IBD IBD Disease Monitoring and Activity Assessment 2

Question 1

Fecal calprotectin levels greater than 250 μg/g in a clinically quiescent IBD patient most likely indicate:

Accepted Answer

Subclinical mucosal inflammation

Answer

Elevated fecal calprotectin (>250 μg/g) in a patient without active symptoms suggests ongoing subclinical mucosal inflammation not apparent from clinical assessment alone, warranting endoscopic reassessment.

Question 2

Which serum antibody is most strongly associated with Crohn's disease and is used as part of serological testing in IBD workup?

Accepted Answer

ASCA (anti-Saccharomyces cerevisiae antibody)

Answer

ASCA (anti-Saccharomyces cerevisiae antibody) is most strongly associated with Crohn's disease, while pANCA is more associated with ulcerative colitis; their combination helps differentiate between the two conditions.

Question 3

Therapeutic drug monitoring (TDM) for infliximab in IBD patients primarily involves measuring:

Accepted Answer

Serum trough drug concentrations and anti-drug antibodies

Answer

TDM for infliximab measures serum trough concentrations (drawn just before the next infusion) and anti-drug antibodies to guide dose optimization and identify the cause of primary or secondary loss of response.

Question 4

Which laboratory pattern is most characteristic of iron deficiency anemia due to chronic intestinal bleeding in IBD?

Accepted Answer

Low ferritin, low serum iron, and elevated TIBC

Answer

Iron deficiency anemia from chronic GI blood loss presents with low ferritin (depleted stores), low serum iron, and elevated TIBC (total iron-binding capacity), reflecting the body's compensatory upregulation of iron-transport protein.

Question 5

Which vitamin deficiency requires specific monitoring in patients with Crohn's disease affecting the terminal ileum or following ileal resection?

Accepted Answer

Vitamin B12 (cobalamin)

Answer

Vitamin B12 absorption occurs exclusively in the terminal ileum via intrinsic factor; Crohn's disease involving this segment or ileal resection impairs B12 uptake, necessitating regular monitoring and parenteral supplementation.

IBD - Inflammatory Bowel Disease Practice Test

IBD - Inflammatory Bowel Disease Practice Test

IBD IBD Disease Monitoring and Activity Assessment 2