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Gastro > Inflammatory bowel disease > Flashcards

Inflammatory bowel disease Flashcards

1
Q

Mainstay of therapy of mild to moderate UC

Effective in inducing remission in UC (limited in CD)

A

Sulfasalazine and other 5 ASA agents

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2
Q

Composed of 2 ASA radicals linked by an azithromycin bond, which is split in colon by bacterial reduction

A

Ols alanine

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3
Q

Unencapsulated version of mesalamine used in Europe for maintenance of remission

A

Salofalk

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4
Q

Once a day formulation of mesalamine

A

Lialda

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5
Q

When are glucocorticoids indicated

A

Mod to severe UC and CD remission

They have no role in maintenance therapy and must be tapered once remission has been induced

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6
Q

What are the role of antibiotics in IBD?

A

Abx have no role in treatment of active to quiescent UC, except in pouchitis in UC patient

+ role in CD

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7
Q

Top of the pyramid treatment for moderate to severe ulcerative colitis

A

Cyclosporine

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8
Q

Rx mild to moderate ulcerative colitis

A

5) infiliximab/ adalimumab/ go limutan
4) 6-MP/ azathioprine
3) GC oral
2) GC rectal
1) 5-ASA oral/rectal

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9
Q

Rx mod to severe ulcerative colitis

A

5) cyclosporine
4) adalimumab/ golimumab
3) 6-MP/ azathioprine
2) GC oral
1) GC rectal

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10
Q

Rx fistulizing crohns disease

A

4) Total parenteral nutrition
3) natalizumab/ vedilimimab
2) anti TNF
1) abscess drainage and antibiotics

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11
Q

Rx MILD TO MODERATE CROHNS DISEASE

A

5) infliximab/adalimumab
4) 6 MP, azathioprine, MXT
3) prednisone
2) sulfasalazine
1) budesonide (ideal and right colon)

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12
Q

Rx MOD TO SEVERE CROHNS DISEASE

A

4) TPN
3) Glucocorticoid IV
2) Natalizumab/ vedolizumab
1) 6-MP/ azathioprine/MXT+infliximab/adalimumab/certolizumab

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13
Q

CROHNS vs UC

Antibiotic use confers 2.9x risk of developing childhood IBD

A

UC

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14
Q

CROHNS vs UC

Smoking may prevent disease
Appendectomy is protective

A

UC

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15
Q

CROHNS vs UC

OCP use is a risk factor for disease

A

CROHNS

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16
Q

CROHNS vs UC

38-58% concordance in monozygotic twins

A

CROHNS a

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17
Q

Focal crypt abscesses

A

CROHNS

18
Q

Bifid crypts
Distorted architecture of colon
(+) basal plasma cells and multiple basal lymphoid aggregates

A

UC

19
Q

Earliest change of UC seen on single contrast barium enema

A

Fine mucosal granularity

20
Q

Collar button ulcers

A

UC

21
Q

Post common part of inflammation I CROHNS

A

Terminal ileum

22
Q

Serologic markers in IBD

P ANCa
P ASCA

A

ANCa UC

ASCA CD

23
Q

Complications of these two drugs mimic IBD

A

Ipilimumab CTLA4

Mycophenolate mofetil

24
Q

Responsive to antibiotics

A

CROHNS

In UC if with puchitis

25
Q 
Radiographic features 
Small bowl abnormal
Abnormal terminal ileum 
Segmental colitis 
Asymmetric colitis 
Structure
A

CROHNS disease

26
Q

Extraintestinal manifestations of I D

A 
Derma
Rheuma
Ocular 
Hepatobiliary 
Urologic 
Metabolic bone disorders 
Thromboembolic
27
Q

Neutrophilic dermatitis and metastatic CD

A

Sweet sun

28
Q

Arthritis as an extraintestinal manifestation of CROHNS disease

A

Asymmetric poly articular and migratory

Most often affects the large joints of supper and lower extremities

29
Q

Mainstay of treatment mild to moderate UC

A

Sulfasalazine and other ASA agents

30
Q

Common side effects of ASA

A

Headache nausea hair loss and abdominal pain

31
Q

Management of glucocorticoid dep I d

A

Azathioprine and mercaptopurine

32
Q

AE of AZathioprine and 6-MP

A

Pancreatitis 3-4%

Bone marrow suppression

33
Q

Effective in maintaining remission in active CD

A

Methotrexate

34
Q

Macrolid antibiotic with immunomodulatory properties similar to CSA

A

Tacrolimus

35
Q

Solution to development of anti TNF antibodies (results to decreased response to treatment and inc risk of transfusion reactions)

A

Decreasing dosing intervals

Increasing dosage to 10 mg/kg

36
Q

Risk for this CA when using azathioprine or 6MP

A

Nonhodgkins lymphoma

37
Q

Gold STD diagnostic test for PSC

A

ERCP

38
Q

Extraintestinal manifestation of IBD occurs more often in UC than in CD

A

Primary sclerosing cholangitis

39
Q

Use of UDcA in patients with IBD may cause

A

Colorectal dysplasia

Cancer

40
Q

Risk of psc patients in developing cholangiocarcinoma

A

10-15%

41
Q

MF genitourinary complications of IBD

A

Calculi
Ureteral obstruction
Ileal bladder fistulas

42
Q

TPN plays a role, as dietary antigens may stimulate the mucosal immune response and this may respond to bowel read

A

Active CD (but NOT UC)

Gastro (9 decks)

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