nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 Ulcerative Colitis, Crohn’s Disease And Other Inflammatory Bowel Diseases JASSIN M. JOURIA, MD DR. JASSIN M. JOURIA IS A MEDICAL DOCTOR, PROFESSOR OF ACADEMIC MEDICINE, AND MEDICAL AUTHOR. HE GRADUATED FROM ROSS UNIVERSITY SCHOOL OF MEDICINE AND HAS COMPLETED HIS CLINICAL CLERKSHIP TRAINING IN VARIOUS TEACHING HOSPITALS THROUGHOUT NEW YORK, INCLUDING KING’S COUNTY HOSPITAL CENTER AND BROOKDALE MEDICAL CENTER, AMONG OTHERS. DR. JOURIA HAS PASSED ALL USMLE MEDICAL BOARD EXAMS, AND HAS SERVED AS A TEST PREP TUTOR AND INSTRUCTOR FOR KAPLAN. HE HAS DEVELOPED SEVERAL MEDICAL COURSES AND CURRICULA FOR A VARIETY OF EDUCATIONAL INSTITUTIONS. DR. JOURIA HAS ALSO SERVED ON MULTIPLE LEVELS IN THE ACADEMIC FIELD INCLUDING FACULTY MEMBER AND DEPARTMENT CHAIR. DR. JOURIA CONTINUES TO SERVES AS A SUBJECT MATTER EXPERT FOR SEVERAL CONTINUING EDUCATION ORGANIZATIONS COVERING MULTIPLE BASIC MEDICAL SCIENCES. HE HAS ALSO DEVELOPED SEVERAL CONTINUING MEDICAL EDUCATION COURSES COVERING VARIOUS TOPICS IN CLINICAL MEDICINE. RECENTLY, DR. JOURIA HAS BEEN CONTRACTED BY THE UNIVERSITY OF MIAMI/JACKSON MEMORIAL HOSPITAL’S DEPARTMENT OF SURGERY TO DEVELOP AN E-MODULE TRAINING SERIES FOR TRAUMA PATIENT MANAGEMENT. DR. JOURIA IS CURRENTLY AUTHORING AN ACADEMIC TEXTBOOK ON HUMAN ANATOMY & PHYSIOLOGY. Abstract Although no singular known cause for inflammatory bowel disease exists, medical research has led to new treatments and a reduction in mortality rates associated with the disease. Inflammatory bowel disease includes a variety of gastrointestinal disorders that cause similar symptoms and impact a patient's quality of life. There is no cure, but symptomatic relief can be found with a variety of treatments, including medical, surgical, and nutritional. As with many diseases, a multifaceted approach is commonly the best for successful treatment of inflammatory bowel disease.
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Ulcerative Colitis, Crohn’s Disease And Other Inflammatory ...Ulcerative Colitis, Crohn’s Disease And Other Inflammatory Bowel Diseases JASSIN M. JOURIA, MD DR. JASSIN M. JOURIA
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Diseases JASSIN M. JOURIA, MD DR. JASSIN M. JOURIA IS A MEDICAL DOCTOR, PROFESSOR OF ACADEMIC
MEDICINE, AND MEDICAL AUTHOR. HE GRADUATED FROM ROSS UNIVERSITY SCHOOL OF MEDICINE AND HAS COMPLETED HIS CLINICAL CLERKSHIP TRAINING IN VARIOUS TEACHING HOSPITALS THROUGHOUT NEW YORK, INCLUDING KING’S COUNTY HOSPITAL CENTER AND BROOKDALE MEDICAL CENTER, AMONG OTHERS. DR. JOURIA HAS PASSED ALL USMLE MEDICAL BOARD EXAMS, AND HAS SERVED AS A TEST PREP TUTOR AND INSTRUCTOR FOR KAPLAN. HE HAS DEVELOPED SEVERAL MEDICAL COURSES AND CURRICULA FOR A VARIETY OF EDUCATIONAL INSTITUTIONS. DR. JOURIA HAS ALSO SERVED ON MULTIPLE LEVELS IN THE ACADEMIC FIELD INCLUDING FACULTY MEMBER AND DEPARTMENT CHAIR. DR. JOURIA CONTINUES TO SERVES AS A SUBJECT MATTER EXPERT FOR SEVERAL CONTINUING EDUCATION ORGANIZATIONS COVERING MULTIPLE BASIC MEDICAL SCIENCES. HE HAS ALSO DEVELOPED SEVERAL CONTINUING MEDICAL EDUCATION COURSES COVERING VARIOUS TOPICS IN CLINICAL MEDICINE. RECENTLY, DR. JOURIA HAS BEEN CONTRACTED BY THE UNIVERSITY OF MIAMI/JACKSON MEMORIAL HOSPITAL’S DEPARTMENT OF SURGERY TO DEVELOP AN E-MODULE TRAINING SERIES FOR TRAUMA PATIENT MANAGEMENT. DR. JOURIA IS CURRENTLY AUTHORING AN ACADEMIC TEXTBOOK ON HUMAN ANATOMY & PHYSIOLOGY.
