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Nurse Practitioner:
doi: 10.1097/01.NPR.0000423813.63114.cb
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Crohn disease: Recognition is key

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INSTRUCTIONS Crohn disease: Recognition is key

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Crohn disease: Recognition is key

General Purpose: To provide information on the diagnosis and management of CD. Learning Objectives: After reading the preceding article and taking this test, you should be able to: 1. Identify the epidemiology, signs and symptoms, and complications of and risk factors for CD. 2. Discuss the diagnosis and the treatment of patients with CD.

1. Which statement about CD is accurate?

a. CD occurs primarily in people ages 40 to 50 years old.

b. CD is an autoimmune disease.

c. No familial trend has been identified for CD.

d. CD is more common in the southern than in the northern part of the United States

2. There is a higher incidence of CD in

a. Whites.

b. Hispanics.

c. Blacks.

d. Asians.

3. A factor that aggravates the course of CD is

a. anorexia.

b. a diet lacking saturated fat.

c. small, frequent meals.

d. active smoking.

4. Common symptoms of CD include

a. pain before meals.

b. weight gain.

c. rectal bleeding.

d. upper quadrant abdominal pain.

5. Typically, CD may cause all of the following except

a. abscesses.

b. fatty stools.

c. perforation.

d. fistula formation.

6. Which of the following usually contributes the most to developing a working diagnosis of CD?

a. family history

b. pertinent clinical findings

c. history of recent infection

d. response to medication

7. A common physical finding in CD is

a. a positive McBurney sign.

b. hyperactive BS.

c. a positive psoas sign.

d. bilateral LQ abdominal pain.

8. A lab test that may be useful in differentiating CD from UC is

a. liver function tests.

b. a CBC.

c. protein biomarkers.

d. an ESR.

9. First-line testing for the initial workup of CD includes

a. a left lateral decubitus X-ray.

b. upper and lower GI series.

c. video capsule endoscopy.

d. MRI.

10. Which test is used when a diagnosis of appendicitis needs to be rapidly ruled out?

a. CT

b. colonoscopy

c. esophagogastroduodenoscopy

d. flat and upright X-ray

11. Bowel loop narrowing that may occur in CD is known as

a. cobblestoning.

b. a positive string sign.

c. skip lesion.

d. aphthae.

12. Skip lesions are

a. noncontinuous bowel lesions found in CD.

b. precancerous lesions throughout the colon.

c. classic findings of H. pylori infection.

d. continuous disease involvement of the colon found in UC.

13. The use of probiotics has been shown to

a. control refractory diarrhea.

b. reduce intestinal normal flora.

c. inhibit prostaglandins.

d. increase host vitality.

14. Which drug suppresses T-cell activation?

a. tacrolimus

b. adalimumab

c. sulfasalazine

d. balsalazide

15. Patients receiving azathioprine must receive education about

a. GI irritation and abdominal pain.

b. increased susceptibility to infection and communicable disease prevention.

c. dietary restrictions while taking the drug.

d. increased risk of bleeding.

16. Which drug category acts as antibodies to TNF?

a. 5-aminosalicylic acids

b. probiotics

c. immunosuppressives

d. anticytokines

17. The authors suggest treating CD-associated arthritic joint pain with

a. nonsteroidal anti-inflammatory drugs.

b. aspirin.

c. acetaminophen.

d. corticosteroids.

18. Small areas of significant bowel narrowing are generally treated with a

a. proctocolectomy.

b. strictureplasty.

c. bowel resection.

d. colectomy.

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