IBD IBD Pharmacotherapy 2

Question 1

Ustekinumab (Stelara) targets which cytokine pathway in treating Crohn's disease?

Accepted Answer

IL-12 and IL-23 via the p40 subunit

Answer

TNF-α and lymphotoxin

Answer

IL-4 and IL-13

Answer

IFN-γ directly

Question 2

Which serious opportunistic infection risk requires tuberculosis (TB) screening before initiating anti-TNF therapy in IBD?

Accepted Answer

TNF blockade impairs macrophage killing of Mycobacterium tuberculosis, risking TB reactivation

Answer

Anti-TNF drugs directly activate latent TB virus

Answer

TNF inhibitors increase gut permeability to mycobacteria

Answer

Anti-TNF therapy depletes NK cells selectively

Question 3

Tofacitinib (Xeljanz) is approved for which IBD indication in the United States?

Accepted Answer

Moderately to severely active ulcerative colitis

Answer

Moderately to severely active Crohn's disease

Answer

Pouchitis after IPAA surgery

Answer

Mild ulcerative colitis as first-line therapy

Question 4

Metronidazole and ciprofloxacin in Crohn's disease are most appropriate for treating which complication?

Accepted Answer

Perianal fistulas and abscesses

Answer

Luminal small bowel disease

Answer

Crohn's-related arthropathy

Answer

Small bowel strictures

Question 5

Combination therapy with infliximab and azathioprine is superior to monotherapy primarily because of which pharmacological interaction?

Accepted Answer

Azathioprine reduces infliximab immunogenicity by suppressing anti-drug antibody formation

Answer

Azathioprine enhances TNF-α production

Answer

Azathioprine increases infliximab receptor binding

Answer

They have synergistic effects on JAK-STAT signaling

Question 6

Which IBD medication carries a Black Box Warning for increased risk of lymphoma, specifically hepatosplenic T-cell lymphoma?

Accepted Answer

Thiopurines (azathioprine/6-MP) especially in young males

Answer

Vedolizumab

Answer

Mesalamine

Answer

Ustekinumab