Inflammatory Bowel Disease

Question 1

CxFx. also, what kind of diarrhea is more frequent for CD and UC?

Answer 1

diarrhea, blood in the stool, weight loss, and fever.
CD: watery diarrhea
UC: bloody diarrhea

Question 2

Both Crohn disease (CD) and
ulcerative colitis (UC)  extraintestinal manifestations

Answer 2

• Arthralgias
• Uveitis, iritis
• Skin manifestation (erythema nodosum, pyoderma gangrenosum, sweet Sx
  )
• Sclerosing cholangitis (more frequent in UC)
  P-ANCA= all rheumatologic complaints

Question 3

Erythema nodosum is an indicator of

Answer 3

disease activity.

Question 4

wich of the IBD has Fistulas and abscesses, Masses and obstruction, Perianal disease?

Answer 4

CD. fistulas even entero-entero. enterovaginal, etc

Not UC

Question 5

wich of the IBD is curable

Answer 5

UC w Qx

Question 6

hystologic properties of IBSs: CD vs UC

Answer 6

CD: Transmural (non-caseating) granulomas
UC: Entirely mucosal

Question 7

When to do CA screening in IBD?

Answer 7

After 8 to 10 years of colonic involvement, with

colonoscopy every 1 to 2 years.

Question 8

IBD most accurate test

Answer 8

Endoscopy when the disease can be reached by a scope

Question 9

CD dx test

Answer 9

as it is mainly in the small bowel, radiologic tests such as barium studies
will detect the lesions.
“skip lesions” through entire GI tract

Question 10

if Dx unclear, what immunological test would you use and how to interpret results according to disease.

Answer 10

Antineutrophil cytoplasmic antibody (ANCA): + UC
Anti-Saccharomyces cerevisiae antibody
(ASCA): + CD

Question 11

Acute exacerbations of disease are treated with

Answer 11

steroids in both CD and UC.
prednisone or budesonide.
also r/o C.Difficile. omed: “atb too (cipro metro)

Question 12

Chronic maintenance of remission is with

Answer 12

5-ASA derivatives such as
mesalamine.
Asacol (mesalamine) is used for UC

y coating mesalamine with pH-sensitve coating.
Coating dissolves when pill reaches terminal ileum where the pH is > 7.

and Pentasa (mesalamine) for
CD

Permeable microgranules allow for Permeable microgranules allow for mesalamine release throughout the release throughout the intestinal tract intestinal tract.

Question 13

UC largely limited to the rectum Tx

Answer 13

Rowasa (mesalamine)*

is an 5-ASA compound that become anti-inflammatory superficially in the gut

Question 14

IBD treatments

Anti TNF:

Answer 14

Adalimumab (humira)
Infliximab (remicade)**** tho mainly cd. cuz ya know, uc and qx go good
Certolizumab (cimzia)
Golimumab (simponi)

Question 15

Who is the Anti-IL 12/23:

Answer 15

Ustekinumab (stelara)

Question 16

when the disease is so severe that severe recurrences develop as the steroids are
stopped. what to give?

Answer 16

Azathioprine and 6-mercaptopurine.

this guys are good for both UC and CD

Question 17

Perianal CD tx

Answer 17

ciprofloxacin and metronidazole.

This must be drained

Question 18

Fistulae and severe disease** unresponsive to other agents is treated with

Answer 18

antitumor
necrosis factor (TNF) agents such as infliximab.

Question 19

if fistulae only does not respond to anti-TNF agents

Answer 19

qx

Question 20

UC can be cured with

Answer 20

colectomy.

Question 21

In CD, surgery is used exclusively for

Answer 21

bowel

obstruction.

Question 22

If the disease is refractory to all other treatment

Answer 22

vedolizumab (entyvio)(alphaintegrin

inhibitor).

Question 23

________ is a steroid specific for
IBD. First pass effect is good for IBD
treatment.

Answer 23

Budesonide

Question 24

UC Bx

Answer 24

superficial inflamation, crypt abcesses

Question 25

CD nutritional manifestations

Answer 25

b12 and fat malabsortion

duod: Fe, osteopenia