NURS 5333 Family 1 Geriatrics delirium
and GI part 2 Study Guide + Questions
with Accurate Solutions
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:
,-Cigarette smoking
-Dietary factors can trigger Crohn's disease.
-Diet is high in refined sugars, animal fat, protein meat and fish.
-If they get Clostridium difficile infection, this may trigger flare and make treatment
of Crohn's disease more difficult
Chron's interview with pt...
fatigue, fever, weight loss, prolonged diarrhea, perianal disease, crampy
abdominal pain, and bleeding.
Children will actually present with failure to thrive.
Factors that exacerbate Crohn's disease are recurrent infections, smoking,
NSAIDs, antibiotics, and stress.
Presentation of Crohn's disease
varies with location of the disease
-s/s sepsis, fever, tachycardia, hypotension, or wasting, and malnutrition.
On abdominal exam: focal or diffuse tenderness, distention, rebound guarding,
rectal disease, or a palpable mass.
Perianal exam will show fistula and fissures, erythema nodosum( in picture),
possibly psoriasis on the dermatologic exam.
Lab tests for Chrons?
"I BLED Bloody Stool Come C"
serum Iron
, vitamin B12
liver function tests
ESR
vitamin D 25-OH
blood serum chemistries
stool calprotectin
C-reactive protein
CBC
Diagnostic Tests for chrons
Upper endoscopy should be done for patients with upper GI symptoms which would be
antral narrowing, segmental stricturing, or inflammatory mucosa. If there's small bowel
involvement,
CT or MRE
MRE has no radiation so this is important in young patients.
A capsule endoscopy allows small bowel visualization but no biopsy
Signs of small bowel disease are
"CHRISTMAS FIR"
cobblestone appearance
high temp
Reduced Lumen
Intestinal Fistulae
and GI part 2 Study Guide + Questions
with Accurate Solutions
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:
,-Cigarette smoking
-Dietary factors can trigger Crohn's disease.
-Diet is high in refined sugars, animal fat, protein meat and fish.
-If they get Clostridium difficile infection, this may trigger flare and make treatment
of Crohn's disease more difficult
Chron's interview with pt...
fatigue, fever, weight loss, prolonged diarrhea, perianal disease, crampy
abdominal pain, and bleeding.
Children will actually present with failure to thrive.
Factors that exacerbate Crohn's disease are recurrent infections, smoking,
NSAIDs, antibiotics, and stress.
Presentation of Crohn's disease
varies with location of the disease
-s/s sepsis, fever, tachycardia, hypotension, or wasting, and malnutrition.
On abdominal exam: focal or diffuse tenderness, distention, rebound guarding,
rectal disease, or a palpable mass.
Perianal exam will show fistula and fissures, erythema nodosum( in picture),
possibly psoriasis on the dermatologic exam.
Lab tests for Chrons?
"I BLED Bloody Stool Come C"
serum Iron
, vitamin B12
liver function tests
ESR
vitamin D 25-OH
blood serum chemistries
stool calprotectin
C-reactive protein
CBC
Diagnostic Tests for chrons
Upper endoscopy should be done for patients with upper GI symptoms which would be
antral narrowing, segmental stricturing, or inflammatory mucosa. If there's small bowel
involvement,
CT or MRE
MRE has no radiation so this is important in young patients.
A capsule endoscopy allows small bowel visualization but no biopsy
Signs of small bowel disease are
"CHRISTMAS FIR"
cobblestone appearance
high temp
Reduced Lumen
Intestinal Fistulae
