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. Which radiological sign on plain abdominal X-ray suggests toxic megacolon as a complication of IBD? → Transverse colon diameter >6 cm with mucosal edema
2. Which perianal Crohn's complication requires examination under anesthesia (EUA) with seton placement? → Complex perianal fistula
3. Which IBD-associated hepatobiliary manifestation requires liver transplant evaluation and is associated with significant risk of cholangiocarcinoma? → Primary sclerosing cholangitis (PSC)
4. Which serological marker combination pattern is most consistent with ulcerative colitis? → pANCA positive, ASCA negative
5. In UC, the histological finding of 'crypt abscesses' involves accumulation of which cells within crypts? → Neutrophils
6. 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
7. What is the preferred imaging modality for evaluating small bowel involvement in Crohn's disease? → CT enterography (CTE) or MR enterography (MRE)
8. 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
9. Which non-invasive biomarker is released from neutrophils in inflamed intestinal mucosa and correlates most closely with endoscopic disease activity in IBD? → Fecal calprotectin
10. The low FODMAP diet is most appropriately used in IBD to manage which condition? → Concurrent irritable bowel syndrome (IBS)-like symptoms in IBD remission
11. 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
12. Which finding on pouchoscopy is consistent with chronic antibiotic-refractory pouchitis? → Persistent mucosal inflammation, ulceration, and edema despite ≥4 weeks of antibiotics
13. 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
14. 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
15. 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
16. Dysbiosis in IBD most commonly involves a reduction in which beneficial bacterial genus? → Faecalibacterium
17. 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)
18. 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
19. Fistula formation in Crohn's disease most commonly occurs between which two structures? → Terminal ileum and sigmoid colon (ileo-sigmoid)
20. 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
21. Which IBD-associated antibody is most specific for Crohn's disease? → ASCA (anti-Saccharomyces cerevisiae antibody)
22. True or False: IBD is an unpredictable disease, with periods of flares and remission. → True
23. Which pre-operative factor most increases the risk of complications after IPAA surgery for UC? → Chronic corticosteroid use (>20 mg/day prednisone)
24. Probiotics in IBD have the most evidence for clinical benefit in which specific indication? → Prevention of relapse in ulcerative colitis (VSL#3 for pouchitis specifically)
25. The specific carbohydrate diet (SCD) in IBD is based on which theoretical mechanism? → Restricting complex carbohydrates to starve pathogenic bacteria and improve gut dysbiosis
26. In ulcerative colitis clinical trials, mucosal healing is most commonly defined as a Mayo endoscopic subscore of: → 0 or 1
27. Which serum antibody is most strongly associated with Crohn's disease and is used as part of serological testing in IBD workup? → ASCA (anti-Saccharomyces cerevisiae antibody)
28. Which laboratory finding is most characteristic of active Crohn's disease affecting the terminal ileum? → Vitamin B12 deficiency and macrocytic anemia
29. Ozanimod, approved for UC, works through which novel mechanism? → Sphingosine-1-phosphate (S1P) receptor modulation, sequestering lymphocytes in lymph nodes
30. The client diagnosed with IBD is prescribed total parental nutrition (TPN). Which intervention should the nurse implement? → Check the client's glucose level