Inflammatory Bowel Disease Maintenance Treatments Quiz
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Questions and Answers

What is the recommended treatment for Diff infection in ulcerative colitis patients?

  • NSAIDs
  • Broad spectrum antibiotics
  • TPN
  • PO vancomycin (correct)

    • Which of the following is NOT recommended in the management of ulcerative colitis?

  • High-dose NSAIDs (correct)
  • Nicotine therapy
  • Probiotics
  • Surgery

    • When is surgery likely indicated in ulcerative colitis?

  • Mild symptoms with short duration
  • Responsive to medication therapy within 2 days
  • Experiencing mild side effects from medication
  • Severe colitis unresponsive to conventional therapy (correct)

    • What is an indication for cancer surveillance in ulcerative colitis patients?

    <p>High-grade dysplasia (HGD)</p> Signup and view all the answers

    Which of the following treatments has limited place in ulcerative colitis therapy according to the text?

    <p>Curcumin</p> Signup and view all the answers

    What is the hypothesis regarding chronic intestinal inflammation?

    <p>It is due to inappropriate response to the normal microbiome</p> Signup and view all the answers

    Which adverse effect is associated with long-term use of Metronidazole?

    <p>Neuropathy</p> Signup and view all the answers

    What is the mechanism of action of Ciprofloxacin?

    <p>Inhibits DNA-gyrase promoting breakage of DNA</p> Signup and view all the answers

    Which of the following describes the mechanism of action of Thiopurines?

    <p>Metabolites are incorporated into replicating DNA and halt replication</p> Signup and view all the answers

    What should be monitored when a patient is on Azathioprine or Mercaptopurine?

    <p>CBC, SCr/BUN, LFTs</p> Signup and view all the answers

    Why is TPMT testing necessary before initiating Thiopurine therapy?

    <p>To guide dosing and prevent myelosuppression</p> Signup and view all the answers

    What is the main difference between the step-up and top-down approach for treating inflammatory bowel disease (IBD)?

    <p>Step-up approach starts with more potent therapies first, while top-down approach uses low potency drugs initially.</p> Signup and view all the answers

    Which medication for IBD is specifically mentioned to have therapeutic activity occurring throughout the entire gastrointestinal (GI) tract?

    <p>Mesalamine</p> Signup and view all the answers

    What is a common symptom of mesalamine-based reactions when the dosage exceeds 3g/day?

    <p>Nausea</p> Signup and view all the answers

    Which medication used in IBD treatment is a dimer of two 5-ASA molecules?

    <p>Olsalazine</p> Signup and view all the answers

    What is the mechanism of action of corticosteroids in treating IBD?

    <p>Blocks migration of leukocytes to reduce inflammation</p> Signup and view all the answers

    Which form of budesonide has less systemic adverse effects compared to prednisone?

    <p>Oral budesonide MMX</p> Signup and view all the answers

    What is the recommended treatment for mild-moderate Crohn's disease limited to the ileum and colon?

    <p>Budesonide CIR</p> Signup and view all the answers

    How should Prednisone be tapered for moderate-severe Crohn's disease induction?

    <p>Decrease by 5 mg/week until 20 mg, then decrease by 2.5-5 mg/week</p> Signup and view all the answers

    What is the most appropriate next step in treatment if a patient with moderate-severe Crohn's disease does not respond to corticosteroids?

    <p>Add thiopurines or methotrexate</p> Signup and view all the answers

    What is the dosing range for Azathioprine when used without biologics?

    <p>1.5-2.5 mg/kg/day</p> Signup and view all the answers

    Which of the following medications is NOT effective for moderate-severe Crohn's disease induction according to the guidelines?

    <p>Cyclosporine</p> Signup and view all the answers

    What is the maximum duration of total steroid use recommended for tapering in moderate-severe Crohn's disease induction?

    <p>3 months</p> Signup and view all the answers

    What is the mechanism of action of Methotrexate as an immunomodulator?

    <p>Inhibits dihydrofolate reductase</p> Signup and view all the answers

    Which adverse effect is associated with Methotrexate as an immunomodulator?

    <p>Hepatotoxicity</p> Signup and view all the answers

    Prior to initiating TNF-α inhibitors, what should be assessed for?

    <p>Risk for infection</p> Signup and view all the answers

    Which vaccine should be given before initiating TNF-α inhibitors treatment?

    <p>Flu vaccine</p> Signup and view all the answers

    What is a common clinical pearl related to monitoring patients on Infliximab?

    <p>Assessment for TB reactivation</p> Signup and view all the answers

    Which TNF-α inhibitor is 100% humanized?

    <p>Golimumab</p> Signup and view all the answers

    What is the recommended maintenance dose interval for Adalimumab?

    <p>Every 4 weeks</p> Signup and view all the answers

    Which type of treatment failure occurs if there is a low or undetectable trough level of TNF-α inhibitors with antibody development?

    <p>Immune-mediated PK failure</p> Signup and view all the answers

    What should be considered if there is inadequate response to TNF-α inhibitors due to inflammatory mediators not being blocked by the current therapy?

    <p>Choose another agent or class</p> Signup and view all the answers

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