Clinical- IBD

Question 1

Rapid Fire: I will say a characteristic of a disease and you will tell me whether it’s crohns or ulcerative colitis. Ready?

Located anywhere in the GI tract

Answer 1

crohns

Question 2

Continuous lesion

Answer 2

Ulcerative colitis

Question 3

Rarely have strictures

Answer 3

Ulcerative colitis

Question 4

Fistulas present

Answer 4

crohns

Question 5

Only in colon

Answer 5

ulcerative colitis

Question 6

skipping lesion

Answer 6

crohns

Question 7

Fewer bowel movements, less bleeding, and more abd pain

Answer 7

crohns

Question 8

No fistulas

Answer 8

ulcerative colitis

Question 9

Common strictures

Answer 9

corhns

Question 10

Frequent bloodly bowel movements with minimal abdominal pain.

Answer 10

ulcerative colitis (UC)

Question 11

What % of patients with IBD have arthritis?

Answer 11

10-20%

Question 12

What HLA-B27 disease is IBD assocaited with?

Answer 12

Akylosing Spondylitis

Question 13

What % of IBD patients present with erythema nodosum, apthous ulcers, or pyoderma gangenosum?

Answer 13

10%

Question 14

What % of patients present with episcleritis or uveitis?

Answer 14

5%

Question 15

What % of IBD patients present with primary sclerosing cholangitis?

Answer 15

5%

Question 16

What can form in the kidneys in crohns?

Answer 16

calcium oxalate stones

Question 17

What can form in the kidneys in UC?

Answer 17

uric acid stones (due to dehydration)

Question 18

Case: an IBD pt comes in with elevated alkaline phosphatase. What disease is this pt most likely experiencing?

Answer 18

Primary sclerosing colangitis

literally meaning hardening of the bile duct

Question 19

Which antiinflammatory can be given for the treament of mild-moderate UC?

Answer 19

sulfasalazine

Question 20

Which 2 drugs are the 5-ASA class?

Answer 20

Mesalamine + Olsalazine

“MO money MO problems”

Question 21

In what form of administration of aminosalcylates would u use for proctitis + L-sided colitis?

Answer 21

tropical (i.e. suppository)

Question 22

What route of administration you u use for Asacol + pentasa for pancolitis?

Answer 22

oral

gig.itty.goo.

Question 23

In what stage of UC would you give prednisone?

Answer 23

When it has progressed to pancolitis

Question 24

You shouldn’t exceed what dose of prednisome every 5 days for treating UC?

Answer 24

5mg

Question 25

Why can't u give opiates in chronic UC patients?

Answer 25

cuz they can cause toxic megacolon whenever i see megacolon i think of the massive terd episode of south park.

Question 26

When is the criteria for performing a colectomy in a UC pt?

Answer 26

when they have severe tintractable idsease, acute life threatening complication, colon stricture, or colon cancer

Question 27

True or False: sulfasalazine maintains remission in chrons as it does in UC.

Answer 27

False.

Question 28

Ture or False: sulfasalazine does not ahve additive effects or sparing effects when given with corticosteroids for crohns.

Answer 28

true

Question 29

True or false: sulfasalazine is not effective as prophylaxis in crohns.

Answer 29

True

Question 30

Budesone is a corticosteroid to treat what type of crohns?

Answer 30

mild-mod small bowel + colon crohns

Question 31

Which 2 drugs are good for maintenance therapy in crohns?

Answer 31

6-MP and Azathoprine

Question 32

What is the chemical structure of 6-MP relative to azathioprine?

Answer 32

6-MP is the active metabolite of azathioprine

Question 33

Why is 6-MP + azathioprine good to use with steroids?

Answer 33

Cuz u can lower the dose of steroids

Question 34

Metronidazole treats CD in what part of the GI tract?

Answer 34

Perianal

Question 35

How long does it take for metronidazole to start showing it's effects?

Answer 35

6 weeks. THATS A LONG ASS TIME.

Question 36

Which drug is used in CD because it's a TNF-alpha antibody?

Answer 36

infliximab (remicade)

Question 37

What type of chrons does a pt need to have to treat with infliximab?

Answer 37

fistulizing crohns

Question 38

What is the role of infliximib, as far as treating Sx, in CD?

Answer 38

maintians remission