~ Ulcerative Colitis ~ - pindi

[ArchivalUser]

A 23-year-old woman has a 3-week history of rectal discomfort, tenesmus, and mild bright red blood per rectum. Bowel movements occur three or four times daily and are of normal consistency but typically are blood streaked. She also intermittently passes blood without a bowel movement. The patient does not have significant abdominal pain, nausea, vomiting, or weight loss.

Physical examination is normal except for some blood on the examining finger on rectal examination. Initial laboratory studies are also normal except for a hemoglobin of 11.2 g/dL (112 g/L). Colonoscopy shows normal mucosa in the distal ileum and throughout the colon down to the descending colon. The rectum and sigmoid colon have changes consistent with active colitis, including mucosal ulcerations, friability, and purulent exudate. Biopsy samples are consistent with ulcerative colitis. Stool cultures show no growth of pathogens.

Which of the following is the most appropriate therapy at this time?

A Mesalamine suppositories
B Oral mesalamine (Pentasa®)
C Mesalamine enemas
D Hydrocortisone enemas
E Oral prednisone

[ArchivalUser]

CCC

[ArchivalUser]

CC

[ArchivalUser]

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[ArchivalUser]

dono which mesalamine???

[ArchivalUser]

CCCCCCCCCCC

[ArchivalUser]

Topical therapy with 5-ASA compounds is the treatment of choice (not steroid enemas) for mildly active proctitis or proctosigmoiditis. They are very effective in inducing and maintaining remission. For proctitis, 5-ASA suppositories are used and enemas are recommended for proctosigmoiditis.

5-ASA enemas are significantly superior in inducing remission and have less side effects compared with steroid enemas. Although the symptomatic improvement will be seen within a few days, treatment should be continued for at least four to six weeks. Doses should be tapered off during this time as complete healing takes place.

Oral therapy with sulfasalazine or with newer 5-aminosalicylates is the treatment of choice for moderately active proctosigmoiditis.

Newer 5-aminosalicylates like mesalamine are more costly but have fewer side effects. Folic acid supplementation should be given to patients on sulfasalazine.

Steroids are used when these 5-aminosalicylates compounds fail to induce remission. Steroids should not be used for maintenance of remission. Immunomodulator drugs like azathioprine or 6-MP are used when patient becomes steroid dependent or he is refractory to steroids.

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((For proctitis, 5-ASA suppositories are used and enemas are recommended for proctosigmoiditis)).

so the answer is C

[ArchivalUser]

~ YEP .... c ... IS THE CORRECT ANSWER ~

[ArchivalUser]

cc