Abstract
Although no singular known cause for inflammatory bowel disease
exists, medical research has led to new treatments and a reduction in
mortality rates associated with the disease. Inflammatory bowel
disease includes a variety of gastrointestinal disorders that cause
similar symptoms and impact a patient's quality of life. There is no
cure, but symptomatic relief can be found with a variety of treatments,
including medical, surgical, and nutritional. As with many diseases, a
multifaceted approach is commonly the best for successful treatment
1. Inflammatory bowel disease (IBD) is actually a group of disorders that a. similarly cause inflammation in the gastrointestinal tract. b. affect the same areas of the intestine. c. respond treatment in the same way. d. All of the above
2. True or False: All types of IBD develop along the
gastrointestinal tract in the areas of the small or large intestines. a. True b. False
3. Two of the most common types of inflammatory bowel
disease (IBD) are a. ulcerative proctitis and Crohn’s disease. b. ulcerative proctosigmoiditis and proctitis. c. ulcerative colitis and sclerosing cholangitis. d. ulcerative colitis and Crohn’s disease.
4. Sclerosing cholangitis causes inflammation and scarring
within the a. the cecum. b. bile ducts. c. descending colon. d. the ileum.
5. _________________ is a chronic condition that causes
inflammation of the intestinal tract with concomitant ulcerations of the intestinal mucosa. a. Ulcerative proctosigmoiditis b. Behcet’s disease c. Ulcerative colitis d. Sclerosing cholangitis
Inflammatory bowel disease causes periods of active illness in which
affected persons suffer from multiple symptoms that include pain and
diarrhea, followed by periods of remission, in which there are few to
no symptoms at all. The chronic nature of the disease has confounded
clinicians and medical scientists who have researched its causes and
the most appropriate forms of treatment to be able to induce
remission and alleviate some of the debilitating symptoms.
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1. Inflammatory bowel disease (IBD) is actually a group of disorders that a. similarly cause inflammation in the gastrointestinal tract. b. affect the same areas of the intestine. c. respond treatment in the same way. d. All of the above
2. True or False: All types of IBD develop along the gastrointestinal tract in the areas of the small or large intestines. a. True b. False
3. Two of the most common types of inflammatory bowel
disease (IBD) are a. ulcerative proctitis and Crohn’s disease. b. Behcet’s disease and proctitis. c. ulcerative colitis and sclerosing cholangitis. d. ulcerative colitis and Crohn’s disease.
4. Sclerosing cholangitis causes inflammation and scarring
within the
a. the cecum. b. bile ducts. c. descending colon. d. the ileum.
5. _________________ is a chronic condition that causes
inflammation of the intestinal tract with concomitant ulcerations of the intestinal mucosa. a. Ulcerative proctosigmoiditis b. Behcet’s disease c. Ulcerative colitis d. Sclerosing cholangitis
6. Behcet’s disease is an inflammatory condition that causes ulcers a. in the mouth and on the genitalia. b. inflammation in the gastrointestinal tract. c. the eye, the brain, and the spinal cord. d. All of the above
7. The ulceration associated with ulcerative colitis often will
only affect _____________________ of the intestinal tract. a. the muscularis layer b. submucosal layer c. muscularis and submucosal layers d. the mucosal and submucosal layers
8. Ulcerative colitis differs from Crohn’s disease because with
Crohn’s disease, ulcerations typically a. cause Clostridium difficile infection. b. extend through all layers of the intestinal tract. c. are limited to the colon and rectum. d. does not develop in the ileum.
