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PHCP 2 > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

(70 cards)

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1
Q

two forms of idiopathic inflammatory bowel disease (IBD)

A

Ulcerative colitis (UC) & Crohn’s disease

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2
Q

mucosal inflammatory condition confined to the rectum and colon

A

Ulcerative colitis (UC)

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3
Q

transmural inflammation of gastrointestinal (GI) mucosa that may occur in any part of the GI tract

A

Crohn’s disease

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4
Q

Autoimmune IBD

A

Ulcerative colitis (UC)

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5
Q

Extensive immune reaction

A

Crohn’s disease

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6
Q

shift toward the presence of more proinflammatory bacteria in the GI tract

A

dysbiosis

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7
Q

Th1 cytokine activity is excessive in

A

CD

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8
Q

Th2 cytokine activity is excessive with

A

UC

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9
Q

___ cytokine activity is excessive in CD

A

Th1

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10
Q

____ cytokine activity is excessive with UC

A

Th2

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11
Q

pivotal proinflammatory cytokine that is increased in the mucosa and intestinal lumen of patients with CD and UC

A

Tumor necrosis factor-α (TNF-α)

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12
Q

found in a high percentage of patients with UC and less frequently with CD

A

Antineutrophil cytoplasmic antibodies

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13
Q

appears to be protective for ulcerative colitis but associated with increased frequency of Crohn disease

A

Smoking

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14
Q

Local complications (involving the colon) occur in the majority of patients with

A

UC

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15
Q

A major complication of UC is

A

toxic megacolon

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16
Q

severe condition that occurs in up to 7.9% of UC patients admitted to hospitals

A

toxic megacolon

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17
Q

The risk of _______________ is much greater in patients with UC as compared with the general population.

A

colonic carcinoma

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18
Q

commonly occurs in patients with IBD and is typically asymptomatic and migratory

A

Arthritis

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19
Q

Ocular complications occur in some patients

A

iritis, episcleritis, and conjunctivitis

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20
Q

Inflammation of the bile duct

A

cholangitis

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21
Q

Bile duct cancer

A

cholangiocarcinoma

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22
Q

Large painful sores/ulcers in skin

A

pyoderma gangrenosum

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23
Q

Abrupt onset of papules and nodules that coalesce to form plaques

A

Sweet syndrome

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24
Q

Affected region: Rectum

A

Proctitis

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25
Affected region: rectum, sigmoid colon, descending colon
Left-sided colitis
26
Affected region: rectum, sigmoid colon, descending colon, transverse colon, ascending colon
Extensive pancolitis
27
Affected region: rectum, sigmoid colon
Proctosigmoiditis
28
Characterized by Cobblestone appearance due to ulceration and elevation of the remainder of the mucosa
Crohn’s disease
29
most common site of the disorder (CD)
terminal ileum
30
Nutritional deficiencies are common with Crohn disease
weight loss, iron deficiency anemia, vitamin B12 deficiency, folate deficiency, hypoalbuminemia, hypokalemia, and osteomalacia
31
_________ formation is common and occurs much more frequently than with UC
Fistula
32
generally reserved for patients with severe malnutrition or those who fail enteral therapy or have a contraindication to receiving enteral therapy
Parenteral nutrition
33
may be necessary when the UC patient has disease uncontrolled by maximum medical therapy
Colectomy
34
Mild to Moderate UC
● Oral/ Topical Mesalamine ● 4-6 grams of sulfasalazine
35
Moderate to Severe UC
Oral prednisone
36
Oral prednisone dose
40-60mg/ day
37
replaces those who are unresponsive to the max dose of oral mesalamine
Oral prednisone (40-60mg/ day)
38
for patients unresponsive to ASAs, corticosteroids, or other immunosuppressive agents
TNF-alpha inhibitors
39
Sever intractable UC
IV Hydrocortisone 300mg in three divided doses or methylprednisolone 60mg OD
40
First line therapies for UC
IV Hydrocortisone 300mg in three divided doses or methylprednisolone 60mg OD
41
IV hydrocortisone dose
300mg
42
methylprednisolone dose
60mg od
43
Patients who are unresponsive to parenteral corticosteroids after 3 to 7 days can receive
cyclosporine or infliximab
44
optimal dose to prevent relapse is ____
2 to 2.4 g/day of mesalamine
45
optimal dose to prevent relapse is
2 to 2.4 g/day of mesalamine
46
do not have a role in the maintenance of remission with UC because they are ineffective
Steroids
47
considered first-line therapies and are frequently used for the treatment of moderate to severe Crohn disease
prednisone 40 to 60 mg/day or Oral corticosteroids
48
viable first-line option for patients with mild to moderate ileal or right-sided (ascending colonic) disease
Budesonide (Entocort)
49
Budesonide (Entocort) at a dose of
9 mg daily
50
given orally as 10 to 20 mg/kg/day in divided doses
Metronidazole
51
useful in some patients with CD, particularly for patients with colonic or ileocolonic involvement
Metronidazole
52
useful in some patients who are unresponsive to sulfasalazine
Metronidazole
53
Metronidazole dose
10 to 20 mg/kg/day
54
effective in maintaining steroid-induced remission
Azathioprine and mercaptopurine
55
limited to use for patients not achieving adequate response to standard medical therapy or in the setting of steroid dependency
Azathioprine and mercaptopurine
56
demonstrated some efficacy for induction of remission in Crohn disease, and for corticosteroid sparing effects
Methotrexate
57
Methotrexate dose
15–25 mg
58
MTX risks
bone marrow suppression, hepatotoxicity, and pulmonary toxicity (BPH)
59
most effective and thus the preferred agents in the management of moderate to severe CD
TNF-α inhibitors
60
The use of TNF-α inhibitors in combination with __________ has quickly become the preferred approach to the treatment of moderate to severe CD.
thiopurines
61
options for patients who do not respond to steroids or TNF-α inhibitors
integrin antagonists
62
preferred approach to treatment of moderate to severe CD
TNF-α inhibitors in combination with thiopurines
63
considered for maintenance therapy for up to 1 year
Budesonide
64
Used for patients who have become corticosteroid dependent
Budesonide
65
effective in maintaining remission in CD
Azathioprine and mercaptopurine
66
weak evidence to suggest that, ________ is effective in maintaining remission in Crohn disease
methotrexate
67
should be administered IV to reduce acute inflammation
Steroids in high dosages
68
may exacerbate the underlying IBD and predispose patients to GI bleeding
NSAID use
69
Anemia secondary to blood loss from the GI tract can be treated with
oral ferrous sulfate
70
Vitamin B12 or ______ may also be required.
folic acid

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