Crohn Disease

Question 1

Farmer and associates classification of Crohn disease

Answer 1

on the basis of location alone - ileocolic, purely colonic, small bowel, and perianal

Question 2

Vienna classification

Answer 2

categorizes disease on the basis of location, age of onset, and disease behavior

Question 3

Vienna classification - location

Answer 3

terminal ileum (L1), colon (L2), terminal ileum and colon (L3), and any location proximal to the terminal ileum (L4)

Question 4

Vienna classification - age of onset

Answer 4

less than 40 years of age (A1) and 40 years of age or older (A2)

Question 5

Vienna classification - disease behavior

Answer 5

nonstricturing and nonpenetrating (B1), stricturing (B2), and penetrating (B3)

Question 6

Crohn disease of the small bowel has the

Answer 6

highest recurrence rate

Question 7

Abscesses

Answer 7

particularly common with ileocolic Crohn disease

Question 8

Risk of colorectal cancer is approximately

Answer 8

three times higher in patients with Crohn disease than in the general population

Question 9

Duodenal Crohn disease can lead to

Answer 9

gastric outlet obstruction, and in children can be mistaken for annular pancreas

Question 10

When duodenal Crohn does not respond to medical therapy,

Answer 10

gastrojejunostomy with vagotomy is the preferred surgical treatment

Question 11

Crohn disease of the SB is not common but associated with

Answer 11

one of highest overall recurrence rates

Question 12

Two most prevalent strictureplasty technique:

Answer 12

Heineke-Mikulicz and Finney

Question 13

Heineke-Mikulicz strictureplasty

Answer 13

best suited for strictures up to 5 to 7 cm long

Question 14

Finney strictureplasty

Answer 14

best suited for strictures up to 10 to 15 cm long

Question 15

Side-to-side strictureplasty

Answer 15

suitable for longer areas of stricture

Question 16

Crohn disease is generally more severe on

Answer 16

the mesenteric side of the bowel

Question 17

Percent of patients diagnosed with Crohn disease that have ileocolic disease

Answer 17

~ 50%

Question 18

The most common fistulas associated with ileocolic Crohn disease

Answer 18

ileosigmoid

Question 19

Ileocolic Crohn disease is often associated with

Answer 19

intra-abdominal abscess or fistulas

Question 20

Colonic involvement is present in

Answer 20

29 to 44% of patients with Crohn disease

Question 21

Differentiation between Crohn colitis and ulcerative colitis can be difficult in the absence of

Answer 21

SB or anal disease

Question 22

Colonic Crohn disease appears to be more frequently associated with

Answer 22

cutaneous manifestations (e.g., pyoderma gangrenosum)

Question 23

The main indications for operative management of colonic Crohn disease are:

Answer 23

stricture, malignancy, side effect of medical therapy, and failure of medical therapy

Question 24

Toxic megacolon

Answer 24

any condition associated with colitis that is severe enough to result in sloughing of the colonic mucosa, thereby permitting endodoxins to enter the circulatory system and evoke a septic response

Question 25

Anal strictures pose

Answer 25

functional obstruction and lead to continuing problems with fistulas and suppurative disease

Question 26

Anal Crohn disease without stenosis

Answer 26

easier to treat medically - with metronidazole and anti-TNF Ab

Question 27

Mesalamine

Answer 27

reduces postoperative recurrence of Crohn disease

Question 28

Postoperative surveillance of Crohn

Answer 28

no clear guidelines at present

Question 29

Smoking affects

Answer 29

overall severity of Crohn disease - with smokers having a 34% higher recurrence rate and a higher rate of reoperation than nonsmokers