9. True or False: Inflammatory bowel disease (IBD) may be
caused solely by uncontrolled stress. a. True b. False
10. ______________ is an infection that is often contracted by
a patient while in a hospital or healthcare environment. a. Microscopic colitis b. Celiac disease c. Clostridium difficile d. H. pylori
11. True or False: True or False: Approximately 15 percent of
people with IBD have indeterminate colitis. a. True b. False
12. _____________________ can cause inflammation along any part of the gastrointestinal tract and is not limited to specific areas.
a. Crohn’s disease b. Pan-colitis c. Ulcerative colitis d. Sclerosing cholangitis
13. With _________________ the surface of the intestinal
lining often appears rough with a “cobblestone” appearance that is characteristic of that disease. a. vasculitis b. indeterminate colitis c. Crohn’s disease d. sclerosing cholangitis
14. Ulcerative colitis that affects the entire large intestine,
including the ascending, transverse, descending, and sigmoid portions is sometimes called
a. pan-colitis. b. Behcet’s disease. c. indeterminate colitis. d. sclerosing cholangitis.
15. True or False: Smoking tobacco is a factor that has been
associated with increased incidences of disease flares among those with Crohn’s disease. a. True b. False
16. Ulcerative colitis and other IBDs that affect the large
intestine may be difficult to distinguish from a Clostridium difficile infection because they share the same
a. “cobblestone” appearance. b. symptom, severe diarrhea. c. symptomatic inflammation in the mouth and throat. d. symptomatic psoriasis.
17. Inflammation from Crohn’s disease most often develops in the distal portion of the small intestine known as ___________ and the ileocecal region.
a. the bile ducts b. the cecum c. the duodenum d. the ileum
18. _________________ is an autoimmune condition in which
damage develops in the intestinal tract after ingestion of gluten, a protein found in wheat products. a. H. pylori b. Gastroparesis c. Pyloric stenosis d. Celiac disease
19. The Crohn’s and Colitis Foundation of America (CCFA)
states that there may be a link between microscopic colitis and
a. celiac disease. b. musculoskeletal disorder. c. H. pylori. d. gastroparesis.
20. True or False: Ileocolitis is considered the most common
form of Crohn’s disease. a. True b. False
21. Behcet’s disease is a type of inflammatory bowel disease
and a _____________________ because it is a type of vasculitis that causes inflammation of the blood vessels.
a. autoimmune disorder b. gastrointestinal disorder c. musculoskeletal disorder d. gluten disorder
22. The administration of an enema of short-chain fatty acids in solution to patients with _________________ decreased intestinal inflammation but the symptoms usually returned when the enemas were discontinued.
a. diminished colitis b. indeterminate colitis c. microscopic colitis d. diversion colitis
23. Collagenous colitis occurs when areas of collagen under
the epithelium solidify and the tissue overall becomes a. diffused and thins out. b. impaired and thins out. c. perforated and takes on a “cobblestone” texture. d. concentrated and thick.
24. With __________________ there may be inflammation of
the eye, and severe cases of eye inflammation may lead to complete blindness.
a. celiac disease b. Sjögren’s syndrome c. Behcet’s disease d. pan-colitis
25. True or False: Microscopic colitis has been shown to
increase the risk of colon cancer. a. True b. False
26. When it is not clear whether a patient’s inflammatory
bowel symptoms are caused by Crohn’s disease or ulcerative colitis, the patient is diagnosed with
a. a Clostridium difficile infection. b. pan-colitis. c. Behcet’s disease d. indeterminate colitis.
32. The small intestine is a. named “small” because of its length. b. approximately 8 feet long in adults. c. the longest portion of the gastrointestinal tract. d. All of the above
33. Patients with _________________ develop lymphoid
follicular hyperplasia, which is an increase in the size of lymph node follicles due to increased numbers of white blood cells.
a. celiac disease b. Sjögren’s syndrome c. Behcet’s disease d. diversion colitis
34. True or False: Because of the controversy associated with
classifying indeterminate colitis as an IBD, it is NOT included as part of the International Classification of Diseases, Tenth Revision (ICD-10). a. True b. False
35. The group most likely to suffer from microscopic colitis is
a. males of all ages. b. older females. c. young males. d. adolescent females.
36. The areas of the gastrointestinal tract that may be affected
by microscopic colitis include
a. the large intestine. b. the small intestine. c. the stomach. d. All of the above
37. The major difference between Crohn’s disease in the mouth and orofacial granulomatosis is that the patient with Crohn’s disease also have
a. overgrowths of granulation tissue. b. inflammation and scarring within the bile ducts. c. gastrointestinal tract lesions and inflammation. d. aphthous stomatitis (similar to canker sores) in the mouth.
