Crohn's Disease

Which is true regarding the incidence and demographics of CrohnÂ’s disease?
1. 5 times more common in Whites than Blacks
2. 4 times more common in men than women
3. Increasing incidence in England
4. Increased incidence in Jewish population
Which is NOT one of the pathologic findings in the intestine with CrohnÂ’s disease?
1. Bowel wall thickening
2. Dilated intestinal lymphatics
3. Granulomas in intestinal wall
4. Hyperplasia of goblet cells
T or F: skip areas are commonly seen in CrohnÂ’s disease?
1. True
2. False
Which is NOT one of the common symptoms of CrohnÂ’s disease?
1. Weight loss in about 50%
2. Abdominal pain in 75%
3. Fever in 25%
4. Diarrhea in more than half of patients
Is rectal bleeding more common with CrohnÂ’s disease or ulcerative colitis?
1. CrohnÂ’s disease
2. Ulcerative colitis
3. Equivalent
T or F: Children with CrohnÂ’s disease are usually diagnosed promptly.
1. True
2. False
Which has a more chronic continuous course; CrohnÂ’s disease or ulcerative colitis?
1. CrohnÂ’s disease
2. Ulcerative colitis
3. Equivalent
What is the most common form of CrohnÂ’s disease in children requiring surgery?
1. Colonic form
2. Ileal form
3. Ileocolic form
Which is NOT an extraintestinal manifestation of CrohnÂ’s disease?
1. Poor growth
2. Lack of sexual maturation
3. Stomatitis
4. Uveitis
5. All of the above are manifestations
Perianal ulcers in CrohnÂ’s disease are painful or painless?
1. Painless
2. Painful
Which is NOT true regarding the laboratory findings in CrohnÂ’s disease?
1. Stool cultures usually positive
2. Sed rate often increased
3. Hypoalbuminemia is common
4. Vitamin B Â– 12 absorption may be abnormal
What is the most common site of internal fistula in CrohnÂ’s disease?
1. Ileum to Ileum
2. Ileal to transverse colon
3. Ileal to ascending or sigmoid colon
4. Ileum to bladder
If a fistula develops in CrohnÂ’s disease after appendectomy, the fistula connects the skin and ____?
1. Distal ileum
2. Base of appendix
3. Colon
Is toxic megacolon common with CrohnÂ’s disease?
1. Yes
2. No
Urinary tract infection in a patient with CrohnÂ’s disease would be most likely to suggest what?
1. Rectosigmoid disease and poor bladder emptying
2. Bladder involvement
3. Enterovesical fistula
How much is the incidence of colorectal carcinoma increased an in a patient with CrohnÂ’s disease?
1. 5-fold
2. 10-fold
3. 20-fold
4. 50-fold
Which is NOT part of the medical management of CrohnÂ’s disease?
1. Low protein diet
2. Low roughage diet
3. Sulfasalazine
4. Flagyl occasionally
What is the long-term incidence of tumors forming on patients with CrohnÂ’s disease treated with azathioprine / prednisone?
1. 10-fold increase
2. 25-fold increase
3. 50-fold increase
4. 80-fold increase
T or F: The mnemonic Â“IHOPÂ” describes the most common indications for operation in CrohnÂ’s disease?
1. True
2. False
What percent of CrohnÂ’s disease patients have a family member with the disease?
1. Under 5%
2. 10%
3. 15%
4. 25%
What is the most common indication for operation in children with ileocolic CrohnÂ’s disease?
1. Bleeding
2. Pain
3. Perforation
4. Obstruction
How often does local therapy resolve the symptoms in CrohnÂ’s disease patients with perianal involvement?
1. Less than 5%
2. Less than 5 Â– 10%
3. 15%
4. 25%
Which is the LEAST likely indication for operation in children with CrohnÂ’s disease?
1. Stricture
2. Growth failure
3. Enteric fistula
4. Perianal disease
What is the most common operation done for children with CrohnÂ’s disease?
1. Ileal resection and ileostomy
2. Segmental colon resection
3. Ileal resection and primary anastomosis
4. Total abdominal colectomy
What is the typical incidence of fistula developing after appendectomy in patients with CrohnÂ’s disease?
1. Less than 5%
2. About 1/3rd to 1/4th
3. 50%
What is the recurrence rate for CrohnÂ’s disease involving the small intestine?
1. 5%
2. 15%
3. 25%
4. 50%
T or F: The standard operative treatment for CrohnÂ’s disease is segmental resection with anastomosis; skip areas are not usually removed unless problematic.
1. True
2. False
T or F: Endorectal pull through is sometimes necessary for advanced CrohnÂ’s disease?
1. True
2. False
What is the treatment for enterovesical fistula in patients with CrohnÂ’s disease?
1. Intestinal resection, simple closure of bladder defect
2. Bladder resection, simple closure of intestinal defect
3. Intestinal and bladder resection
Ileostomy without resection or with a bypass procedure carries what risk in CrohnÂ’s?
1. Less chance of clinical improvement
2. Increased complication risk
3. Both
How are intestine to intestine fistulas handled in patients with CrohnÂ’s disease?
1. Intestinal resection, simple closure of uninvolved bowel
2. Resection of both intestinal segments, proximal diversion
3. Resection of both intestinal segments, regardless of involvement
In CrohnÂ’s disease with abdominal pain and no active disease in the cecum or distal ileum, should the appendix be removed?
1. Yes
2. No
T or F: The incidence of appendicitis is lower in patients with CrohnÂ’s disease than the general population?
1. True
2. False
What is the treatment of CrohnÂ’s disease of the duodenum causing obstruction?
1. Gastrojejunostomy
2. Duodenectomy
3. Duodenal diverticularization
4. Gastrojejunostomy and vagotomy
What is the overall recurrence rate within 3 years after operation for CrohnÂ’s disease?
1. 25%
2. 50%
3. 75%
4. 90%
What is the most common site of recurrence after operation for CrohnÂ’s disease?
1. At the anastomosis
2. Distal to the anastomosis
3. Proximal to the anastomosis
How many percent of children or adults will require second operation for CrohnÂ’s disease?
1. 10%
2. 15%
3. 30%
4. 60%
What is the initial management of perianal CrohnÂ’s disease?
1. NPO and TPN
2. Simple debridement
3. Resection of diseased rectum
4. Ileostomy

Crohn's Disease

Quiz