NASPGHAN - Optimizing Therapeutic Safety in Children and Young Adults with IBD
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Post-Test Questions
Which agent used in the treatment of inflammatory bowel disease (IBD) is associated with impaired growth in pediatric patients?
a. Mesalamine
b. Prednisolone
c. Infliximab
d. Exclusive enteral nutrition
Which laboratory test result is especially important to obtain prior to initiating treatment with either 6-mercaptopurine or azathioprine?
a. Thiopurine methyltransferase genotype or phenotype
b. Serum lipid panel
c. Microalbuminuria
d. Purified protein derivative (PPD)
Which of the following characteristics is typically noted in patients who are having infusion reactions associated with infliximab therapy?
a. Abdominal cramping
b. Raynaud's phenomenon
c. Flu-like symptoms
d. Tremor, muscle weakness
A 15-year-old male with severe Crohn's disease (CD) and his parents have decided that they want to begin infliximab therapy. While receiving his third infusion, the patient complains of a headache and says he is feeling flushed and short of breath. How should this infusion reaction be addressed?
Give the patient an antiemetic
Stop infusion-give acetaminophen/antihistamine/corticosteroid-then resume infusion at slower rate
Discontinue infusion immediately and send the patient home
Reduce the dose of infliximab in future infusions
Which rare but important complication was recently associated with the use of thiopurine-type immunomodulators in IBD patients?
a. Diminished calcium absorption and bone density
b. Microalbuminuria and decreased creatinie clearance
c. Nonmelanoma skin cancer
d. Elevated blood sugar
Kim is a 16-year-old with moderate CD. While you are discussing treatment options with her family, Kim is concerned about the possibility of prednisone therapy affecting her appearance. What would you tell her about her chances of experiencing such an effect?
a. 1% or less
b. Approximately 10%-15%
c. Approximately 30%
d. Over 50%
Jason is a 14-year-old boy with severe ulcerative colitis. High-dose corticosteroid treatment has failed to control his disease and you have decided to begin tacrolimus therapy. Which of the following precautions is recommended prior to initiating tacrolimus therapy?
a. Dermatologic
b. Draw a titer for Varicella antibody
c. Start prophylaxis against Pneumocystis carinii
d. Start folic acid supplementation (1 mg once daily)
What is the dose frequency for methotrexate therapy in pediatric IBD patients?
a. Once daily
b. Once weekly
c. Every 2-4 days depending on the patient's tolerance
d. Methotrexate is used only in adult IBD patients
Which of the following adverse events is associated with anti-TNF IBD therapies, ie, infliximab, adalimumab, and certolizumab?
a. Lupus-like reactions
b. Pancreatitis
c. Interstitial nephritis
d. Neural tube defects arising from folic acid deficiency
A 13-year-old CD patient who recently started sulfasalazine therapy now complains of nausea and skin rash. Which strategy offers the best approach to addressing these adverse events?
a. Recommend antiemetic and minimal sun exposure
b. Change to a mesalamine product that does not contain sulfa
c. Recommend folic acid supplementation (1 mg once daily)
d. Add an immunomodulator, eg, tacrolimus or cyclosporine
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Please rate the following:
The program was relevant to my work.
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Content matched stated objectives.
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Usefulness of handouts/AV.
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Quality of facilities.
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How well did the educational sessions 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: Increase the understanding of how to minimize adverse events of drug therapy for pediatric inflammatory bowel disease (IBD)
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
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I don't know
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
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I don't know
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By meeting the above objective my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly Agree
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I don't know
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Objective 2: Implement monitoring strategies for the management of potential adverse events in pediatric IBD patients receiving medical therapy
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
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
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly Agree
Agree
I don't know
Disagree
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Objective 3: Employ long-term treatment and maintenance strategies that minimize the potential associated risks toward growth and development in pediatric IBD patients
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
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
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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Objective 4: Implement a systematic approach to diagnosis and management based upon a standard algorithm
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
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I don't know
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
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly Agree
Agree
I don't know
Disagree
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Objective 5: Delineate the features of IBD-unclassified and how to follow up these cases
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
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I don't know
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
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly learned strategies.
Strongly Agree
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I don't know
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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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Was the mode of education effective for learning?
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If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
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If you answered 'No' to any of the above questions, please explain:
Were you solicited by sales personnel in an educational room while you attended this educational activity?
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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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