38. According to an article in the Journal of Gastroenterology
and Hepatology Research, indeterminate colitis is considered to be _________________ given to initiate treatment for the affected patient. a. a final diagnosis b. a non-IBD diagnosis c. a temporary diagnosis d. a pre-diagnosis classification
39. __________________ is a form of ulcerative colitis that
includes rectal involvement of the rectum only and NOT other areas of the colon.
a. diversion colitis b. indeterminate colitis c. proctosigmoiditis d. ulcerative proctitis
40. True or False: Diversion colitis develops in the large
intestine and usually develops into colon cancer.
a. True b. False
41. True or False. The exact cause of microscopic colitis has
CORRECT ANSWERS: 1. Inflammatory bowel disease (IBD) is actually a group of
disorders that
a. similarly cause inflammation in the gastrointestinal tract. p. 5: “Inflammatory bowel disease is actually a group of disorders that all cause similar effects of inflammation in the gastrointestinal tract.”
2. True or False: All types of IBD develop along the
gastrointestinal tract in the areas of the small or large intestines.
b. False pp. 5-6: “Both of these diseases cause intestinal inflammation, pain, and tissue damage in the gastrointestinal tract. Ulcerative colitis primarily affects the large intestine, while Crohn’s disease is most common in the small intestine, but can occur anywhere along the digestive tract.”
3. Two of the most common types of inflammatory bowel
disease (IBD) are
d. ulcerative colitis and Crohn’s disease. p. 5: “Two of the most common types of IBD are ulcerative colitis and Crohn’s disease.”
4. Sclerosing cholangitis causes inflammation and scarring within the
b. bile ducts. p. 9: “A small percentage of patients develop sclerosing cholangitis, which causes inflammation and scarring within the bile ducts.”
5. _________________ is a chronic condition that causes inflammation of the intestinal tract with concomitant ulcerations of the intestinal mucosa.
c. Ulcerative colitis p. 7: “Ulcerative colitis [is] a chronic condition that causes inflammation of the intestinal tract with concomitant ulcerations of the intestinal mucosa….”
6. Behcet’s disease is an inflammatory condition that causes
ulcers
a. in the mouth and on the genitalia. b. inflammation in the gastrointestinal tract. c. the eye, the brain, and the spinal cord. d. All of the above
p. 54: “Behcet’s disease is an inflammatory condition that causes ulcers in the mouth and on the genitalia, as well as inflammation in the gastrointestinal tract, blood vessels, the eye, the brain, and the spinal cord.”
7. The ulceration associated with ulcerative colitis often will only affect _____________________ of the intestinal tract.
d. the mucosal and submucosal layers p. 15: “The ulceration associated with ulcerative colitis often only affects the mucosal and submucosal layers of the intestinal tract, but typically does not extend down into the muscularis layer.”
8. Ulcerative colitis differs from Crohn’s disease because with Crohn’s disease, ulcerations typically
b. extend through all layers of the intestinal tract. p. 15: “The disease process associated with ulcerative colitis differs from Crohn’s disease: with Crohn’s disease, ulcerations can extend through all layers of the intestinal tract.”
9. True or False: Inflammatory bowel disease (IBD) may be caused solely by uncontrolled stress.
b. False p. 8: “Although stress is known to be a triggering factor for a disease flare, uncontrolled stress is not the cause of ulcerative colitis or of any other type of IBD.”
10. ______________ is an infection that is often contracted by
a patient while in a hospital or healthcare environment.
c. Clostridium difficile p. 17: “[C. difficile] is often a healthcare-associated infection, in which patients contract it while in the hospital or healthcare environment.”
11. True or False: Approximately 15 percent of people with IBD
have indeterminate colitis.
a. True p. 59: “Approximately 15 percent of people with IBD have indeterminate colitis.”
12. _____________________ can cause inflammation along any part of the gastrointestinal tract and is not limited to specific areas.
a. Crohn’s disease p. 23: “Unlike ulcerative colitis and some other forms of IBD, Crohn’s disease can cause inflammation along any part of the gastrointestinal tract and is not limited to specific areas.”
13. With _________________ the surface of the intestinal lining often appears rough with a “cobblestone” appearance that is characteristic of that disease.
c. Crohn’s disease p. 24: “The surface of the intestinal lining often appears rough with a “cobblestone” appearance that is characteristic of Crohn’s disease.”
