32 Questions
What is the recommended treatment for Diff infection in ulcerative colitis patients?
PO vancomycin
Which of the following is NOT recommended in the management of ulcerative colitis?
High-dose NSAIDs
When is surgery likely indicated in ulcerative colitis?
Severe colitis unresponsive to conventional therapy
What is an indication for cancer surveillance in ulcerative colitis patients?
High-grade dysplasia (HGD)
Which of the following treatments has limited place in ulcerative colitis therapy according to the text?
Curcumin
What is the hypothesis regarding chronic intestinal inflammation?
It is due to inappropriate response to the normal microbiome
Which adverse effect is associated with long-term use of Metronidazole?
Neuropathy
What is the mechanism of action of Ciprofloxacin?
Inhibits DNA-gyrase promoting breakage of DNA
Which of the following describes the mechanism of action of Thiopurines?
Metabolites are incorporated into replicating DNA and halt replication
What should be monitored when a patient is on Azathioprine or Mercaptopurine?
CBC, SCr/BUN, LFTs
Why is TPMT testing necessary before initiating Thiopurine therapy?
To guide dosing and prevent myelosuppression
What is the main difference between the step-up and top-down approach for treating inflammatory bowel disease (IBD)?
Step-up approach starts with more potent therapies first, while top-down approach uses low potency drugs initially.
Which medication for IBD is specifically mentioned to have therapeutic activity occurring throughout the entire gastrointestinal (GI) tract?
Mesalamine
What is a common symptom of mesalamine-based reactions when the dosage exceeds 3g/day?
Nausea
Which medication used in IBD treatment is a dimer of two 5-ASA molecules?
Olsalazine
What is the mechanism of action of corticosteroids in treating IBD?
Blocks migration of leukocytes to reduce inflammation
Which form of budesonide has less systemic adverse effects compared to prednisone?
Oral budesonide MMX
What is the recommended treatment for mild-moderate Crohn's disease limited to the ileum and colon?
Budesonide CIR
How should Prednisone be tapered for moderate-severe Crohn's disease induction?
Decrease by 5 mg/week until 20 mg, then decrease by 2.5-5 mg/week
What is the most appropriate next step in treatment if a patient with moderate-severe Crohn's disease does not respond to corticosteroids?
Add thiopurines or methotrexate
What is the dosing range for Azathioprine when used without biologics?
1.5-2.5 mg/kg/day
Which of the following medications is NOT effective for moderate-severe Crohn's disease induction according to the guidelines?
Cyclosporine
What is the maximum duration of total steroid use recommended for tapering in moderate-severe Crohn's disease induction?
3 months
What is the mechanism of action of Methotrexate as an immunomodulator?
Inhibits dihydrofolate reductase
Which adverse effect is associated with Methotrexate as an immunomodulator?
Hepatotoxicity
Prior to initiating TNF-α inhibitors, what should be assessed for?
Risk for infection
Which vaccine should be given before initiating TNF-α inhibitors treatment?
Flu vaccine
What is a common clinical pearl related to monitoring patients on Infliximab?
Assessment for TB reactivation
Which TNF-α inhibitor is 100% humanized?
Golimumab
What is the recommended maintenance dose interval for Adalimumab?
Every 4 weeks
Which type of treatment failure occurs if there is a low or undetectable trough level of TNF-α inhibitors with antibody development?
Immune-mediated PK failure
What should be considered if there is inadequate response to TNF-α inhibitors due to inflammatory mediators not being blocked by the current therapy?
Choose another agent or class
Test your knowledge on maintenance treatments for mild to moderate inflammatory bowel disease in the colon, including Budesonide rectal foam, antibiotics like Metronidazole and Ciprofloxacin, and immunomodulators. Explore the hypotheses and adverse effects associated with these treatments.
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