Question

1) Which of the following factors increases the risk of developing Crohn’s disease (CD) in Caucasians?
Smoking
Smoking cessation
Breastfeeding
High vitamin D levels
2) Which of the following pathologic features indicate CD more than ulcerative colitis?
Fistulas
Rectal bleeding
Continuous disease distribution
Abdominal tenderness
3) Which of the following is true regarding the pathophysiology of CD?
Crohn’s disease is normally confined to the colon and rectum
Crohn’s disease commonly has a “cobblestone” appearance in which the diseased bowel is separated by segments of healthy bowel
Crohn’s disease is often mild and not progressive in nature
Unlike ulcerative colitis, Crohn’s disease is not associated with extraintestinal complications
4) Which of the following classes of medications are used primarily to treat CD flares but should not be used long-term?
Immunomodulators
Anti-TNF agents
5-aminosalicylates
Corticosteroids

Answer 1

1) Smoking — cigarette smoking is a well-established risk factor for developing Crohn’s disease in Caucasians.

2) Fistulas — transmural inflammation in Crohn’s leads to fistula formation (more characteristic of CD than UC).

3) Crohn’s commonly has a “cobblestone” appearance with diseased segments separated by healthy bowel — CD produces skip lesions and cobblestoning of the mucosa.

4) Corticosteroids — used to induce remission in flares but are not recommended for long-term maintenance because of systemic adverse effects.