14. Ulcerative colitis that affects the entire large intestine, including the ascending, transverse, descending, and sigmoid portions is sometimes called
a. pan-colitis. p. 15: “Ulcerative colitis that affects the entire large intestine, including the ascending, transverse, descending, and sigmoid portions is sometimes called pan-colitis.”
15. True or False: Smoking tobacco is a factor that has been associated with increased incidences of disease flares among those with Crohn’s disease.
a. True p. 25: “Smoking tobacco is a factor that has been associated with increased incidences of disease flares among those with Crohn’s disease.”
16. Ulcerative colitis and other IBDs that affect the large intestine may be difficult to distinguish from a Clostridium difficile infection because they share the same
b. symptom, severe diarrhea. p. 17: “Ulcerative colitis and other forms of IBD that affect the large intestine increase the risk of Clostridium difficile infection in the gastrointestinal tract. C. difficile infection tends to cause severe diarrhea, which may make it difficult to establish IBD versus C. difficile as the cause of diarrhea.”
17. Inflammation from Crohn’s disease most often develops in the distal portion of the small intestine known as ___________ and the ileocecal region.
d. the ileum p. 24: “Although it can affect any part of the gastrointestinal tract, the inflammation from Crohn’s most often develops in the distal portion of the small intestine—the ileum—and the junction between the small intestine and the cecum, known as the ileocecal region.”
18. _________________ is an autoimmune condition in which
damage develops in the intestinal tract after ingestion of gluten, a protein found in wheat products.
d. Celiac disease p. 49: “The Crohn’s and Colitis Foundation of America (CCFA) states that there may be a link between microscopic colitis and celiac disease, an autoimmune condition in which damage develops in the intestinal tract after ingestion of gluten, a protein found in wheat products.”
19. The Crohn’s and Colitis Foundation of America (CCFA) states that there may be a link between microscopic colitis and
a. celiac disease. p. 49: “The Crohn’s and Colitis Foundation of America (CCFA) states that there may be a link between microscopic colitis and celiac disease, an autoimmune condition in which damage develops in the intestinal tract after ingestion of gluten, a protein found in wheat products.”
20. True or False: Ileocolitis is considered the most common
form of Crohn’s disease.
a. True p. 33: “Ileocolitis is considered the most common form of Crohn’s disease.”
21. Behcet’s disease is a type of inflammatory bowel disease and a _____________________ because it is a type of vasculitis that causes inflammation of the blood vessels.
c. musculoskeletal disorder p. 55: “In addition to being classified as a type of inflammatory bowel disease, Behcet’s is also a musculoskeletal disorder because it is a type of vasculitis that causes inflammation of the blood vessels.”
22. The administration of an enema of short-chain fatty acids
in solution to patients with _________________ decreased intestinal inflammation but the symptoms usually returned when the enemas were discontinued.
d. diversion colitis p. 53: “An early study in the New England Journal of Medicine tested the effects of enema administration of short-chain fatty acids in solution to patients with diversion colitis and found that patients who received enemas had diminished colitis symptoms and decreased intestinal inflammation.”
23. Collagenous colitis occurs when areas of collagen under
the epithelium solidify and the tissue overall becomes
d. concentrated and thick. p. 47: “Collagenous colitis occurs when areas of collagen under the epithelium solidify and the tissue overall becomes concentrated and thick.”
24. With __________________ there may be inflammation of the eye, and severe cases of eye inflammation may lead to complete blindness.
c. Behcet’s disease p. 56: “There are various other symptoms seen with Behcet’s disease that do not necessarily affect the gastrointestinal tract, including sores on the skin, which appear as red, pus-filled lesions. There may be inflammation of the eye, most commonly the iris and the uvea, although the retina may also become inflamed and the patient may have vision loss, excess tear production, and photophobia. Severe cases of eye inflammation may lead to complete blindness.”
25. True or False: Microscopic colitis has been shown to
increase the risk of colon cancer.
b. False p. 50: “Unlike Crohn’s disease or ulcerative colitis, microscopic colitis has not been shown to increase the risk of colon cancer.”
