Q1. A patient who was recently diagnosed with Crohn’s disease is concerned about their diet and fears that everything they eat will cause symptoms. What breakfast option would you recommend for them?
A. Yogurt with berries and granola
B. Egg whites and white toast
C. Banana and peanut butter
D. Raw vegetables
Answer: B
Rationale: Patients with Crohn’s disease want to limit fiber, dairy, and fats. All of these are difficult to break down and may trigger inflammatory responses. Egg whites and white toast are low in fiber, dairy, and fat and should not cause your patient to experience adverse effects. All other answer choices have foods high in these.
Q2. True or false? Patients with Crohn’s disease have a genetic predisposition and always experience abdominal cramping, diarrhea, and malnutrition from birth.
Answer: False
Rationale: There is a genetic predisposition for Crohn’s disease, and it tends to run in families, however, patients can present with Crohn’s disease at any age but usually between 10-30 years.
Q3. What is the main difference in physiology between Crohn’s disease and ulcerative colitis?
A. There are no differences, the names can be used synonymously
B. Crohn’s Disease involves skip lesions and impacts segments of the GI tract; ulcerative colitis impacts the entire rectum and colon
C. Ulcerative colitis involves skip lesion and impacts segments of the GI tract; Crohn’s disease impacts the entire rectum and colon
D. Crohn’s disease is curable; ulcerative colitis is not
Answer: B
Rationale: Crohn’s disease impacts any area between the mouth and the anus. It involves skip lesions and impacts certain areas with inflammation while other areas remain uninflamed. However, ulcerative colitis affects the entire rectum and colon. There is no known cure for Crohn’s disease.
Q4. You are an advanced practitioner at a gastroenterologist. You are seeing an 18-year old girl with severe abdominal pain, diarrhea, and loss of appetite who was referred to you by their primary care provider. You suspect that she has developed Crohn’s disease, how would you confirm this diagnosis?
A. Perform an endoscopy or colonoscopy with biopsies
B. Perform a stress test
C. Exploratory laparotomy
D. Barium swallow
Answer: A
Rationale: An endoscopy and colonoscopy are diagnostic tests that allow visualization of the internal organs including the: stomach, small intestine, and large intestine. These tests allow visualizations of fissures, a cobblestone appearance, and structural abnormalities related to the pathophysiology of Crohn’s disease. Biopsies can be collected and sent to a laboratory to examine tissue samples. A stress test, exploratory laparotomy, and barium swallow test would not be helpful in diagnosing Crohn’s disease.
Q5. Referencing the Patient Case Presentation, what are Svetlana’s risk factors for developing Crohn’s Disease? (select all that apply)
A. Ashkenazi Jewish descent
B. Age
C. Being sexually active
D. Being female
Answer: A, B, D
Rationale: Risk factors for developing Crohn’s Disease include: being of Ashkenazi Jewish descent, being between 10-40 years old, and being female. Svetlana falls into all three of those categories. There is no known link between sexual activity and the onset of Crohn’s Disease.