IBD Maintenance Treatment Drugs Quiz
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IBD Maintenance Treatment Drugs Quiz

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Questions and Answers

What is the most common occurrence in patients with fistulating Crohn’s disease?

  • Sepsis associated with fistulae
  • Asymptomatic perianal fistulae
  • Peripheral neuropathy
  • Symptomatic perianal fistulae (correct)

    • Which medication is usually given for up to 3 months due to concerns about peripheral neuropathy in the treatment of fistulating Crohn’s disease?

  • Azathioprine
  • Metronidazole (correct)
  • Mercaptopurine
  • Ciprofloxacin

    • Which medication is used to control inflammation in fistulating Crohn’s disease and is continued for maintenance?

  • Colestyramine
  • Loperamide hydrochloride
  • Codeine phosphate
  • Azathioprine (correct)

    • What is a common approach to managing symptomatic fistulating Crohn’s disease besides medical therapy?

    <p>Surgical drainage</p> Signup and view all the answers

    Which antibiotic can improve symptoms of fistulating Crohn’s disease, but complete healing rarely occurs?

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

    What is the primary aim of drug treatment for Crohn's disease?

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

    Which type of treatment aims to close and maintain closure of fistulas in Crohn's disease?

    <p>Non-drug treatment</p> Signup and view all the answers

    Which medication is typically used as monotherapy to induce remission in acute Crohn's disease?

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

    In Crohn's disease, what plays an important role in supportive care aside from drug treatment?

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

    When should surgery be considered in patients with Crohn's disease?

    <p>In all cases</p> Signup and view all the answers

    What is the recommended treatment for patients with active fistulating Crohn's disease who have not responded to conventional therapy?

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

    What should be ensured before using Infliximab in patients with sepsis?

    <p>All sepsis is actively draining</p> Signup and view all the answers

    What is the only recommended approach for managing non-perianal fistulating Crohn's disease?

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

    Which condition is characterized by diffuse mucosal inflammation and has a relapsing-remitting pattern?

    <p>Ulcerative colitis</p> Signup and view all the answers

    What should be continued as maintenance treatment for at least one year in patients with active fistulating Crohn's disease?

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

    What is a common symptom of Crohn’s disease?

    <p>Rectal bleeding</p> Signup and view all the answers

    Which complication can arise in Crohn's disease that involves the formation of a fistula between the intestine and adjacent structures?

    <p>Perianal fistula</p> Signup and view all the answers

    What are common extra-intestinal manifestations associated with Crohn's disease?

    <p>Eye abnormalities</p> Signup and view all the answers

    Which of the following is a potential complication of Crohn’s disease that may require surgical intervention?

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

    In Crohn's disease management, what might be monitored in patients at risk to assess the risk of fractures?

    <p>Bone density (osteopenia)</p> Signup and view all the answers

    What is the recommended treatment for patients with acute moderate-to-severe ulcerative colitis who are under specialist care?

    <p>Janus kinase inhibitors</p> Signup and view all the answers

    In the treatment of acute severe ulcerative colitis, when should immediate hospital admission be considered?

    <p>In cases of lifethreatening conditions</p> Signup and view all the answers

    What is the second-line therapy for patients with acute severe ulcerative colitis who show little or no improvement within 72 hours of starting intravenous corticosteroids?

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

    If intravenous corticosteroids are contraindicated, declined, or cannot be tolerated in the treatment of acute severe ulcerative colitis, what other treatment option should be considered?

    <p>Intravenous ciclosporin</p> Signup and view all the answers

    Which medication can be used to treat acute exacerbations of severely active ulcerative colitis if ciclosporin is contraindicated or clinically inappropriate?

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

    What is the recommended treatment for maintaining remission in patients with ileocolonic Crohn's disease who have had complete macroscopic resection within the previous 3 months?

    <p>Azathioprine in combination with up to 3 months' postoperative metronidazole</p> Signup and view all the answers

    Why are biologic therapies no longer recommended to maintain remission after complete macroscopic resection of ileocolonic Crohn's disease?

    <p>There is limited evidence supporting their use</p> Signup and view all the answers

    Which drug is indicated for Crohn's disease patients intolerant of or unsuitable for azathioprine or mercaptopurine for maintenance?

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

    Why are aminosalicylates no longer recommended for Crohn's disease management?

    <p>They lack clinical efficacy</p> Signup and view all the answers

    When should budesonide be used in patients with Crohn's disease?

    <p>Never in patients post-macroscopic resection</p> Signup and view all the answers

    For patients with extensive ulcerative colitis, what is the first-line treatment recommended for mild-to-moderate initial presentation or inflammatory exacerbation?