26. When it is not clear whether a patient’s inflammatory
bowel symptoms are caused by Crohn’s disease or ulcerative colitis, the patient is diagnosed with
d. indeterminate colitis. p. 59: “When it is not clear whether a patient’s symptoms are caused by Crohn’s disease or ulcerative colitis, the patient is diagnosed with indeterminate colitis. Approximately 15 percent of people with IBD have indeterminate colitis.”
27. Common autoimmune diseases that are seen with
collagenous colitis include
a. myasthenia gravis. p. 50: “Common conditions that are seen with collagenous colitis include Sjögren’s syndrome, thyroiditis, and myasthenia gravis.”
28. Patients with microscopic colitis typically have frequent, watery diarrhea
b. with or without abdominal pain and cramping. p. 48: “People with microscopic colitis typically have frequent, watery diarrhea with or without abdominal pain and cramping;….”
29. People with indeterminate colitis typically have symptoms
only affecting
a. the large intestine. p. 59: “People with indeterminate colitis typically have symptoms only affecting the large intestine.”
30. The treatment for ____________________ includes the
administration of anti-inflammatory agents, immunosuppressants, corticosteroids, and biologic therapies.
b. indeterminate colitis pp. 61-62: “The treatment for indeterminate colitis is often similar to that given for ulcerative colitis. Many patients with this type of disease have benefitted from administration of anti-inflammatory agents, immunosuppressants, corticosteroids, and biologic therapies.”
31. True or False: The majority of people with Behcet’s develop
aphthous stomatitis.
a. True p. 55: “The majority of people with Behcet’s develop aphthous stomatitis: inflammation and ulcerations in the mouth that are similar in appearance to canker sores.”
c. the longest portion of the gastrointestinal tract. p. 31: “The small intestine is the longest portion of the gastrointestinal tract. Its name refers to the diameter of the intestinal lumen rather than its length. The average length of the small intestine is approximately 20 feet long in adults.”
33. Patients with _________________ develop lymphoid
follicular hyperplasia, which is an increase in the size of lymph node follicles due to increased numbers of white blood cells.
d. diversion colitis p. 51: “Patients with diversion colitis develop lymphoid follicular hyperplasia, which is an increase in the size of lymph node follicles due to increased numbers of white blood cells.”
34. True or False: Because of the controversy associated with
classifying indeterminate colitis as an IBD, it is NOT included as part of the International Classification of Diseases, Tenth Revision (ICD-10).
b. False p. 60: “Although the term is somewhat controversial for use, indeterminate colitis is included as part of the International Classification of Diseases, Tenth Revision (ICD-10). Some clinicians prefer to call the condition Inflammatory Bowel Disease, Unclassified.”
35. The group most likely to suffer from microscopic colitis is
b. older females. p. 46: “This specific type of inflammatory bowel disease most commonly affects older adults, with a higher percentage of older females than males affected by collagenous colitis, one of the subtypes of the disease.”
36. The areas of the gastrointestinal tract that may be affected by microscopic colitis include
a. the large intestine. p. 46: “A patient suffering from microscopic colitis experiences pain and diarrhea but there is no obvious source during examination. The condition only affects the large intestine, the sigmoid colon, and the rectum.”
37. The major difference between Crohn’s disease in the
mouth and orofacial granulomatosis is that the patient with Crohn’s disease also have
c. gastrointestinal tract lesions and inflammation.
p. 43: “[A]ccording to Zbar, et al., in the Journal of Crohn’s and Colitis, the major difference between Crohn’s disease in the mouth and orofacial granulomatosis is that the patient with Crohn’s disease has concomitant lesions and inflammation elsewhere in the gastrointestinal tract, while orofacial granulomatosis typically only affects the mouth.”
38. According to an article in the Journal of Gastroenterology
and Hepatology Research, indeterminate colitis is considered to be _________________ given to initiate treatment for the affected patient.
c. a temporary diagnosis p. 60: “According to an article in the Journal of Gastroenterology and Hepatology Research, indeterminate colitis is considered to be a temporary diagnosis, given to initiate treatment for the affected patient and put in place until further testing or changes in the pathophysiology of the disease reveals which type of IBD is present.”
39. __________________ is a form of ulcerative colitis that includes rectal involvement of the rectum only and NOT other areas of the colon.
d. ulcerative proctitis p. 19: “Approximately 46 percent of patients with ulcerative colitis have rectal involvement, called ulcerative proctitis when it affects only the rectum, and ulcerative proctosigmoiditis when the sigmoid colon is also involved.”
