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PY3 > IBD DR. J > Flashcards

IBD DR. J Flashcards

1
Q

In IBD what two factors are involved to cause a chronic state of dysregulated mucosal immune function?

A
  1. Exogenous
  2. Endogenous
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2
Q

Transmural inflammation of any part of the GI Tract.

A

Crohn’s disease

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3
Q

Confluent mucosal inflammation of the colon starting at the anal verge and extending proximal for a viable extent

A

Ulcerative colitis

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4
Q

Which disease can affect any part of the GI tract from the mouth to the anus?

A

CD

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5
Q

What part of the GI Tract is often spared in CD?

A

Rectum

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6
Q

Which disease is limited to the mucosa and superficial submucosa, with the deeper layers unaffected except in fulminant disease?

A

UC

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7
Q

What cells reside at the base of the crypts and give rise to all absorptive and secretory cells making up the epithelial layer?

A

Intestinal stem cells

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8
Q

Cells that produce the mucus layer

A

Goblet cells

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9
Q

Cells that produce antimicrobial peptides

A

Paneth cells

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10
Q

Cells that synthesize IgA which prevents invasion by pathogenic organisms and helps to maintain a homeostatic balance

A

Plasma cells

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11
Q

_____ cells and innate immune cells detect micro iota using pattern recognition receptors

A

Epithelial

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12
Q

Commensals in IBD are recognized as what?

A

Pathogenic

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13
Q

TNF alpha and INF gamma are ___inflammatory with ____ effects on barrier function

A

Pro; negative

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14
Q

CD1d, RIPK1 and IL-10 are ____inflammatory with ______ effects.

A

Anti; protective

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15
Q

The CD the cytokine profile is representative of what mediated inflammatory response?

A

T-helper1 (TH1)

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16
Q

The UC inflammatory response is mediated by what pathway?

A

TH2 pathway

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17
Q

What is the TH2 pathway mostly under control of?

A

IL-4

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18
Q

TNF alpha exists in a _____

A

Stable homotrimer

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19
Q

Both ___+_____ TNF can perform their biological function by binding to their receptors

A

Membrane; soluble

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20
Q

What does TNF trigger?

A

Apoptosis and breaks epithelial barrier

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21
Q

What does TNF drive?

A

Adaptive immune response

22
Q

What produces TNF? What does TNF recruit?

A

Immune cells

23
Q

What does TNF modulate?

A

Immune cell function

24
Q

What is the MOA of anti- TNF Biologics?

A

Bind to homotrimeric TNF alpha to neutralize TNF alpha mediated pro-inflammatory signaling

25
Q

Fully human antibody against IL-12/23 that binds to the p40 subunit

A

Ustekinumab

26
Q

Small molecule inhibitor of JAK activity that prevents JAK dependent phosphorylation of STAT proteins

A

Tofacitinib

27
Q

What is sulfasalazines site of delivery?

A

Colon

28
Q

What are the 3 anti-inflammatory pro drug formulations?

A
  1. Sulfasalazine
  2. Olsalazine
  3. Balsalazide
29
Q

What are the 3 key factors for drug delivery

A
  1. Mucus
  2. pH
  3. Commensals
30
Q

The prodrugs all contain what bond?

A

Azo bond

31
Q

What is the therapeutic moeity of sulfasalazine?

A

5- ASA

32
Q

5-ASA acts _____ in the colon; ____ absorbed in the mucosa

A

Topically; poorly

33
Q

5-ASA is highly ____phobic

A

Lipo

34
Q

What mechanism makes 5- ASA active?

A

N-acetylation

35
Q

Pentasa has a ________ release

A

Time dependent

36
Q

Eudragit and Asacol have _____ dependent release

A

pH

37
Q

Where is Asacol released?

A

Terminal ileum and cecum

38
Q

What is 5-ASA incorporated into for a time delayed release?

A

Microparticles of lipophilic matrix dispersed within a hydrophilic matrix

39
Q

The core of 5-ASA microparticles are coated with what?

A

A pH dependent gastric acid resistant polymer

40
Q

Each APRISO capsule has what type of release dosage form?

A

Delayed and extended

41
Q

What problems can immunosuppressants cause?

A

They can increase the risk of infection and malignancies

42
Q

Glucocorticoids are quickly______

A

Absorbed

43
Q

What is essential for both MC and GC activity?

A

3-one-4-ene

44
Q

Where does cyclosporine act?

A

At an early stage in antigen receptor induced differentiation of T cells and blocks their activation

45
Q

What does cyclosporine bind to?

A

Cyclophilin

46
Q

What does cyclophilin form?

A

A complex that inhibits the cytoplasmic phosphates calcineurin

47
Q

What does cyclosporine inhibit?

A

Gene transcription

48
Q

What is the key excipient in sandimmune?

A

Cremophor

49
Q

Immunosuppressant macrolide antibiotic

A

Tacrolimus

50
Q

What does tacrolimus bind to?

A

FK binding protein

51
Q

Living food supplements or components of bacteria that have been shown to have beneficial effects on human health

A

Probiotics

PY3 (24 decks)

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