    <p>Combine a topical aminosalicylate and a high-dose oral aminosalicylate</p> Signup and view all the answers

    What is recommended as monotherapy for patients with proctosigmoiditis who prefer not to use enemas or suppositories?

    <p>High-dose oral aminosalicylate</p> Signup and view all the answers

    If remission is not achieved in patients with left-sided ulcerative colitis within 4 weeks of aminosalicylate treatment, what should be considered next?

    <p>Add a high-dose oral aminosalicylate</p> Signup and view all the answers

    What should be offered to patients with extensive ulcerative colitis if initial treatment with topical aminosalicylate does not result in remission?

    <p>High-dose oral aminosalicylate</p> Signup and view all the answers

    Which treatment approach should be considered for patients in whom aminosalicylates are unsuitable?

    <p>Both oral and topical corticosteroids</p> Signup and view all the answers

    What should be offered if response remains inadequate after adding an oral corticosteroid to high-dose aminosalicylate treatment?

    <p>Topical treatment</p> Signup and view all the answers

    In what situation should monotherapy with high-dose oral aminosalicylate be considered for patients with proctosigmoiditis?

    <p>For patients who prefer not to use enemas or suppositories</p> Signup and view all the answers

    Which treatment option should be offered if remission is not achieved within 4 weeks despite using either topical or oral corticosteroids?

    <p>Add a high-dose oral aminosalicylate</p> Signup and view all the answers

    What is the main symptom of coeliac disease?

    <p>Malabsorption of nutrients</p> Signup and view all the answers

    Which of the following is a common symptom of diverticular disease?

    <p>Acute abdominal pain</p> Signup and view all the answers

    What action should be taken if a patient presents with diverticulitis symptoms?

    <p>Start a high-fiber diet</p> Signup and view all the answers

    Which of the following is NOT a typical symptom of diverticular disease?

    <p>Weight gain</p> Signup and view all the answers

    What type of pain is commonly experienced by individuals with diverticulitis?

    <p>Stabbing lower abdomen pain</p> Signup and view all the answers

    Which age group is most commonly affected by diverticular disease?

    <p>Over 40 years old</p> Signup and view all the answers

    What distinguishes diverticulosis from diverticular disease?

    <p>Occasional large rectal bleeds</p> Signup and view all the answers

    Which condition shares symptoms that may overlap with diverticular disease according to the text?

    <p>Irritable bowel syndrome</p> Signup and view all the answers

    What distinguishes acute diverticulitis from uncomplicated diverticular disease?

    <p>Presence of fever and rectal bleeding</p> Signup and view all the answers

    Which term defines the presence of small pouches protruding from the walls of the large intestine?

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

    What is one of the aims of treatment for diverticular disease?

    <p>Improve quality of life</p> Signup and view all the answers

    What dietary advice should be given to patients with diverticulosis or diverticular disease?

    <p>Increase dietary fibre intake</p> Signup and view all the answers

    Which symptom may indicate acute diverticulitis?

    <p>Rectal bleeding</p> Signup and view all the answers

    What is a potential complication of chronic bowel disorders according to the text?

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

    In the context of gastrointestinal diseases, what is a common non-drug management approach besides diet and lifestyle changes?

    <p>Surgical intervention</p> Signup and view all the answers

    What is the recommended approach for patients with acute diverticulitis who are systemically well?

    <p>Watchful waiting and no antibacterial prescribing</p> Signup and view all the answers

    When should patients with suspected complicated acute diverticulitis and uncontrolled abdominal pain be referred to the hospital?

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

    What is not recommended for preventing recurrent acute diverticulitis?

    <p>Treatment with aminosalicylates</p> Signup and view all the answers

    In the management of diverticulitis, what should be offered to patients with persistent or worsening symptoms?

    <p>Watchful waiting and reassessment</p> Signup and view all the answers

    What should be considered for patients with significant rectal bleeding due to diverticular disease?

    <p>Urgent hospital referral</p> Signup and view all the answers

    What is a recommended approach for managing diverticulosis, an asymptomatic condition?

    <p>Implementing a high-fiber diet</p> Signup and view all the answers

    Which medication is NOT recommended for patients with diverticular disease?

    <p>Nonsteroidal anti-inflammatory drugs</p> Signup and view all the answers

    What is the suggested treatment for patients with persistent constipation or diarrhea related to diverticular disease?

    <p>Bulk-forming laxatives</p> Signup and view all the answers

    In patients with acute diverticulitis, what may be required based on the severity of the condition?

    <p>Surgical management</p> Signup and view all the answers

    What should patients with diverticular disease be informed about concerning the benefits of increasing fiber in their diet?

    <p>Long-term commitment to a high-fiber diet</p> Signup and view all the answers

    What is the primary aim of managing coeliac disease?

