Inflammatory Bowel Disease Longitudinal Care Practice Test

A 35-year-old woman with a known history of left-sided ulcerative colitis, maintained on high-dose oral mesalamine, presents to her primary care physician with a 3-week history of increased stool frequency (from 2 to 6 per day), urgency, and intermittent bloody stools. She is hemodynamically stable and her C-reactive protein is 15 mg/L (normal <5 mg/L).

A 34-year-old man with fistulizing Crohn disease has been receiving infliximab infusions every 8 weeks for 18 months with good effect. Two weeks after his most recent infusion, he develops symmetric polyarthritis of his hands and knees and a faint malar rash. He denies fever. Laboratory studies show a newly positive antinuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA) antibodies.