[MCQ] Inflammatory bowel disease- Part 6

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Inflammatory bowel disease- Part 6

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Congratulations - you have completed Inflammatory bowel disease- Part 6. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Anti-TNF monoclonal antibody useful in treatment of moderate to severely active CD in patients is ?

A	Infliximab
B	Adalimumab
C	Certolizumab pegol
D	All of the above

Question 1 Explanation:

Anti-TNF monoclonal antibodies, infliximab, adalimumab, and certolizumab pegol, are effective in the treatment of moderate to severely active CD in patients who have not responded despite complete & adequate therapy with a corticosteroid or an immunosuppressive agent.

Question 2

Infusion reaction that occur with Infliximab therapy is due to ?

A	Antibody to Infliximab
B	Concurrent Methotrexate therapy
C	Anti ds-DNA antibody
D	Antinuclear factor

Question 2 Explanation:

The development of antibodies to infliximab (ATI) is associated with an increased risk of infusion reactions and a decreased response to treatment

Question 3

Which one of the following is considered to be useful additional therapy with treatment of CD with Infliximab ?

A	Oral steroids
B	5-ASA
C	Azathioprine
D	Elemental diet

Question 3 Explanation:

If infliximab is used episodically for flares, concomitant immunosuppression with AZA, 6-MP or methotrexate in therapeutic doses is recommended to reduce clinical consequences of immunogenicity of chimeric antibodies. SONIC (Study of Biologic and Immunomodulator-Naïve Patients with Crohn’s Disease) Trial compared infliximab plus azathioprine, infliximab alone and azathioprine alone in moderate-to-severe Crohn’s disease with infliximab plus azathioprine group showing best results and no greater adverse events

Question 4

Which of the following is associated with infliximab therapy ?

A	Lymphoma
B	Leukemia
C	New-onset psoriasis
D	All of the above

Question 5

Infliximab is not useful in ?

A	Crohn’s disease
B	Rheumatoid arthritis
C	Ankylosing spondilitis
D	Primary sclerosing cholangitis

Question 6

Which of the following is not an indication of Infliximab therapy ?

A	Steroid dependant CD
B	Fistulizing CD
C	Maintenance of remission in CD
D	Mechanical small intestinal obstruction in CD

Question 7

Adalimumab is a ?

A	IgG1 chimeric monoclonal antibody against TNF
B	IgG1 recombinant human monoclonal antibody against TNF
C	IgG4 chimeric monoclonal antibody against TNF
D	P75 TNF receptor fusion protein

Question 7 Explanation:

Less immunogenic than Infliximab, Adalimumab is a recombinant human monoclonal IgG1 antibody containing only human peptide sequences. Adalimumab binds TNF and neutralizes its function by blocking the interaction between TNF and its cell-surface receptor.

Question 8

Which one of the following specifically blocks Integrin-4 and prevents lymphocyte trafficking to the intestine in IBD ?

A	Anti IL-12 P40 antibody
B	Anti gamma interferon
C	Natalizumab
D	Basiliximab

Question 8 Explanation:

Humanized monoclonal antibody to alpha-4 integrin - Natalizumab inhibits lymphocyte trafficking and is effective in treatment of moderate to severely active CD who have had an inadequate response or are unable tolerate conventional CD therapies and anti-TNF monoclonal antibody therapy.

Question 9

Natalizumab is a ?

A	IgG1 chimeric monoclonal antibody against TNF
B	IgG1 recombinant human monoclonal antibody against TNF
C	IgG4 recombinant humanized immunoglobulin G4 antibody against 4 integrin
D	P75 TNF receptor fusion protein

Question 9 Explanation:

Natalizumab is a recombinant humanized immunoglobulin G4 antibody against 4 integrin that is effective in the induction and maintenance of remission in CD patients

Question 10

Natalizumab causes progressive multifocal leukoencephalopa thy (PML) by reactivation of which virus ?

A	Hepatitis B
B	Human JC polyoma virus
C	Hepatitis C
D	Cytomegalovirus (CMV)

Question 10 Explanation:

Natalizumab reactivates the human JC polyoma virus, which can lead to progressive multifocal leukoencephalopathy (PML)

Question 11

Which one of the following helps in intestinal restitution and repair ?

A	TNF
B	EGF
C	GM-CSF
D	IL-12

Question 12

Which of the following is false in females with IBD ?

A	Normal fertility rates in quiescent IBD
B	Fallopian tubes scarred by inflammatory process of CD, especially on right side
C	Fallopian tubes scarred by inflammatory process of CD, especially on left side
D	Dyspareunia common

Question 12 Explanation:

Fallopian tubes can be scarred by inflammatory process of CD, especially on right side because of the proximity of terminal ileum

Question 13

In IBD, which of following drugs is safe for use in pregnancy ?

