Cancer Treatment Medications
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What is the primary mechanism of action of biological therapies in reducing inflammation?

  • Enhancing the activity of immunomodulators
  • Stimulating the immune system
  • Increasing the production of corticosteroids
  • Reducing the activity of tumor necrosis factor (TNF) (correct)
  • What is the most common cause of intestinal obstruction?

  • Twisting of the bowel
  • Paralytic ileus
  • Tumors
  • Adhesions (correct)
  • Which of the following is a clinical presentation of intestinal obstruction?

  • Weight loss
  • Diarrhea
  • Abdominal distension (correct)
  • Increased appetite
  • What is the diagnostic tool used to confirm intestinal obstruction?

    <p>CT scan</p> Signup and view all the answers

    Which of the following medications is an immunomodulator?

    <p>Mercaptopurine</p> Signup and view all the answers

    What is the treatment option for intestinal obstruction caused by twisting of the bowel?

    <p>Surgery</p> Signup and view all the answers

    What is the primary goal of treatment for intestinal obstruction?

    <p>Removing the obstruction</p> Signup and view all the answers

    Which of the following is a complication of intestinal obstruction?

    <p>Perforation</p> Signup and view all the answers

    What is the primary symptom of Irritable Bowel Syndrome (IBS)?

    <p>Abdominal pain</p> Signup and view all the answers

    What is the main difference between Crohn's Disease and Ulcerative Colitis?

    <p>Location of inflammation in the GI tract</p> Signup and view all the answers

    What is the primary location affected in Ulcerative Colitis?

    <p>Rectum and sigmoid</p> Signup and view all the answers

    What is the purpose of a barium enema in IBD diagnosis?

    <p>To help differentiate between Crohn's disease and Ulcerative Colitis</p> Signup and view all the answers

    What is the primary goal of treatment in Crohn's Disease?

    <p>Induce remission</p> Signup and view all the answers

    What is the primary goal of dietary treatment in IBD?

    <p>To reduce inflammation through a low-residue diet</p> Signup and view all the answers

    What is the role of corticosteroids in the treatment of Crohn's Disease?

    <p>To induce remission</p> Signup and view all the answers

    What is the mechanism of action of aminosalicylates in IBD treatment?

    <p>Inhibition of prostaglandins, leading to decreased inflammation</p> Signup and view all the answers

    What is the name of the biologic medication used to treat Crohn's Disease?

    <p>Adalimumab</p> Signup and view all the answers

    What is the main complication of Crohn's Disease?

    <p>Fistulas</p> Signup and view all the answers

    What is the primary action of corticosteroids in IBD treatment?

    <p>Decrease of inflammation, but with a risk of hyperglycemia</p> Signup and view all the answers

    What is the purpose of immunomodulators in IBD treatment?

    <p>To alter the immune response, leading to decreased inflammation</p> Signup and view all the answers

    What is the role of surgery in the treatment of Crohn's Disease?

    <p>To remove affected areas of the intestine</p> Signup and view all the answers

    What is the primary treatment option for IBS?

    <p>High fiber diet</p> Signup and view all the answers

    What is the complication of Ulcerative Colitis that may require surgery?

    <p>Severe inflammation that does not respond to medical therapy</p> Signup and view all the answers

    What is the characteristic of the stools in Ulcerative Colitis?

    <p>Bloody, liquid, and grayish in color</p> Signup and view all the answers

    What is the likely diagnosis of the patient who becomes increasingly somnolent and has a drop in BP after being admitted to the surgical floor?

    <p>Intestinal Obstruction</p> Signup and view all the answers

    Which type of hepatitis is transmitted through the fecal-oral route?

    <p>Hepatitis A</p> Signup and view all the answers

    What is the primary goal of nutrition therapy in the management of severe malnutrition?

    <p>Providing high-calorie and high-carbohydrate diet</p> Signup and view all the answers

    What is the primary intervention for managing hyperglycemia in patients receiving total parenteral nutrition?

    <p>Monitoring blood glucose levels</p> Signup and view all the answers

    What is the primary indication for using antiviral and immunomodulating drugs in patients with hepatitis?

    <p>Chronic hepatitis B and C</p> Signup and view all the answers

    What is the primary purpose of administering corticosteroids in the management of intestinal obstruction?

    <p>To reduce inflammation and swelling</p> Signup and view all the answers

    What is the primary complication of intestinal obstruction that requires close monitoring?

    <p>Bowel ischemia</p> Signup and view all the answers

    What is the primary goal of administering antiemetic medications in patients with hepatitis?

    <p>To prevent nausea and vomiting</p> Signup and view all the answers

    What is the characteristic feature of small-bowel intestinal obstruction?

    <p>Visible peristaltic waves</p> Signup and view all the answers

    Which of the following is a common cause of paralytic ileus?

    <p>Hypokalemia</p> Signup and view all the answers

    What is the typical electrolyte imbalance seen in paralytic ileus?

    <p>Hypokalemia</p> Signup and view all the answers

    Which of the following is a characteristic feature of large-bowel intestinal obstruction?

    <p>Lower abdominal distention</p> Signup and view all the answers

    What is the typical acid-base imbalance seen in small-bowel obstruction?

    <p>Metabolic alkalosis</p> Signup and view all the answers

    Which of the following is a type of mechanical intestinal obstruction?

