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Clin Therapeutics 1 > Exam 4 - IBD > Flashcards

Exam 4 - IBD Flashcards

1
Q

Location of UC vs CD?

A

UC=Colon/rectum

CD=entire GIT

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2
Q

Depth UC vs CD?

A

UC=Superficial

CD=Transmural

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3
Q

UC vs CD colonoscopy?

A

UC=continous inflammation, pseudopolyps

CD=”cobblestone” skip lesions

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4
Q

Rectal bleed, bloody/watery diarrhea in UC or CD?

A

UC

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5
Q

Fatigue, abd pain, feveral in UC or CD?

A

CD

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6
Q

Toxic megacolon and colon cancer in UC or CD?

A

UC

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7
Q

Perianal dz and fistula in UC or CD?

A

CD

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8
Q

UC or CD and surgery?

A

UC=cutative

CD=variable, usually not curative

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9
Q

Nicotine makes UC and CD worse or better?

A

UC=better

CD=worse

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10
Q

Intestinal perf with UC or CD?

A

UC

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11
Q

Intestinal obstruction with UC or CD?

A

CD

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12
Q

UC or CD has more extraintestinal manifestations?

A

UC (bone/joint, eyes, skin, DVT/PE)

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13
Q

What to assess in IBD?

A

Location and severity

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14
Q

Mild UC vs Fulminant UC bowels/day?

A

Mild CD <4

Fulminant ≥10

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15
Q

Bloody stools in Mild UC? In Moderate to Fulminant?

A

Possibly in Mild. Yes in Moderate to Fulminant.

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16
Q

HgB in Mild UC vs Moderate UC?

A

Mild=normal

Moderate= >10.5

17
Q

HgB in Severe UC vs Fulminant UC?

A 
Severe= <10.5
Fulminant= <8 (transfuse!)
18
Q

Chrons Disease Activity Index below 150? Above 450?

A

<150=Remission. ASx.

>450=Severe/Fulminant. Highly sx despite steroid and biologic tx.

19
Q

Tx for Fistulizing CD?

A

Infliximab for cutaneous/external fistula. May need surgery.

20
Q

Tx for Perianal CD?

A

Drain abscess if present. Consult GI/surgery. Metronidazole +/- cipro. Use immunosuppressants/biologics.

21
Q

Tx for Mild-Moderate UC not in entire colon (proctitis, proctosigmoiditis, or distal colitis) to induce remission?

A
  1. Topical aminosal
  2. Caombine w/PO aminosal
  3. Topical/PO steroid
  4. Anti-TNF +/- AZA/6MP or MTX
22
Q

Tx for Mild-Moderate UC in entire colon to induce remission?

A
  1. PO Aminosal +/- topical
  2. Topical/PO steroids
  3. Anti-TNF +/- AZA/6-MP or MTX
23
Q

Mild to Moderate UC bowel movements per day?

A

4-6/day

24
Q

Severe to Fulminant UC bowel movements per day?

A

7-10/day

25
Q

Tx for Severe-Fulminant UC to induce remission?

A
  1. IV steroids 3-7 days
  2. IV Remicade (Anti-TNF) or IV Entyvio (Anti-alpha 4) +/- AZA/6-MP or MTX
  3. IV Cyclosporine
  4. Colectomy (last time)
26
Q

Last-line tx for severe-fulminant UC?

A

Colectomy

27
Q

UC maintenance on steroids switch to?

A

Consider transition from steroids to biologic (Anti-TNF, Anti-alpha-4) +/- immunomodulator (AZA, MTX, Cyclo)

28
Q

Use Tysabri in UC?

A

Nope, but can use Entyvio.

29
Q

When to reassess for symptomatic response in UC?

A

4-8 weeks

30
Q

Mild-Moderate CD in Ileum or R Colon? (CDAI 150-220)

A
  1. Budesonide

2. PO Aminosal or other PO steroid

31
Q

Mild-Moderate CD not in Ileum or R Colon?

A
  1. PO Aminosal

2. PO Steroid

32
Q

Inducation for Moderate-Severe CD in Ileum or R Colon? (CDAI 220-450)

A
  1. PO steroid for 28 days
  2. Anti-TNF (Remicaide, Humira, etc)
  3. Anti-alpha-4 (Entyvo»Tysabri)
33
Q

Maintenance for Moderate-Severe CD in Ileum or R Colon? (CDAI 220-450)

A
  1. Steroid to AZA/6-MP or MTX

2. Continue biologic if used for induction. AZA mono tx bad idea. Inflix +/- AZA good idea!

34
Q

Severe to Fulminant CD tx?

A
  1. IV steroid x3 days
  2. IV Cyclosporine
  3. Biologic (no evidence helps)
  4. Surgery
35
Q

Tx for Fistulizing CD?

A

Remicade

36
Q

Use Tysabri in CD?

A

No!

37
Q

What to test before and during Tysabri use? How often retest?

A

JVC-antibodies.

Test q6m if negative and stop if suddenly positive. If positive at baseline only use for 9-12mo max!

38
Q

When to d/c Tysabri?

A

Test positive for JCV at 6 month check.

Only use for 9-12mo max is positive at baseline.

Clin Therapeutics 1 (12 decks)

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