Week 7 (Inflammatory Bowel Disease)

Question 1

What are the two main types of inflammatory bowel disease (IBD)?

Answer 1

Ulcerative colitis and Crohn’s disease

Question 2

What percentage of IBD cases are classified as indeterminate colitis at presentation?

Answer 2

15-20%

Question 3

What is the estimated direct cost of IBD in the United States?

Answer 3

Exceeding $10 billion

Question 4

What percentage of health care spending for IBD is attributed to inpatient care?

Answer 4

40%

Question 5

What is the estimated prevalence of IBD in US adults?

Answer 5

~1.3% (2.5-3 million)

Question 6

What is the peak age of onset for IBD?

Answer 6

15-25 years

Question 7

What does predictive modeling suggest about the prevalence of IBD in North America over the next 10 years?

Answer 7

It may nearly double

Question 8

Name three environmental triggers of IBD.

Answer 8

• Infections
• Diet
• Stress

Question 9

What dietary factors are associated with IBD onset?

Answer 9

• Low fiber
• Refined sugars
• High fat diet (PUFA, omega-6 & meat)

Question 10

What is the effect of a Mediterranean diet on IBD?

Answer 10

It is recommended

Question 11

How many confirmed genetic loci are associated with IBD?

Answer 11

> 240 confirmed loci

Question 12

What are two specific genetic loci associated with Crohn’s disease?

Answer 12

• NOD2
• ATG16L1

Question 13

What is the monozygotic twin disease concordance rate for Crohn’s disease?

Answer 13

20-50%

Question 14

What is the monozygotic twin disease concordance rate for ulcerative colitis?

Answer 14

15%

Question 15

True or False: Smoking is a protective factor against ulcerative colitis.

Answer 15

True

Question 16

What autoimmune diseases are associated with IBD?

Answer 16

• Asthma
• Multiple sclerosis
• Celiac disease

Question 17

What are two dietary emulsifiers mentioned as risk factors for IBD?

Answer 17

• Carboxymethylcellulose
• Polysorbate-80

Question 18

Fill in the blank: The risk of developing IBD is influenced by alterations in _______.

Answer 18

[colonic flora]

Question 19

What is the typical duration of the studies referenced in dietary research for IBD?

Answer 19

11 days

Question 20

What was a significant finding regarding fecal metabolome changes in IBD studies?

Answer 20

Reductions in short-chain fatty acids and free amino acids

Question 21

What percentage of health care spending for IBD is attributed to pharmacotherapy?

Answer 21

12%

Question 22

What percentage is associated with Crohn’s disease in the given data?

Answer 22

28%

Percentage indicating its prevalence or impact

Question 23

What percentage is associated with ulcerative colitis in the given data?

Answer 23

25%

Percentage indicating its prevalence or impact

Question 24

What percentage is associated with inflammation limited to the colon mucosa?

Answer 24

47%

Percentage indicating its prevalence or impact

Question 25

Name a systemic complication associated with inflammatory bowel disease.

Answer 25

Osteoporosis ## Footnote A condition where bones become weak and brittle

Question 26

What are two conditions linked to inflammatory bowel disease?

Answer 26

* Erythema nodosum * Pyoderma gangrenosum ## Footnote Skin conditions often associated with IBD

Question 27

What cardiovascular condition is related to inflammatory bowel disease?

Answer 27

Cardiovascular disease ## Footnote Increased risk associated with IBD

Question 28

What is the purpose of the Lemann Index in Crohn's disease?

Answer 28

Measures cumulative digestive damage ## Footnote Used to assess the severity of Crohn's disease

Question 29

What is indicated by increases in circulating levels of antimicrobial markers and cytokines?

Answer 29

Alterations to the immune response ## Footnote Early sign of IBD before symptoms appear

Question 30

What is the goal of early effective treatment during the window of opportunity?

Answer 30

Slow disease progression and prevent damage ## Footnote Key strategy in managing IBD

Question 31

What is the first step in diagnosing inflammatory bowel disease?

Answer 31

Clinical suspicion ## Footnote Initial assessment based on symptoms

Question 32

What must be ruled out before diagnosing IBD?

Answer 32

Infection ## Footnote Important to exclude other causes of symptoms

Question 33

List three diagnostic criteria for IBD.

Answer 33

* Endoscopic * Histological * Radiological ## Footnote Criteria used for accurate diagnosis

Question 34

Which smoking status favors Crohn's disease?

Answer 34

Current smoking ## Footnote Smoking can influence the type of IBD

Question 35

What laboratory tests are useful in diagnosing IBD?

Answer 35

* CBC * ESR * CRP * Serologic markers ## Footnote Important tests to evaluate inflammation and immune response

Question 36

What is fecal calprotectin elevated in?

Answer 36

Inflammation ## Footnote Distinguishes IBD from irritable bowel syndrome

Question 37

What are the quick onset therapies for IBD?

Answer 37

* Corticosteroids * Anti-TNF agents * Tofacitinib * Upadacitinib ## Footnote Medications that act quickly to manage symptoms

Question 38

What are some slower onset therapies for IBD?

Answer 38

* Azathioprine/6MP * Methotrexate * Mesalamine * Natalizumab * Vedolizumab * Ustekinumab * Risankizumab * Mirikizumab * Guselkumab * Ozanimod * Etasimoid ## Footnote Medications that take longer to show effects

Question 39

What factors must be considered in IBD treatment?

Answer 39

* Severity of symptoms * Nutritional status * Need for surgery * Insurance/cost * Co-existing conditions ## Footnote Important considerations for personalized treatment plans

Question 40

Name two classes of treatments for IBD.

Answer 40

* Anti-TNF agents * JAK inhibitors ## Footnote Various classes of medications used to manage IBD

Question 41

What is the role of corticosteroids in IBD therapy?

Answer 41

Quick onset treatment ## Footnote Used to rapidly control inflammation

Question 42

True or False: Infliximab is an anti-TNF agent.

Answer 42

True ## Footnote Commonly used medication in IBD treatment

Question 43

Fill in the blank: The treatment strategy for IBD targets the _______.

Answer 43

[Effector Arm] ## Footnote Refers to the mechanism of action of therapies