A	Sulfasalazine
B	Mesalamine
C	Balsalazide
D	All of the above

Question 13 Explanation:

Sulfasalazine, mesalamine, and balsalazide are safe for use in pregnancy and nursing, but additional folate supplementation must be given with sulfasalazine. Topical 5-ASA agents are also safe during pregnancy and nursing. Glucocorticoids are generally safe for use during pregnancy.

Question 14

The safe antibiotics to use for short periods in pregnant CD patients are all except ?

A	Ampicillin
B	Cephalosporin
C	Ciprofloxacin
D	Metronidazole

Question 14 Explanation:

Safest antibiotics in CD in pregnancy for weeks, not months are ampicillin and cephalosporin. Metronidazole can be used in the second or third trimester. Ciprofloxacin causes cartilage lesions and should be avoided.

Question 15

In treatment of IBD with pregnancy, which of the following drugs is contraindicated ?

A	6-Mercaptopurine
B	Azathioprine
C	Methotrexate
D	Cyclosporine

Question 15 Explanation:

Methotrexate is contraindicated in pregnancy and nursing. 6-MP and azathioprine pose minimal or no risk during pregnancy. In severe IBD treated with IV CSA during pregnancy, 80% of pregnancies were successfully completed without development of renal toxicity, congenital malformations, or developmental defects.

Question 16

In pregnancy, exacerbation in Crohn’s disease is seen in ?

A	First trimester
B	Second and third trimesters
C	Postpartum period
D	All of the above

Question 17

In pregnancy, exacerbation in Ulcerative colitis is seen in ?

A	First trimester
B	Second trimester
C	Third trimester
D	All of the above

Question 18

Patients with CD have an increased risk of developing which of the following cancers ?

A	Non-Hodgkin’s lymphoma
B	Hodgkin’s lymphoma
C	Bronchogenic carcinoma
D	Carcinoma cervix

Question 19

Patients with CD have an increased risk of developing which of the following cancers ?

A	Hodgkin’s lymphoma
B	Endometrial carcinoma
C	Bronchogenic carcinoma
D	Squamous cell cancers

Question 19 Explanation:

Patients with CD may have an increased risk of non-Hodgkin’s lymphoma, leukemia, and myelodysplastic syndromes. Severe chronic, complicated perianal disease in CD patients may be associated with an increased risk of cancer in lower rectum and anal canal (squamous cell cancers).

Question 20

Invariably involved site in UC is ?

A	Sigmoid colon
B	Transverse colon
C	Ileum
D	Rectum

Question 21

Which site is usually spared in CD ?

A	Sigmoid colon
B	Transverse colon
C	Ileum
D	Rectum

Question 21 Explanation:

Rectum

Question 22

Most common site of involvement in CD is ?

A	Sigmoid colon
B	Transverse colon
C	Ileum
D	Rectum

Question 22 Explanation:

CD can affect any part of the gastrointestinal tract, from mouth to anus. In 75% of patients with small-intestinal disease, terminal ileum is involved in 90%.

Question 23

Perforation in CD is mainly seen in ?

A	Sigmoid colon
B	Transverse colon
C	Ileum
D	Rectum

Question 23 Explanation:

In CD, perforation occurs in 1 - 2% of patients usually in the ileum, but occasionally in jejunum or as a complication of toxic megacolon

Question 24

Before making a diagnosis of IBD, which of the following infections should be ruled out ?

A	Campylobacter
B	Arcobacter
C	Helicobacter
D	Helicobacter

Question 24 Explanation:

Presentation of Campylobacter enteritis may mimic UC or CD. As Campylobacter enteritis is much more common than UC and CD among young adults, a diagnosis of IBD should not be made until Campylobacter infection has been ruled out

Question 25

Which virus is a predisposing factor for IBD ?

A	Paramyxovirus
B	Orthomyxovirus
C	Arbovirus
D	Hepatitis A

Question 26

Diarrhoea in CD is due to ?

A	Bacterial overgrowth
B	Bile acid malabsorption
C	Increased electrolyte secretion in bowels
D	All of the above

Question 26 Explanation:

Diarrhea in CD is caused by bacterial overgrowth in obstructive stasis or fistulization, bile acid malabsorption due to a diseased or resected terminal ileum and intestinal inflammation with decreased water absorption & increased secretion of electrolytes

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See all quizzes of Peptic Ulcer Disease at here:

1.Anti-TNF monoclonal antibody useful in treatment of moderate
to severely active CD in patients is ?
A. Infliximab
B. Adalimumab
C. Certolizumab pegol
D. All of the above

