Chapter 74: Inflammatory Bowel Disease

Question 1

Classic symptom of IBD

Answer 1

bloody diarrhea

Question 2

Which class of drugs can cause IBD flares

Answer 2

NSAIDs

Question 3

What is the difference between IBS and IBD

Answer 3

IBS does not cause inflammation

Question 4

Ulcerative colitis is characterized by mucosal inflammation confined to the

Answer 4

rectum and colon with superficial ulcerations

Question 5

When UC is limited to the descending colon and rectum, it is called ___ and can be treated with ____

Answer 5

distal disease

topical (rectal) treatment

Question 6

Inflammation limited to the rectum is called

Answer 6

proctitis

Question 7

Fistuals/strictures are common in crohn’s disease or ulcerative colitis

Answer 7

CD

Question 8

Where is Crohn’s Disease located

Answer 8

Entire GI tract

Question 9

Crohn’s Disease depth is

Answer 9

Transmural

Question 10

CD pattern vs UC pattern

Answer 10

CD is non-continuous

UC is continuous

Question 11

What is commonly used to treat acute exacerbations in both UC and CD

Answer 11

short courses of oral or IV steroids

Question 12

What is used for maintenance therapy in UC (distal or mild extensive disease)

Answer 12

aminosalicylates

Question 13

What is preferred for mild CD that is limited to the ileum and proximal colon

Answer 13

Budesonide for less than or = 3 months

After this course, d/c treatment or change to thiopurine or MTX

Question 14

What can be used for moderate-severe CD for maintenance of remission

Answer 14

Anti-TNF agents (Humira, Remicade, Cimzia)
Thiopurine
MTX
Stelara

Question 15

What can be used for refractory treatment or steroid dependent CD

Answer 15

Vedolizumab or natalizumab

Question 16

What can be used for mild UC for maintenance of remission

Answer 16

Mesalamine (5-ASA) rectal and/or oral preferred

Question 17

What can be used for moderate-severe UC for maintenance of remission

Answer 17

Anti-TNF agents (Humira, Remicade, Simponi)
Thiopurine
Cyclosporine
Stelara
Xeljanz

Question 18

What can be used for refractory treatment or steroid dependent UC

Answer 18

Vedolizumab

Question 19

Budesonide brand name

Answer 19

Entocort EC (for CD only)
Uceris (for UC only)

Question 20

If steroids are used long than ___ weeks, they must be tapered

Answer 20

2 weeks

Question 21

If long-term use of steroids is required, must assess

Answer 21

bone density

Question 22

Which drug can be used for both induction and maintenance of UC and CD

Answer 22

Budesonide

Question 23

Rectal steroids (hydrocortisone and budesonide rectal foam) are indicated for __ only

Answer 23

UC

Question 24

When using budesonide, must avoid strong and moderate ____ of which CYP enzyme, including ____

Answer 24

inhibitors
3A4
grapefruit juice and grapefruit products

Question 25

Which formulations does mesalamine come in

Answer 25

oral and rectal

Question 26

Induction with mesalamine for UC oral therapy is used for ___ weeks and rectal therapy for ___ weeks

Answer 26

6-8 oral | 3-6 rectal

Question 27

Mesalamine rectal suppository should be retained in the rectum for at least ___ hours

Answer 27

1-3

Question 28

Mesalamine enema should be retained in the rectum for how long

Answer 28

Overnight

Question 29

Mesalamine CI

Answer 29

hypersensitivity to salicylates or aminosalicylates

Question 30

For distal disease/proctitis in UC, which formulation of mesalamine is more effective

Answer 30

Rectal

Question 31

Mesalamine ER tablet (Asacol) and ER capsule (Delzicol) can

Answer 31

Leave a ghost tablet in the stool

Question 32

Sulfasalazine CI

Answer 32

salicylate and sulfa allergy

Question 33

Balsalazide can cause

Answer 33

staining of the teeth/tongue

Question 34

Patients with which genetic deficiency are at increased risk of myelosuppression when using azathioprine

Answer 34

TPMT

Question 35

Methotrexate can be used for induction & maintenance of remission in mod-severe

Answer 35

CD (in pts who cannot tolerate azathioprine)

Question 36

How is MTX dosed in CD

Answer 36

once weekly by IM or SC route

Question 37

Which immunosuppressive drug is recommended for severe UC

Answer 37

Cyclosporine

Question 38

Natalizumab is only approved for

Answer 38

CD

Question 39

How often is natalizumab given

Answer 39

every 4 weeks

Question 40

Natalizumab should be d/c if no response by ___ weeks

Answer 40

12

Question 41

Vedolizumab is approved for

Answer 41

UC and CD

Question 42

Vedolizumab should be d/c if no response by ___ weeks

Answer 42

14

Question 43

Natalizumab boxed warning

Answer 43

PML

Question 44

Natalizumab is only available through

Answer 44

REMS TOUCH program

Question 45

Natalizumab brand name

Answer 45

Tysarbi

Question 46

Vedolizumab brand name

Answer 46

Entyvio