 2. not for maintenance abx 3. gm - coverage thiopurines 4. slow onset of action thiopurines 5. must monitor for myelotoxicity methotrexate 6. folic acid can help w/ GI SE from ____ calcinurin inh 7. unlabeled use for UC anti-TNF 8. must screen for TB |
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what DF do aminosalicylates NOT come in?
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IV
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HA, N, D, epigastric pain are commonly assoc'd w/ which DF of aminosalicylates?
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PO
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Which is safer during pregnancy pentasa or asacol?
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pentasa (B) bc asacol is C
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should Abx be used for IBD?
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no clear evidence, but maybe for CD
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1. metronidazole covers ____
2. ciprofloxacin covers ____ |
1. metronidazole covers anaerobes
2. ciprofloxacin covers gm -- |
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cipro / metro
1. it's better to use ____ w/ pouchitis 2. peripheral neuropathy is a concern w/ ____ 3. ____ is safer during pregnancy 4. you may see tendon weakness w/ ____ if you're also using steroids |
1. it's better to use cipro w/ pouchitis
2. peripheral neuropathy is a concern w/ metronidazole 3. metronidazole is safer during pregnancy 4. you may see tendon weakness w/ cipro if you're also using steroids |
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1. what is the min amt of time you MUST taper steroids?
2. what if you taper too quickly? |
1. 8 wks
2. PT will relapse |
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steroids may cause what issue if pregnant?
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cleft palate
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T/F steroids can be used in flares and maintenance.
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F only flares
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what are AEs of steroids?
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1. wt gain
2. immunosuppression 3. hyperglycemia 4. moon face / cushing's 5. buffalo hump 6. insomnia 7. osteoporosis 8. psychosis 9. thinning of skin |
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1. how long does it take thiopurines to work?
2. what do you use thiopurines w/ (adjunct)? |
1. 3-6 mo
2. steroids or calcinurin inhibitors |
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thiopurines are effective for PTs that have not responded to ____
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mesalamine
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dosing for thiopurines:
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azathioprine 2 - 2.5mg/kg/d PO
6-MP 0.75 - 1.5 mg/kg/d PO |
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AE of thiopurines:
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allergic rxn, leukopenia
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thiopurines monitoring:
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myelotoxicity --> CBC qwk for 1st 8 wks then q3 mo
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what is TPMT?
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metabolizes thiopurine, may cause myelotoxicity, can be measured before starting on thiopurines
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T/F thiopurines are safe during pregnancy
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T they are safe
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