40. True or False: Diversion colitis develops in the large
intestine and usually develops into colon cancer.
b. False p. 51: “Diversion colitis develops in the large intestine and is usually considered to be benign, ….”
41. True or False. The exact cause of microscopic colitis has been well identified. b. False.
p. 48. “The exact cause of microscopic colitis is unknown.”
The References below include published works and in-text citations of published works that are intended as helpful material for your further reading.
1. Crohn’s and Colitis Foundation of America (CCFA). (2009, Apr.). Managing flares and other IBD symptoms. New York NY: CCFA
2. Peppercorn, M., Kane, S. (2016, Sep.). Patient education: Ulcerative colitis (beyond the basics). Retrieved from http://www.uptodate.com/contents/ulcerative-colitis-beyond-the-basics
3. Parray, F., Wani, M., Malik, A., Wani, S., Bijli, A., Irshad, I., Ul-Hassan, N. (2012, Nov.). Ulcerative colitis: A challenge to surgeons. Int J Prev Med. 3(11): 749-763. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506086/
4. Crohn’s and Colitis Foundation of America. (2012, May). Liver disease and IBD. Retrieved from http://www.ccfa.org/resources/liver-disease-and-ibd.html?referrer=https://www.google.com/
5. University of Alberta IBD Clinic. (2016). What are extra-intestinal manifestations of IBD? Retrieved from http://www.ibdclinic.ca/what-is-ibd/complications/
6. Strober, W., Fuss, I. (2011, May). Pro-inflammatory cytokines in the pathogenesis of IBD. Gastroenterology 140(6): 1756-1767. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773507/
7. Kennedy, A. (2015). The inflammatory response. Retrieved from http://primer.crohn.ie/the-inflammatory-response
8. Bowen, R. (2000, May). Gross and microscopic anatomy of the large intestine. Retrieved from http://arbl.cvmbs.colostate.edu/hbooks/pathphys/digestion/largegut/anatomy.html
9. Taylor, T. (2016). Large intestine. Retrieved from http://www.innerbody.com/anatomy/digestive/large-intestine
10. Crohn’s and Colitis Foundation of America. (2015, Jan.). Intestinal complications. Retrieved from http://www.ccfa.org/assets/pdfs/intestinalcomps.pdf
11. Crohn’s and Colitis Foundation of America. (2012, Sep.). Understanding your risk: C. diff. Retrieved from http://online.ccfa.org/site/PageNavigator/2012_09_enews_landing.html
12. Sandborn, W., et al. (2015, Apr.). Budesonide foam induces remission in patients with mild to moderate ulcerative proctitis and ulcerative proctosigmoiditis. Gastroenterology 148(4): 740-750. Retrieved from http://www.gastrojournal.org/article/S0016-5085(15)00154-7/fulltext
13. Dewint, P., et al. (2014). Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn’s disease: a randomized, double-blind, placebo controlled trial (ADAFI). Gut 2014; 63: 292-299.
14. Colon & Rectal Surgery Associates. (2016). What is ulcerative proctitis? Retrieved from http://www.colonrectal.org/services.cfm/sid:6694/ulcerative_proctitis/index.html
16. University of Maryland Medical Center. (2012, Dec.). Crohn’s disease. Retrieved from http://umm.edu/health/medical/reports/articles/crohns-disease
17. Crohn’s and Colitis Foundation of America. (2015, Jan.). Arthritis and joint pain. Retrieved from http://www.ccfa.org/assets/pdfs/arthritiscomplications.pdf
18. Lashner, B. (2013, Jan.). Crohn’s disease. Retrieved from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/gastroenterology/crohns-disease/
19. IBD Relief. (2016). What is perianal Crohn’s disease? Retrieved from https://www.ibdrelief.com/learn/what-is-ibd/what-is-crohns-disease/perianal-crohns
20. De Zoeten, E., Pasternak, B., Mattei, P., Kramer, R., Kader, H. (2013, Sep.). Diagnosis and treatment of perianal Crohn disease: NASPGHAN clinical report and consensus statement. JPGN 57(3): 401-412.
21. IBD Relief. (2016). What is ileocolitis? Retrieved from https://www.ibdrelief.com/learn/what-is-ibd/what-is-crohns-disease/ileocolitis
22. Bayless, T., Hanauer, S. (2011). Advanced therapy of inflammatory bowel disease (3rd ed.), Volume 2. Shelton, CT: People’s Medical Publishing House USA
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