Toxic Megacolon

Question 1

It is considered toxic megacolon when colon is >____cm in diameter

Answer 1

6

Question 2

Toxic Megacolon is concerning bc it incr the risk of ____

Answer 2

perforation

Question 3

MCC of Toxic Megacolon?

Answer 3

UC (10%)

Question 4

MC infectious cause of Toxic Megacolon?

Answer 4

C. diff (Clindamycin risk)

Question 5

Dx criteria for Toxic Megacolon?

Answer 5

Question 6

Test of choice to confirm a perforation in Toxic Megacolon?

Answer 6

CT W/ Oral Contrast

CT CANNOT determine ET

Question 7

Trmnt for Toxic Megacolon caused by C. diff?

Answer 7

Vancomycin or Fidaxomicin

Question 8

Trmnt for Toxic Megacolon + IBD

Answer 8

Empiric ABX: Ceftriaxone + Metronidazole
Glucocorticoids x 3 days

Question 9

A pt was recently taking Clindamycin and presents with fever, abd pain, and bloody diarrhea. What are you concerned for and what is your initial study of choice?

Answer 9

Concern for C. Diff infection and Toxic Megacolon. Order abd XR for colonic dilation

Question 10

Trmnt for Toxic Megacolon caused by C. diff?

Answer 10

Vancomycin or Fidaxomicin

Question 11

Can you do a full colonoscopy on a pt with toxic megacolon?

Answer 11

No, you will perforate it. Can do limited proctscopy or sigmoidoscopy (doesnt go as far in)