Cancer Treatment Medications

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Questions and Answers

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?

CT scan Signup and view all the answers

Which of the following medications is an immunomodulator?

Mercaptopurine Signup and view all the answers

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

Surgery Signup and view all the answers

What is the primary goal of treatment for intestinal obstruction?

Removing the obstruction Signup and view all the answers

Which of the following is a complication of intestinal obstruction?

Perforation Signup and view all the answers

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

Abdominal pain Signup and view all the answers

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

Location of inflammation in the GI tract Signup and view all the answers

What is the primary location affected in Ulcerative Colitis?

Rectum and sigmoid Signup and view all the answers

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

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

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

Induce remission Signup and view all the answers

What is the primary goal of dietary treatment in IBD?

To reduce inflammation through a low-residue diet Signup and view all the answers

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

To induce remission Signup and view all the answers

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

Inhibition of prostaglandins, leading to decreased inflammation Signup and view all the answers

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

Adalimumab Signup and view all the answers

What is the main complication of Crohn's Disease?

Fistulas Signup and view all the answers

What is the primary action of corticosteroids in IBD treatment?

Decrease of inflammation, but with a risk of hyperglycemia Signup and view all the answers

What is the purpose of immunomodulators in IBD treatment?

To alter the immune response, leading to decreased inflammation Signup and view all the answers

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

To remove affected areas of the intestine Signup and view all the answers

What is the primary treatment option for IBS?

High fiber diet Signup and view all the answers

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

Severe inflammation that does not respond to medical therapy Signup and view all the answers

What is the characteristic of the stools in Ulcerative Colitis?

Bloody, liquid, and grayish in color 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?

Intestinal Obstruction Signup and view all the answers

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

Hepatitis A Signup and view all the answers

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

Providing high-calorie and high-carbohydrate diet Signup and view all the answers

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

Monitoring blood glucose levels Signup and view all the answers

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

Chronic hepatitis B and C Signup and view all the answers

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

To reduce inflammation and swelling Signup and view all the answers

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

Bowel ischemia Signup and view all the answers

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

To prevent nausea and vomiting Signup and view all the answers

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

Visible peristaltic waves Signup and view all the answers

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

Hypokalemia Signup and view all the answers

What is the typical electrolyte imbalance seen in paralytic ileus?

Hypokalemia Signup and view all the answers

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

Lower abdominal distention Signup and view all the answers

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

Metabolic alkalosis Signup and view all the answers

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

Volvulus Signup and view all the answers

What is the typical abdominal examination finding in intestinal obstruction?

Distension Signup and view all the answers

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

White blood cell count 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.