2.Infusion reaction that occur with Infliximab therapy is due to ?
A. Antibody to Infliximab
B. Concurrent Methotrexate therapy
C. Anti ds-DNA antibody
D. Antinuclear factor

3. Which one of the following is considered to be useful
additional therapy with treatment of CD with Infliximab ?
Harrison’s 18th Ed. 2491
A. Oral steroids
B. 5-ASA
C. Azathioprine
D. Elemental diet

4. Which of the following is associated with infliximab therapy ?
A. Lymphoma
B. Leukemia
C. New-onset psoriasis
D. All of the above
5.Infliximab is not useful in ?
A. Crohn’s disease
B. Rheumatoid arthritis
C. Ankylosing spondilitis
D. Primary sclerosing cholangitis

6. Which of the following is not an indication of Infliximab
therapy ?
A. Steroid dependant CD
B. Fistulizing CD
C. Maintenance of remission in CD
D. Mechanical small intestinal obstruction in CD
7. Adalimumab is a ?
A. IgG1 chimeric monoclonal antibody against TNF
B. IgG1 recombinant human monoclonal antibody against TNF
C. IgG4 chimeric monoclonal antibody against TNF
D. P75 TNF receptor fusion protein

8. Which one of the following specifically blocks Integrin-4 and
prevents lymphocyte trafficking to the intestine in IBD ?
A. Anti IL-12 P40 antibody
B. Anti gamma interferon
C. Natalizumab
D. Basiliximab

9. Natalizumab is a ?
A. IgG1 chimeric monoclonal antibody against TNF
B. IgG1 recombinant human monoclonal antibody against TNF
C. IgG4 recombinant humanized immunoglobulin G4 antibody
against 4 integrin
D. P75 TNF receptor fusion protein

10. Natalizumab causes progressive multifocal leukoencephalopa
thy (PML) by reactivation of which virus ?
A. Hepatitis B
B. Human JC polyoma virus
C. Hepatitis C
D. Cytomegalovirus (CMV)

11.Which one of the following helps in intestinal restitution and
repair ?
A. TNF
B. EGF
C. GM-CSF
D. IL-12

12. Which of the following is false in females with IBD ?
A. Normal fertility rates in quiescent IBD
B. Fallopian tubes scarred by inflammatory process of CD,
especially on right side
C. Fallopian tubes scarred by inflammatory process of CD,
especially on left side
D. Dyspareunia common

13. In IBD, which of following drugs is safe for use in pregnancy ?
A. Sulfasalazine
B. Mesalamine
C. Balsalazide
D. All of the above

14. The safe antibiotics to use for short periods in pregnant CD
patients are all except ?
A. Ampicillin
B. Cephalosporin
C. Ciprofloxacin
D. Metronidazole

15. In treatment of IBD with pregnancy, which of the following drugs
is contraindicated ?
A. 6-Mercaptopurine
B. Azathioprine
C. Methotrexate
D. Cyclosporine

16. In pregnancy, exacerbation in Crohn’s disease is seen in ?
A. First trimester
B. Second and third trimesters
C. Postpartum period
D. All of the above
17. In pregnancy, exacerbation in Ulcerative colitis is seen in ?
A. First trimester
B. Second trimester
C. Third trimester
D. All of the above

18. Patients with CD have an increased risk of developing which of
the following cancers ?
A. Non-Hodgkin’s lymphoma
B. Hodgkin’s lymphoma
C. Bronchogenic carcinoma
D. Carcinoma cervix
19. Patients with CD have an increased risk of developing which of
the following cancers ?
A. Hodgkin’s lymphoma
B. Endometrial carcinoma
C. Bronchogenic carcinoma
D. Squamous cell cancers

20. Invariably involved site in UC is ?
A. Sigmoid colon
B. Transverse colon
C. Ileum
D. Rectum
21.Which site is usually spared in CD ?
A. Sigmoid colon
B. Transverse colon
C. Ileum
D. Rectum
22. Most common site of involvement in CD is ?
A. Sigmoid colon
B. Transverse colon
C. Ileum
D. Rectum

23.Perforation in CD is mainly seen in ?
A. Sigmoid colon
B. Transverse colon
C. Ileum
D. Rectum

24. Before making a diagnosis of IBD, which of the following
infections should be ruled out ?
A. Campylobacter
B. Arcobacter
C. Helicobacter
D. All of the above

25. Which virus is a predisposing factor for IBD ?
A. Paramyxovirus
B. Orthomyxovirus
C. Arbovirus
D. Hepatitis A
26. Diarrhoea in CD is due to ?
A. Bacterial overgrowth
B. Bile acid malabsorption
C. Increased electrolyte secretion in bowels
D. All of the above

Inflammatory bowel disease

[MCQ] Inflammatory bowel disease- Part 6

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Inflammatory bowel disease- Part 6

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