IBD Cheat Sheet 2026

The 30 highest-yield IBD facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A client with Crohn's disease is prescribed vedolizumab (Entyvio). The nurse explains that this biologic differs from anti-TNF agents because it: → Acts selectively on the gut by blocking leukocyte migration into the intestinal mucosa
2. Which radiological sign on plain abdominal X-ray suggests toxic megacolon as a complication of IBD? → Transverse colon diameter >6 cm with mucosal edema
3. Which perianal Crohn's complication requires examination under anesthesia (EUA) with seton placement? → Complex perianal fistula
4. Which IBD-associated hepatobiliary manifestation requires liver transplant evaluation and is associated with significant risk of cholangiocarcinoma? → Primary sclerosing cholangitis (PSC)
5. Which serological marker combination pattern is most consistent with ulcerative colitis? → pANCA positive, ASCA negative
6. In UC, the histological finding of 'crypt abscesses' involves accumulation of which cells within crypts? → Neutrophils
7. Cyclosporine IV is used as rescue therapy in severe acute UC refractory to IV corticosteroids. What is its primary mechanism? → Calcineurin inhibition → reduced IL-2 → T-cell suppression
8. What is the preferred imaging modality for evaluating small bowel involvement in Crohn's disease? → CT enterography (CTE) or MR enterography (MRE)
9. Which IBD medication carries a Black Box Warning for increased risk of lymphoma, specifically hepatosplenic T-cell lymphoma? → Thiopurines (azathioprine/6-MP) especially in young males
10. Which non-invasive biomarker is released from neutrophils in inflamed intestinal mucosa and correlates most closely with endoscopic disease activity in IBD? → Fecal calprotectin
11. The low FODMAP diet is most appropriately used in IBD to manage which condition? → Concurrent irritable bowel syndrome (IBS)-like symptoms in IBD remission
12. A client with ulcerative colitis asks whether their disease can spread to the small intestine like Crohn's disease. The nurse's most accurate response is: → No, UC is limited to the colon and rectum, though backwash ileitis can occur
13. Paneth cells in the small intestine contribute to IBD pathogenesis primarily through which mechanism? → Secreting defensins and antimicrobial peptides that are impaired in Crohn's
14. Which finding on pouchoscopy is consistent with chronic antibiotic-refractory pouchitis? → Persistent mucosal inflammation, ulceration, and edema despite ≥4 weeks of antibiotics
15. Combination therapy with infliximab and azathioprine is superior to monotherapy primarily because of which pharmacological interaction? → Azathioprine reduces infliximab immunogenicity by suppressing anti-drug antibody formation
16. A client with IBD is prescribed metronidazole for a perianal fistula. The nurse should teach the client to avoid which substance? → Alcohol
17. A client with IBD has a serum albumin of 2.1 g/dL. What is the most likely clinical consequence the nurse should monitor for? → Peripheral edema from decreased oncotic pressure
18. Axial spondyloarthropathy (sacroiliitis, ankylosing spondylitis) in IBD is characterized by which feature distinguishing it from peripheral arthropathy? → It runs an independent course from IBD and does not improve after colectomy
19. Which of the following best explains why methotrexate is preferred over azathioprine for Crohn's disease in some patients? → Methotrexate has proven efficacy for inducing remission in Crohn's; azathioprine has not
20. The client is diagnosed with an acute exacerbation of IBD. Which priority intervention should the nurse implement first? → Record the frequency, amount, and color of stools
21. Fecal calprotectin is primarily useful in IBD management for which purpose? → Distinguishing IBD flare from IBS-like symptoms and monitoring mucosal inflammation
22. Dysbiosis in IBD most commonly involves a reduction in which beneficial bacterial genus? → Faecalibacterium
23. What is the primary mechanism of action of vedolizumab in IBD treatment? → Gut-selective integrin blockade (anti-α4β7)
24. What is the surgical procedure of choice for ulcerative colitis that is refractory to medical therapy? → Proctocolectomy with ileal pouch-anal anastomosis (IPAA / J-pouch)
25. A postoperative client who had a colectomy for ulcerative colitis develops fever, abdominal distension, and absent bowel sounds on day 3. The nurse suspects: → Anastomotic leak
26. Fecal diversion (loop ileostomy) as a temporizing measure in severe perianal Crohn's disease achieves which primary goal? → Reduces fecal contamination of perineum, allowing healing and biologic therapy to work
27. Fistula formation in Crohn's disease most commonly occurs between which two structures? → Terminal ileum and sigmoid colon (ileo-sigmoid)
28. The highest concentration of microorganisms, or microbes, that live within our bodies is found in the intestines. How many microbes typically live in our gut? → Trillions
29. Which IBD-associated antibody is most specific for Crohn's disease? → ASCA (anti-Saccharomyces cerevisiae antibody)
30. True or False: IBD is an unpredictable disease, with periods of flares and remission. → True