    <p>Reducing the risk of complications from malabsorption</p> Signup and view all the answers

    Why should patients with coeliac disease be advised against self-medicating with over-the-counter vitamins or mineral supplements?

    <p>To avoid potential interactions with other drugs</p> Signup and view all the answers

    Why is supplementation of key nutrients sometimes required for patients with coeliac disease?

    <p>To compensate for insufficiencies in dietary intake</p> Signup and view all the answers

    Which of the following is the only effective treatment for coeliac disease?

    <p>Strict, life-long, gluten-free diet</p> Signup and view all the answers

    What should be undertaken before initiating supplementation for patients with coeliac disease?

    <p>Consultation with a member of the healthcare team</p> Signup and view all the answers

    Which symptom is NOT commonly associated with Crohn's disease?

    <p>Weight gain</p> Signup and view all the answers

    What is a potential complication of Crohn's disease that can lead to growth failure and delayed puberty in children?

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

    Which symptom is characteristic of diverticulitis?

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

    What is a common symptom of coeliac disease?

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

    Which condition presents with thickened areas of the gastro-intestinal wall and deep ulceration with granulomas?

    <p>Crohn's disease</p> Signup and view all the answers

    What symptom is NOT typically seen in diverticular disease?

    <p>Weight loss</p> Signup and view all the answers

    Which disease may be associated with extra-intestinal manifestations such as arthritis and skin abnormalities?

    <p>Crohn's disease</p> Signup and view all the answers

    What can be a potential complication of Crohn's disease that involves the formation of a fistula between the intestine and other structures?

    <p>Colorectal cancer</p> Signup and view all the answers

    Which symptom is NOT commonly associated with coeliac disease?

    <p>Rectal bleeding</p> Signup and view all the answers

    What symptom can be indicative of Crohn's disease?

    <p>Blood in stool</p> Signup and view all the answers

    What is a potential complication of diverticular disease involving acute inflammation or infection of the diverticula?

    <p>Formation of fistulas between the intestine and other structures</p> Signup and view all the answers

    Which symptom is commonly shared between coeliac disease and diverticular disease?

    <p>Upper abdominal pain</p> Signup and view all the answers

    What should be considered if patients with diverticular disease experience mild abdominal pain, constipation, or occasional rectal bleeds?

    <p>Management with high-fiber diet and lifestyle changes</p> Signup and view all the answers

    Which feature is characteristic of acute diverticulitis compared to chronic diverticular disease?

    <p>Palpable abdominal mass</p> Signup and view all the answers

    When patients with suspected diverticular disease present with abdominal tenderness, mild lower abdominal pain, and constipation, what condition should be differentiated to avoid misdiagnosis?

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

    Which autoimmune condition is associated with chronic inflammation of the small intestine due to abnormal immune response in the intestinal mucosa?

    <p>Coeliac disease</p> Signup and view all the answers

    What dietary proteins, when consumed, can lead to malabsorption of nutrients in individuals with coeliac disease?

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

    In confirmed cases of refractory coeliac disease, what treatment can be considered for initial management while awaiting specialist advice?

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

    Which gastrointestinal disorder is characterized by diverticular disease and diverticulitis, often requiring different management approaches?

    <p>Inflammatory bowel disease</p> Signup and view all the answers

    For individuals with diverticular disease and diverticulitis, what type of care is recommended for maintaining remission and preventing complications?

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

    What is the recommended initial treatment for patients with acute diverticulitis who are systemically well?

    <p>Simple analgesia with paracetamol</p> Signup and view all the answers

    Which patients should be referred to hospital urgently for suspected complicated acute diverticulitis?

    <p>Those with significant rectal bleeding</p> Signup and view all the answers

    Why are aminosalicylates or prophylactic antibacterials not recommended for preventing recurrent acute diverticulitis?

    <p>They have no role in diverticulitis management</p> Signup and view all the answers

    What should patients with Crohn's disease avoid self-medicating with to prevent complications?

    <p>Over-the-counter vitamins or mineral supplements</p> Signup and view all the answers

    Which intervention is preferred if response remains inadequate after adding an oral corticosteroid to high-dose aminosalicylate treatment?

    <p>Consider alternative treatment options</p> Signup and view all the answers

    What is the primary aim of treating diverticular disease?

    <p>To relieve symptoms and improve quality of life</p> Signup and view all the answers

    In diverticular disease, what dietary advice should be given to patients with constipation on a low-fiber diet?

    <p>Gradually increase dietary fiber intake</p> Signup and view all the answers

    What should patients with diverticulosis or diverticular disease be advised to include in their diet?

    <p>Whole grains, fruit, and vegetables</p> Signup and view all the answers

    What is the advice regarding fluid intake when patients increase their dietary fiber?