    <p>Volvulus</p> Signup and view all the answers

    What is the typical abdominal examination finding in intestinal obstruction?

    <p>Distension</p> Signup and view all the answers

    Which of the following laboratory tests is often elevated in intestinal obstruction?

    <p>White blood cell count</p> Signup and view all the answers

    Study Notes

    Inflammatory Bowel Disease (IBD)

    • Idiopathic, inflammatory, autoimmune disease
    • Age of onset: 20-30s
    • Higher incidence in Caucasians than African Americans and Hispanics
    • Higher incidence in developed countries
    • Higher risk for colon cancer and decreased quality of life due to symptoms

    Types of IBD

    • Crohn's Disease (CD)
      • Inflammatory disease of small intestine (mainly) and can occur anywhere in GI tract
      • Inflammation causes thickening, leading to fistulas and/or bowel obstruction
    • Ulcerative Colitis (UC)
      • Ends in "itis"
      • Affects colon (ulcers)
      • Most cases only affect the rectum and sigmoid
      • Continuous and diffuse inflammation

    Signs and Symptoms of IBD

    • Crohn's Disease:
      • Diarrhea
      • Abdominal pain
      • Fever
      • Anorexia
      • Visible peristalsis
      • Anemia
      • Weight loss
      • Fistula
      • Signs of poor nutrition (brittle nails and hair, malabsorption)
    • Ulcerative Colitis:
      • Bloody, liquid stools with mucus
      • Urge to defecate comes on quickly
      • Nutritional deficiencies
      • Hemorrhage
      • LLQ abdominal pain
      • Weight loss
      • Tenesmus (rectal fullness, inability to pass stools, straining during BMs)

    Diagnosis and Treatment of IBD

    • Diagnosis:
      • Barium enema
      • Colonoscopy
      • Sigmoidoscopy
      • Biopsy
    • Treatment:
      • Medications:
        • Aminosalicylates (inhibit prostaglandins, decreasing inflammation)
        • Corticosteroids (decrease inflammation)
        • Immunomodulators (alter immune response)
      • Dietary changes:
        • Low residue diet
        • Avoid seeds, beans, nuts, and kernels
        • Avoid caffeine and alcohol
        • Increase omega-3s
        • Small, frequent meals
        • Nutritional supplements
      • Surgery (curative in UC, not in CD)

    Intestinal Obstruction

    • Small bowel obstruction:
      • Abdominal discomfort or pain with visible peristaltic waves
      • Upper or epigastric abdominal distention
      • N/V, possibly containing fecal matter
      • Obstipation
      • Severe fluid and electrolyte disturbances
    • Large bowel obstruction:
      • Intermittent lower abdominal cramping
      • Lower abdominal distention
      • Minimal or no vomiting
      • Constipation or ribbon-like stools
      • No major fluid and electrolyte imbalance
    • Diagnosis:
      • Labs: Elevated WBC, electrolyte imbalance, metabolic acidosis or alkalosis
      • PE: Distension, visible hernia?

    Irritable Bowel Syndrome (IBS)

    • Symptoms:
      • Diarrhea or constipation
      • Abdominal pain or discomfort
      • Bloating
      • Urgency to defecate
    • Diagnosis:
      • Must satisfy Rome Criteria
      • Rule out other causes
    • Treatment:
      • Dietary changes:
        • High fiber diet
        • Avoid caffeine
        • Avoid raw foods
      • Medications:
        • Antispasmodics
        • Antidepressants
        • Laxatives
      • Other treatments:
        • Peppermint oil capsules
        • TCA's (for pain and psychiatric disorders)

    Hepatitis

    • Types:
      • A: Fecal-oral route, contaminated food, like a GI illness
      • B: Blood or open sores, direct contact, unprotected sex, needle stick, sharing razor
      • C: IV drug use, chronic infection leading to cirrhosis
      • D: IV drugs, sex
      • E: Waterborne infection from fecal contamination, like hepatitis A
    • Symptoms:
      • Flu-like symptoms
      • Fatigue
      • Loss of appetite
      • Nausea and vomiting
      • Abdominal pain
      • Dark urine
      • Yellowing of the skin and eyes

    Osteomalacia

    • Interventions and nutrition therapy:
      • Rest
      • High carbohydrate and calorie diet
      • Moderate fat and low-moderate protein diet
      • Small frequent meals
      • Avoid alcohol
      • Vitamin supplements
    • Drug therapy:
      • Antiemetic
      • Antiviral and immunomodulating drugs for chronic hepatitis B and C

    Nutritional Options

    • Total Parenteral Nutrition (TPN):
      • Management of severe malnutrition
      • Lab values: Pre-albumin, blood glucose
      • Interventions:
        • Change TPN bag and set within 24 hours
        • Monitor blood glucose level
        • Monitor signs and symptoms of hyperglycemia
        • Follow infusion rate and normal saline flush rate
    • Nasogastric Tube (NGT) and Jejunostomy:
      • Feeding or food supplement
      • Interventions:
        • Follow infusion rate and normal saline flush rate
        • Check for residuals
        • Position head of the bed in high Fowlers

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    Description

    This quiz covers medications used to treat cancer, including mercaptopurine and methotrexate, as well as biological therapies that reduce inflammation. It also discusses potential side effects and complications.

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