MedBugs: SAQ #132

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Case: Checkpoint inhibitor colitis

A 63-year-old male comes into your ED. Hey! You’ve met him before; metastatic melanoma, brain mets, pretty much coning then, but recovered and discharged home on nivolumab and ipilimumab. TODAY, he’s come in with lower abdominal pain, bloody diarrhoea and low-grade temp. His inflammatory markers are moderately elevated.

1. What is the diagnosis, and the (2) most likely causes? (3 marks) 3 marks

These CPI (check-point inhibitor) drugs are quite different to OG (original gangster) chemo.

2. How do their mechanisms differ? What kind of adverse effects, or general consequences do you most commonly see in ED as a result?(4 marks) 4 marks

3. List (6) adverse effects of CPIs from (6) different organ systems. (6 marks) 6 marks

4. What are the (5) most important prongs of his management, with dosing as appropriate? (5 marks) 5 marks

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Case: Checkpoint inhibitor colitis

1. What is the diagnosis, and the (2) most likely causes? (3 marks) 3 marks

2. How do their mechanisms differ? What kind of adverse effects, or general consequences do you most commonly see in ED as a result?(4 marks) 4 marks

3. List (6) adverse effects of CPIs from (6) different organ systems. (6 marks) 6 marks

4. What are the (5) most important prongs of his management, with dosing as appropriate? (5 marks) 5 marks

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