IBD

Question 1

labs

Answer 1

• CBC w/ diff
• LFTs
• CRP/ESR
• Fe/B12/folate, Vit D

Fecal calprotectin (stool neutrophils, 93/95% for IBD)

Question 2

monitoring for complications

Answer 2

stricture: obstructive sx, usually in terminal ileum if 2/2 CD
fistula: think recurrent UTIs
abscess: fevers + peritonitis/abd pain

perianal disease: seen in 1/3 of CD pts; perirectal abscess, fissures, fistulas

Question 3

health maintenence

Answer 3

immunizations; caution w/ live attenuated

colorectal ca screening: screen after 8 years of disease and then q1y or per GI

ID screening: if on TNF-a, annual TB screening

Question 4

Pharmacologic agents for UC

Answer 4

1. 5-ASA (mesalamine, sulfasalazine) [induction + maint]
   - monitor renal fxn, risk of interstitial nephritis
2. Thiopurines (azathioprine) [maintenence]
   - CBC w/ diff, LFTs, and lipase q2wk then q1-3m
3. steroids used as induction

mod-severe disease
-Anti-TNFa

Question 5

Pharmacologic agents for CD

Answer 5

5-ASA has limited data with CD

1. Thiopurines (azathioprine) [maintenence]
   - CBC w/ diff, LFTs, and lipase q2wk then q1-3m
2. steroids used as induction
3. mod-severe disease
   - Anti-TNFa