NURS 5333 Family 1 Geriatrics delirium and GI
part 2 Study Guide + Questions with Accurate
Solutions
bloody and accompanied by abdominal pain, incontinence, fever, and weight loss.
Ulcerative colitis is a chronic relapsing and remitting inflammatory disease of the bowel
causing recurrent episodes of diarrhea that is often ???
Ulcerative colitis is idiopathic.
It's possibly autoimmune dysfunction
1 genetic predisposition
-diet,
-colonic microbiome.
Almost universally involves the terminal colon, greater than 95% of the patients
have rectal involvement
Ulcerative colitis risk factors are?
Risk factors are: Age 15 to 40 years.
First degree relatives with ulcerative colitis is a risk factor
-disruption of colonic microbiome by diet or infection, --dietary factors, especially the
Western diet,
-antibiotic use
- lack of breastfeeding in an infant
- obesity, and NSAID use.
ulcerative colitis PMH?
,obtaining a history, these patients CO: frequent diarrhea that may be bloody or include
mucus, frequent small bowel movements associated with tenesmus, colicky abdominal
pain, urgency, and fecal incontinence.
Onset is gradual and progressive over weeks. Episodes are sometimes accompanied by
fever, weight loss, fatigue, and anemia.
There's a smaller peak in ages 50 to 80 years
Clinical presentation and diagnostic studies are used to determine severity of UC....
With mild, the patient will have less than four stools daily with or without blood, no
systemic symptoms, and normal erythrocyte sedimentation rate, or ESR.
Moderate is greater than four stools daily, no or minimal systemic symptoms.
Severe is greater than six blood stools daily, evidence of systemic illness with fever,
tachycardia, anemia, or high ESR.
Fulminant is usually greater than 10 stools daily, continuous bleeding, signs of systemic
illness as in severe abdominal tenderness, blood transfusion requirement, and colonic
dilatation on abdominal x-rays
leukocytosis and anemia will support a diagnosis of ulcerative colitis. Urea and
electrolyte abnormalities such as hypokalemia also support the diagnosis of ulcerative
colitis.
Liver function abnormalities such as low albumin indicate severe disease. An ESR or C-
reactive protein elevation supports the diagnosis and helps define severity.
, Ferritin and transferrrin should be done if the patient is anemic to determine the iron
deficiency versus chronic disease anemia.
initial diagnostic testing in ulcerative colitis,
You patient has SEVERE ulcerative colitis. Should they get a colonoscopy in UC/
crohns?
Complete colonoscopy in severe ulcerative colitis may be contraindicated due to the risk
of perforation or precipitation of toxic megacolon.
Pharmacologic treatment for ulcerative colitis:
oral aminosalicylate such as 5-ASA for chronic treatment of mild to moderate disease.
Balsalazide (Colazal, Giazo)
Mesalamine (Apriso, Asacol, Delzicol, Lialda, Pentasa)
Olsalazine (Dipentum)
Sulfasalazine (Azulfidine, Sulfazine)
Rectal 5-ASA options or the oral 5-ASA options as an enema or suppository are used
sometimes, steroid enemas or suppositories for proctitis or proctosigmoiditis, oral and
parenteral steroids to manage more severe exacerbations
In patients that are not responsive to steroids, immunomodulators : azathioprine and 6-
mercaptopurine.
Chron's risk factors are:
part 2 Study Guide + Questions with Accurate
Solutions
bloody and accompanied by abdominal pain, incontinence, fever, and weight loss.
Ulcerative colitis is a chronic relapsing and remitting inflammatory disease of the bowel
causing recurrent episodes of diarrhea that is often ???
Ulcerative colitis is idiopathic.
It's possibly autoimmune dysfunction
1 genetic predisposition
-diet,
-colonic microbiome.
Almost universally involves the terminal colon, greater than 95% of the patients
have rectal involvement
Ulcerative colitis risk factors are?
Risk factors are: Age 15 to 40 years.
First degree relatives with ulcerative colitis is a risk factor
-disruption of colonic microbiome by diet or infection, --dietary factors, especially the
Western diet,
-antibiotic use
- lack of breastfeeding in an infant
- obesity, and NSAID use.
ulcerative colitis PMH?
,obtaining a history, these patients CO: frequent diarrhea that may be bloody or include
mucus, frequent small bowel movements associated with tenesmus, colicky abdominal
pain, urgency, and fecal incontinence.
Onset is gradual and progressive over weeks. Episodes are sometimes accompanied by
fever, weight loss, fatigue, and anemia.
There's a smaller peak in ages 50 to 80 years
Clinical presentation and diagnostic studies are used to determine severity of UC....
With mild, the patient will have less than four stools daily with or without blood, no
systemic symptoms, and normal erythrocyte sedimentation rate, or ESR.
Moderate is greater than four stools daily, no or minimal systemic symptoms.
Severe is greater than six blood stools daily, evidence of systemic illness with fever,
tachycardia, anemia, or high ESR.
Fulminant is usually greater than 10 stools daily, continuous bleeding, signs of systemic
illness as in severe abdominal tenderness, blood transfusion requirement, and colonic
dilatation on abdominal x-rays
leukocytosis and anemia will support a diagnosis of ulcerative colitis. Urea and
electrolyte abnormalities such as hypokalemia also support the diagnosis of ulcerative
colitis.
Liver function abnormalities such as low albumin indicate severe disease. An ESR or C-
reactive protein elevation supports the diagnosis and helps define severity.
, Ferritin and transferrrin should be done if the patient is anemic to determine the iron
deficiency versus chronic disease anemia.
initial diagnostic testing in ulcerative colitis,
You patient has SEVERE ulcerative colitis. Should they get a colonoscopy in UC/
crohns?
Complete colonoscopy in severe ulcerative colitis may be contraindicated due to the risk
of perforation or precipitation of toxic megacolon.
Pharmacologic treatment for ulcerative colitis:
oral aminosalicylate such as 5-ASA for chronic treatment of mild to moderate disease.
Balsalazide (Colazal, Giazo)
Mesalamine (Apriso, Asacol, Delzicol, Lialda, Pentasa)
Olsalazine (Dipentum)
Sulfasalazine (Azulfidine, Sulfazine)
Rectal 5-ASA options or the oral 5-ASA options as an enema or suppository are used
sometimes, steroid enemas or suppositories for proctitis or proctosigmoiditis, oral and
parenteral steroids to manage more severe exacerbations
In patients that are not responsive to steroids, immunomodulators : azathioprine and 6-
mercaptopurine.
Chron's risk factors are:
