CROHNS (INFLAMMATORY BOWEL DISEASE)

Question 1

The term “inflammatory bowel disease” includes what two conditions

Answer 1

ulcerative colitis and Crohn’s disease

Question 2

Pertinent Anatomy of a patient with Inflammatory Bowel Disease (Crohns)

Answer 2

which can affect any segment of the gastrointestinal tract from the mouth to the anus, involves “skip lesions,” and is transmural.

Question 3

chronic, recurrent disease characterized by patchy transmural
inflammation involving any segment of the gastrointestinal tract from the mouth to
the anus.
Consists of segmental involvement by a nonspecific inflammatory process

Answer 3

Crohn’s

Question 4

When it involves the terminal ileum, there is malabsorption of

Answer 4

digested foods, B12,

Bile Salts and Calcium.

Question 5

Crohn’s disease and ulcerative colitis may be associated in ___ of patients with a
number of extraintestinal manifestations

Answer 5

50%

Question 6

Crohn’s and UC extraintestinal manifestations:

Just Crohns

Answer 6

erythema nodosum, pyoderma gangrenosum, thromboembolic
events.
oral ulcers, anorectal disease

Question 7

Patients should be encouraged to become involved in what foundation

Answer 7

Crohn's and Colitis Foundation
of America (CCFA).

Question 8

Is IBD genetic

Answer 8

yes

Question 9

Crohns description

Answer 9

(a) Insidious onset
(b) Intermittent bouts of low-grade fever, diarrhea, and right lower quadrant pain.
(c) May present with right lower quadrant mass and tenderness. Some may present
additionally with perianal disease such as abscesses and fistulas.
(d) May present with radiographic or endoscopic evidence of ulceration, stricturing, or
fistulas of the small intestine or colon.
(e) 1/3 of cases involve the small bowel only, usually the terminal ileum (ileitis).
(f) Half of all cases involve the small bowel and colon, usually the terminal ileum and
adjacent proximal ascending colon (ileocolitis).
(g) Cigarette smoking is strongly associated with the development of Crohn’s disease,
resistance to medical therapy, and early disease relapse.

Question 10

Crohn’s Symptoms

Answer 10

variety of symptoms and signs.

(b) In eliciting the history, the clinician should take particular note of
1) Fevers
2) The patient’s general sense of well- being
3) Weight loss
4) The presence of abdominal pain
5) The number of liquid bowel movements per day
6) Prior surgical resections
(c) Physical examination should focus on the patient’s
1) Temperature
2) Weight, and nutritional status
3) The presence of abdominal tenderness or an abdominal mass
4) Rectal examination
5) Extra-intestinal manifestations

Question 11

Most commonly, there is one or a combination of the following clinical
constellations.

Answer 11

1) Chronic inflammatory disease
2) Physical examination reveals focal tenderness, usually in the right lower
quadrant.
3) Penetrating disease and fistula
4) Perianal disease

Question 12

the most common presentation and is

often seen in patients with ileitis or ileocolitis.

Answer 12

Chronic inflammatory disease
a) Patients report low-grade fever, malaise, weight loss, and loss of energy
b) In patients with ileitis or ileocolitis, there may be diarrhea, which is usually
non-bloody and often intermittent.
c) Cramping or steady right lower quadrant or periumbilical pain is common.

Question 13

Narrowing of the small bowel may occur as a result

of inflammation, spasm, or fibrotic stenosis.

Answer 13

Intestinal obstruction
(1 Patients report postprandial bloating, cramping pains, and loud
borborygmi.
(2 Obstruction may occur in patients with active inflammatory symptoms
or later in the disease from chronic fibrosis without other systemic
symptoms or signs of inflammation.