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NAPLEX 2023 > Chapter 74: Inflammatory Bowel Disease > Flashcards

Chapter 74: Inflammatory Bowel Disease Flashcards

1
Q

Types of Inflammatory Bowel Disease (IBD)

A

Ulcerative Colitis and Crohn’s Disease

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2
Q

Classic symptom of IBD

A

bloody diarrhea

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3
Q

Which class of drugs can cause IBD flares

A

NSAIDs

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4
Q

What is the difference between IBS and IBD

A

IBS does not cause inflammation and is not as serious

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5
Q

Ulcerative colitis is characterized by mucosal inflammation confined to the

A

rectum and colon with superficial ulcerations

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6
Q

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

A

distal disease
topical (rectal) treatment

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7
Q

Inflammation limited to the rectum is called

A

proctitis

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8
Q

Are fistulas/strictures are common in crohn’s disease or ulcerative colitis?

A

CD

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9
Q

Where is Crohn’s Disease located

A

Entire GI tract

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10
Q

Crohn’s Disease depth is

A

Transmural

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11
Q

CD pattern vs UC pattern

A

CD is non-continuous
UC is continuous

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12
Q

diagnosis of IBD

A

colonoscopy with tissue biospy

imaging can be useful as well

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13
Q

lifestyle management to help IBD

A

smaller, more frequent meals, low fat and dairy diet, drink plenty of water, avoid alcohol and caffeine

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14
Q

useful OTC agents in IBD

A

antidiarrheals or antispasmodic (careful)
vitamin supplements
probiotics

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15
Q

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

A

short courses of oral or IV steroids

used until remission and tapered 8-12 weeks

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16
Q

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

A

aminosalicylates

ie. 5-ASA

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17
Q

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

A

Budesonide for ≤ 3 months

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

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18
Q

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

A

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

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19
Q

What can be used for refractory treatment or steroid dependent CD

A

Vedolizumab or natalizumab (integrin receptor antagonists)

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20
Q

What can be used for mild UC for maintenance of remission

A

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

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21
Q

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

A 
Anti-TNF agents (Humira, Remicade, Simponi)
Thiopurine
Cyclosporine
Stelara (IL antagonist)
Xeljanz (JK inhibitor)
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22
Q

What can be used for refractory treatment or steroid dependent UC

A

Vedolizumab (integrin receptor antagonist)

23
Q

Budesonide brand name

A 
Entocort EC (for CD only)
Uceris (for UC only)
24
Q

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

A

2 weeks

25
Q

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

A

Budesonide

26
Q

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

A

UC

use for 3 months in maintenance

27
Q

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

A

inhibitors
3A4
grapefruit juice and grapefruit products

28
Q

mesalamine ER capsules brand name

A

Pentasa

29
Q

mesalamine ER tablets brand name

A

Asacol HD

30
Q

mesalamine enema brand name

A

Rowasa

31
Q

mesalamine suppository brand name

A

Canasa

32
Q

Which formulations does mesalamine come in

A

oral (caps, tabs) and rectal (enema, suppository)

33
Q

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

A

6-8 weeks oral
3-6 weeks rectal

34
Q

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

A

1-3h

35
Q

Mesalamine enema should be retained in the rectum for how long

A

Overnight (~8h)

36
Q

Mesalamine CI

A

hypersensitivity to salicylates or aminosalicylates

37
Q

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

A

Rectal

38
Q

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

A

Leave a ghost tablet in the stool

39
Q

Sulfasalazine CI

A

salicylate and sulfa allergy

40
Q

Balsalazide can cause

A

staining of the teeth/tongue

41
Q

Which genetic deficiency is checked for azathioprine?

what’s the risk?

A

TPMT

are at increased risk of myelosuppression

42
Q

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

A

CD (in pts who cannot tolerate azathioprine)

43
Q

How is MTX dosed in CD

A

once weekly by IM or SC route

44
Q

Which immunosuppressive drug is recommended for severe UC

A

Cyclosporine

45
Q

Natalizumab is only approved for

A

CD

46
Q

How often is natalizumab given

A

every 4 weeks

47
Q

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

A

12

48
Q

Vedolizumab is approved for

A

UC and CD

49
Q

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

A

14

50
Q

Natalizumab boxed warning

A

PML

51
Q

Natalizumab is only available through

A

REMS TOUCH program

52
Q

Natalizumab brand name

A

Tysabri

53
Q

Vedolizumab brand name

A

Entyvio

NAPLEX 2023 (88 decks)

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