NASPGHAN - Improving Health Supervision in Pediatric and Young Adult Patients With IBD - Case Based Newsletter
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Posttest Questions
Patients with inflammatory bowel disease (IBD) often present with:
Abdominal bloating
Excessive weight gain
Prolonged constipation
Bloody stool
When considering a diagnosis of IBD:
Presence of symptoms alone is adequate for diagnosis
Laboratory workup, including complete blood count, inflammatory markers, liver function tests, and stool studies should be obtained
Colonoscopic examination should be performed immediately to assess for colon cancer
The patient should be referred immediately for subspecialty care
A 13-year-old girl presents to your office with abdominal pain, diarrhea, and weight loss. After obtaining laboratory studies, you would like to obtain some imaging studies to assess for the presence and location of intestinal inflammation. Which assessment tool is MOST appropriate?
The choice depends on the patient’s clinical presentation and history
Computed tomography
Magnetic resonance imaging
Ultrasound
According to the International Society for Clinical Densitometry, what is the recommended procedure for monitoring bone mineral density in children with IBD?
Full-body dual x-ray absorptiometry (DXA) scans, including the skull, at least 3 months apart
Full-body DXA scans, minus the skull, at least 3 months apart
Full-body DXA scans, including the skull, at least 6 months apart
Full-body DXA scans, minus the skull, at least 6 months apart
You have recently diagnosed an 11-year-old boy with ulcerative colitis. Due to his increased risk for colon cancer, when should he begin regular colonoscopic surveillance screening?
Immediately
At age 16 years
Between ages 18 and 21 years
By age 30 years
Your 16-year-old IBD patient is being treated with immunosuppressive therapy (6-mercaptopurine). Which of the following immunizations are appropriate for this patient?
Varicella vaccination
Annual influenza vaccination
Measles-mumps-rubella vaccination
Rotavirus vaccination
You are using an immunomodulator to maintain clinical remission in a 14-year-old teenager with Crohn disease involving her small intestine. She is now experiencing a flare in her disease. Which of the following drug classes is most likely to be useful in the management of this patient?
Nonsteroidal anti-inflammatory drugs (eg, ibuprofen)
Aminosalicylates (eg, sulfasalazine)
Biologics (eg, infliximab)
Cyclosporine
Which of the following treatments is typically used for both the induction and long-term maintenance phases of treatment of patients with ulcerative colitis?
Aminosalicylates
Corticosteroids (eg, prednisone)
Antibiotics (eg, ciprofloxacin)
Cyclosporine
You are currently treating a 17-year-old young man with ulcerative colitis. During the past 3 office visits, he has become less responsive and appears more withdrawn. What would be your first step with this patient?
Diagnose the patient with clinical depression and prescribe antidepressant medication
Ask the patient and his parents about additional changes in his mood, behavior, school performance, and relevant stressors
Refer the patient immediately to a psychiatrist
Wait until the patient brings up the changes in his mood
According to studies in children with IBD, which of the following treatments has shown the best evidence of efficacy and safety in pediatric patients with depression?
Antidepressants
Patient education and group support
Hypnosis
Cognitive behavioral therapy
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Please rate the following:
The program was relevant to my work.
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The content matched the stated objectives.
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How well did the educational material give a balanced view of therapeutic options, including the use of generic names?
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If you rated any of the above questions with "fair," "poor," "disagree," or "strongly disagree," please explain:
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Objective 1: Utilize appropriate screening tools for the accurate diagnosis of IBD in pediatric, adolescent, and young adult patients in the primary care setting
By meeting the above objective, my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my professional performance will improve because I should be able to implement the new strategies.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly agree
Agree
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Strongly disagree
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Objective 2: Initiate and/or monitor recommended pharmacotherapy
By meeting the above objective, my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my professional performance will improve because I should be able to implement the new strategies.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly agree
Agree
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Objective 3: Screen and diagnose IBD patients suffering from comorbid depression
By meeting the above objective, my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my professional performance will improve because I should be able to implement the new strategies.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly agree
Agree
Disagree
Strongly disagree
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Objective 4: Develop collaborative care plans with primary and subspecialty providers in efforts to provide appropriate pharmacotherapy and social support for patients with IBD and their families
By meeting the above objective, my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my professional performance will improve because I should be able to implement the new strategies.
Strongly agree
Agree
Disagree
Strongly disagree
By meeting the above objective, my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly agree
Agree
Disagree
Strongly disagree
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Please answer the following:
Do you believe this activity was appropriate for the scope of your professional practice?
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Was the educational content scientifically sound?
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Was the educational content free from commercial bias?
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No
Was the mode of education effective for learning?
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No
If there was off-label or investigational medications mentioned in this activity, was this information disclosed?
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If you answered 'No' to any of the above questions, please explain:
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What did you learn during this activity that you intend to integrate into your practice?
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What questions have arisen in your practice for which you need answers/strategies that you can implement?
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What patient problems or patient challenges do you feel you are not able to address appropriately or to your satisfaction?
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What problems are your patients communicating to you that need attention or follow-up?
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Are you interested in basic, intermediate or advanced level trainings?
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What barriers might you have that would interfere with implementation of new information from this training?
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How could this training be improved to impact your competence or performance in practice?
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