IBD Flashcards
Extraintestinal manifestations of IBD that are associated with active GI disease
•Oral ulcers,Erythema nodosum, Large joint arthritis, episcleritis.
Extraintestinal manisfestations of IBD that are independent of GI disease
•Primary sclerosing cholangitis, ankylosing spondylitis, uveitis, pyoderma gangrenosum, kidney stones
Gallstones.
Crohn’s disease, which of the genetic variants would lead to early initial surgery due to stricturing disease
Nod2/CARD15
Role of Ustekinumab in induction and maintenance of Crohn’s disease
Monoclonal antibody against IL-12 and IL-23, which share the same IL-12p40 subunit. The antibody recognition of this cytokine reduces the differentiation of naïve CD4+ T helper cells into effector T cells, TH1, and TH17
pANCA and ASCA in IBD
Positive pANCA + Negative ASCA = UC (97% specific)
Positive ASCA + Negative pANCA = Crohns (97% specific)
Agents used for maintainence of remission in ulcertaive colitis
Azathioprine, cyclosporine, vedolizumab, infliximab
Recently -Tofacitinib -Janus kinase inhibitor- used in
induction and maintainance
FMT in IBD
No evidence in Crohn’s
UC -some benefit? donor specific
Condition to be considered if cholestatic LFTs in patient with UC
Sclerosing cholangitis
Late complication of bariatric surgery presenting with bloating, weight loss
Small intestinal bacterial overgrowth
Predictors of severity in CD
Age<40 Weight loss >5kg Fever at diagnosis Increased platelet count at diagnosis Presence of perianal lesions Stricturing disease
Most sensitive/ gold standard for C Diff infection
Cytotoxin assay
Cytokine not involved in pathogenesis of Crohn’s
IL-5
Monoclonal Ab shown effectiveness in induction and maintainance of CD
Ustekinumab
Against IL-12 and 23
Reduced differentiation of naïve T cells to helper T cells
MOA of infliximab
Binds to TNF-Alpha and prevents TNF from binding to its receptor
Vedolizumab in IBD- MOA
Binds to integrin alpha4B7 on T lymphocytes and causes gut selective anti inflammatory activity