    <p>Increase fluid intake</p> Signup and view all the answers

    What is a key aspect of non-drug management for diverticular disease patients and their families?

    <p>Educating about diet, lifestyle changes, and symptom management</p> Signup and view all the answers

    What is a key consideration in the management of an arrhythmia?

    <p>Precise diagnosis of the underlying causes</p> Signup and view all the answers

    In the context of atrial fibrillation, what is the primary aim of treatment?

    <p>Reducing symptoms and preventing complications</p> Signup and view all the answers

    For patients with atrial fibrillation, what should they be assessed for?

    <p>Risk of stroke and thromboembolism</p> Signup and view all the answers

    In cases of persistent ectopic beats, what is sometimes used as a treatment option?

    <p>Beta-blockers</p> Signup and view all the answers

    How can atrial fibrillation be managed according to the text?

    <p>'Rate control' or 'rhythm control'</p> Signup and view all the answers

    What is the recommended action for patients with life-threatening hemodynamic instability caused by new-onset atrial fibrillation?

    <p>Undergoing emergency electrical cardioversion without delay</p> Signup and view all the answers

    What is the preferred method of cardioversion for patients with atrial fibrillation present for more than 48 hours?

    <p>Electrical cardioversion</p> Signup and view all the answers

    When is rate control preferred over rhythm control in patients with atrial fibrillation according to the text?

    <p>When the onset of arrhythmia is more than 48 hours</p> Signup and view all the answers

    Which anti-arrhythmic drug can be used for pharmacological cardioversion in patients without structural or ischemic heart disease?

    <p>Flecainide acetate</p> Signup and view all the answers

    What should be avoided in patients with suspected acute decompensated heart failure presenting with atrial fibrillation?

    <p>Calcium-channel blockers</p> Signup and view all the answers

    What should be ensured before performing electrical cardioversion in patients with atrial fibrillation present for more than 48 hours?

    <p>Full anticoagulation for at least 3 weeks</p> Signup and view all the answers

    Which medication can be given intravenously for urgent rate control in patients with atrial fibrillation?

    <p>Beta-blockers</p> Signup and view all the answers

    What type of management is recommended for patients with suspected concomitant acute decompensated heart failure and atrial fibrillation?

    <p>Seeking senior specialist advice on beta-blockers</p> Signup and view all the answers

    What medication may be considered for maintaining sinus rhythm up to 12 months after electrical cardioversion?

    <p>Amiodarone hydrochloride</p> Signup and view all the answers

    In patients with new-onset atrial fibrillation to be treated with a rhythm-control strategy, what should be considered in choosing between pharmacological and electrical cardioversion?

    <p>Clinical circumstances</p> Signup and view all the answers

    What is the preferred first-line treatment strategy for atrial fibrillation, except in certain cases?

    <p>Rate control</p> Signup and view all the answers

    When should digoxin monotherapy be considered for initial rate control in patients with atrial fibrillation?

    <p>In predominantly active patients with non-paroxysmal atrial fibrillation</p> Signup and view all the answers

    What medication can be used to control ventricular rate as monotherapy, according to the text?

    <p>Diltiazem hydrochloride</p> Signup and view all the answers

    When considering combination therapy for ventricular rate control, which drug should NOT be combined with digoxin?

    <p>Sotalol hydrochloride</p> Signup and view all the answers

    What factors should be considered when choosing the appropriate rate-control drug for a patient?

    <p>Comorbidities and heart rate</p> Signup and view all the answers

    Study Notes

    • Treatment for Crohn's disease aims to induce and maintain remission, relieve symptoms, and improve quality of life while minimizing drug toxicity.
    • Non-drug management options for Crohn's disease include smoking cessation, attention to nutrition, and surgery in certain cases.
    • Drug treatment for acute Crohn's disease includes corticosteroids for remission induction, loperamide or codeine for diarrhea management, and colestyramine for relief of diarrhea.
    • In fistulating Crohn's disease, surgery and medical treatment aim to close and maintain closure of the fistula, with options such as metronidazole, ciprofloxacin, azathioprine, mercaptopurine, and infliximab.
    • Ulcerative colitis is characterized by chronic inflammatory conditions with a relapsing-remitting pattern and significant morbidity.
    • Treatment for acute moderate-to-severe ulcerative colitis can include Janus kinase inhibitors, biological drugs, intravenous corticosteroids, ciclosporin, or surgery.
    • For acute severe ulcerative colitis, immediate hospital admission is required, with options including intravenous corticosteroids, ciclosporin, and infliximab in certain cases.

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    Description

    Test your knowledge on the maintenance treatment drugs for inflammatory bowel disease including methotrexate, azathioprine, and mercaptopurine. Learn about the indications and contraindications for using these medications in IBD patients.

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