Inflammatory Bowel disease

Question 1

When should screening colonoscopy begin for patients with IBD?

Answer 1

beginning 8 years after onset of symptoms/diagnosis and then every 1-3 years

Question 2

Findings on histology of Crohn’s disease:

Answer 2

microscopic granulomas, lymphoid aggregates, transmural involvement

Question 3

When is stricturoplasty the preferred management strategy for Crohn’s disease?

Answer 3

when resection of multiple segments of bowel continuity would sacrifice a large amount of normal bowel or leave the patient with <100cm of bowel continuity

Question 4

Ideal length of ileal J pouch:

Answer 4

15-20 cm

Question 5

Main medical treatment of fulminant UC:

Answer 5

IV steroids

Question 6

treatment of duodenal Crohn’s involving the 1st or 2nd portion of the duodenum:

Answer 6

gastrojejunostomy with vagotomy (to avoid marginal ulcers)

Question 7

treatment of duodenal Crohn’s involving 3rd or 4th portion of duodenum:

Answer 7

duodenojejunostomy

Question 8

Emergency treatment of toxic megacolon or fulminant UC:

Answer 8

total abdominal colectomy with end ileostomy

Question 9

long term and interaoperative complications of ileal J pouch:

Answer 9

increased risk of GU dysfunction, infertility, increased bowel frequency and soiling, and increased risk of presacral bleeding

Question 10

treatment of short segment singe small bowel stricture (5-7cm)

Answer 10

Heinecke Mikulicz stricturoplasty

Question 11

treatment of single medium segment of small bowel stricture (10-15cm)

Answer 11

Finney stricturoplasty

Question 12

treatment of long segment of small bowel stricture (>15cm)

Answer 12

Michelassi stricturoplasty

Question 13

True or false. Stricturoplasties are at lower risk for postoperative bleeding from the suture line than simple resection,

Answer 13

false. higher risk

Question 14

Extraintestinal manifestations of Crohns that improve after resection of disease portion:

Answer 14

erythema nodosum, pyoderma gangrenosum, aphthous ulcers, stomatitis, episcleritis, uveitis, and peripheral arthralgias

Question 15

Most common complication of IPAA:

Answer 15

pouchitis

Question 16

Endoscopic features of ulcerative colitis:

Answer 16

continuous mucosal involvement, pseudopolyps, superficial fissures, and loss of normally visualized endoscopic vascular pattern

Question 17

Endoscopic and operative features of Crohn’s disease:

Answer 17

granulomas, cobbestone appearance, transmural involvement, patchy areas of disease, rectal sparing, anal involvement, creeping fat, ulcerations, fissures, fistulas, abscesses

Question 18

True or False. Crohn’s disease is associated with an increased risk of small bowel adenocarcinoma.

Answer 18

true