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13 Cards in this Set
- Front
- Back
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What are the long term complications of uc |
Colectoral cancer Secondary osteoporosis Venous thromboembolism Toxic mega colon |
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What is a contraindication during acute flare ups of uc |
Loperamide/codeine for |
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In uc when is oral treatment used? |
Extensive colitis (proximal) Inflammation affecting most of the ascending (proximal) colon. Affects whole colon |
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In uc when are suppositories used? |
In proctitis- inflammation of rectum
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When are enemas and foam preparations used? |
Back (Definition) |
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What is the treatment for acute mild-moderate uc? Proctitis |
1st line aminosalicylate - rectal If not in remission after 4 weeks add oral aminosalicylate Alternative - rectal corticosteroid or oral prednisolone |
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What is the treatment for acute mild to moderate proctosigmoiditis and left sided colitis? |
1st line - rectal aminosalicylate 2nd line - if remission isn’t achieved after 4 weeks high dose oral aminosalicylate Add rectal aminosalicylate or or oral beclometasone if necessary Alternative- oral prednisolone alone
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What is the treatment for acute mild to moderate extensive colitis? |
Topical aminosalicylate and high dose oral aminosalicylate
2nd line if no remission within 4 weeks - stop topical aminosalicylate and give high dose oral aminosalicylate and prednisolone |
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What is the treatment for subacute (moderate-severe) uc? |
Oral prednisolone Alternative: monoclonal antibodies or biological drugs - Adalimumab, infliximab |
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What is the treatment for initial treatment failure in all extents of acute mild- moderate uc? |
Add oral prednisolone after 4 weeks with aminosalicylate or topical corticosteroid after 4-8 weeks Add oral tacrolimus if no response after 2-4 weeks |
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What is the treatment for severe acute uc |
Immediate hospital admission - life threatening medical emergency. 1st line - iv corticosteroids e.g hydrocortisone or methyl prednisolone AND assess need for surgery Alternative- iv ciclosporin OR surgery 2nd line - symptoms don’t improve/worsen within 72 hours Iv ciclosporin + iv corticosteroid OR surgery Alternative to ciclosporin - infliximab |
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How is remission maintained in proctitis and proctosigmoiditis? |
Rectal amino salicylate alone or with oral aminosalicylate - administered daily or as part of intermittent regimen e.g 2-3 times weekly or first 7 days of each month Can give oral aminosalicylates alone if patients prefer not to use enemas/suppositories but not as effective |
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How is remission maintained in extensive colitis and left sided colitis? |
Low dose oral aminosalicylate Single daily dose more effective than multiple daily doses but has more side effects
Oral azathioprine/mercaptopurine If 2+ acute flare ups in 12 months that required systemic corticosteroids or if remission not maintained by aminosalicylates or after severe flare up |
