IBD Clinical

Question 1

UC areas at diagnosis

Answer 1

usually distal, possibly L side

Question 2

Endoscopic severity of disease

0 normal

1 mild

2 moderate

3 severe

Answer 2

0- no friability, intact vascular pattern

1- erythema, dec vasc pattern, mild friability

2- marked erythema, absent vasc, friabaility

3- same as 2 w bleeding/granulations

Question 3

Remission means

Mucosal healing

Taper

Mesalamine abosrption

Answer 3

resolution of sx/lab values

resolution

steroids

20%

Question 4

Mild

Moderate

Severe tx of UC

problem w steroids

Answer 4

5ASA, CS

CS, infliximab, aza

Cyclosporine, inflix, aza

delayed mucosal healing, use for 6+ wks

Question 5

C diff in UC

tx with

Serum infliximab levels predict

Answer 5

more aggressive, longer course, more mortality

oral vanc

UC severity/response- inc level inc response

Question 6

Vedolizumab typically used alongside

Mesalamine in CD

IV steroids for CD

Answer 6

Anti TNF/immune modulator

not effective

severe flares not responsive to oral

Question 7

Thiopurine indications

___ testing before starting

Methotrexate contraindications

Anti TNF ab

Answer 7

Steroid dependence/refractory
Combo
Post op/fistuals

TPMT

monitor LFT, pred, no ETOH

infliximab, adalimumab, certolizumab, golimumab

Question 8

Biologic therapy for CD

Infliximab helps aza in

what predicts sustained, steroid free remission of CD

Answer 8

failed remission, requires steroids
fistula
early onset
proximal location
deep ulcers

mucosal healing

complete endoscopic healing

Question 9

anti TNF restarting, assess for

Aza malignant SE

Answer 9

biomarkers to identify clinical relapse

B cell lymphoma, non melanoma skin cancer