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Quiz: Culture, Food, Family, and Stigma

Test your understanding of Chapter 19. Choose the best answer, then click Show Answer to check.

Question 1

What is self-stigma?

  1. When the public reacts negatively to a group of people
  2. When a school refuses to give a student accommodations
  3. When a person with a condition turns negative beliefs about that condition on themselves
  4. When a doctor keeps a patient's diagnosis private
Show Answer

The correct answer is C. Self-stigma is internalizing stigma, for example a teen with IBS thinking "I'm disgusting." Option A describes public stigma, the other form in Corrigan and Watson's framework.

Concept Tested: Self-Stigma Bloom's Level: Remember

Question 2

What is a 504 plan?

  1. A written school plan, under Section 504 of the Rehabilitation Act of 1973, listing accommodations a student with a disability needs for equal access to education
  2. A medical prescription that only a gastroenterologist can write
  3. A special education plan for students with learning disabilities only
  4. A plan that lowers the grades a student needs to pass
Show Answer

The correct answer is A. A 504 plan is developed by the school with the student and family and lists accommodations such as unlimited restroom access. Option C is wrong because 504 plans cover students with many kinds of disabilities, including chronic illnesses like IBD. IEPs, which are plans for students who need special education services, fall under a different law, the Individuals with Disabilities Education Act. Option D is wrong because accommodations remove barriers without lowering expectations.

Concept Tested: 504 Plan Bloom's Level: Remember

Question 3

In the 2009 survey of 211 adults with IBD, about what share reported feeling stigmatized because of their disease?

  1. 10%
  2. 25%
  3. 50%
  4. 84%
Show Answer

The correct answer is D. Eighty-four percent reported perceived stigma. The 10% figure (A) is a mix-up with a different number: stigma explained 10% to 22% of the variation in quality of life scores.

Concept Tested: Stigma Bloom's Level: Remember

Question 4

Why can illness concealment make a gut condition harder to treat?

  1. Hiding symptoms makes the immune system more active.
  2. If symptoms are hidden, doctors, schools, and families don't get the information they need to adjust treatment and offer support.
  3. Concealment is illegal under Section 504.
  4. Hiding symptoms always causes a flare within a week.
Show Answer

The correct answer is B. Concealment cuts off information: a doctor can't adjust treatment for symptoms they never hear about. Option A invents a direct biological effect that the chapter doesn't claim.

Concept Tested: Illness Concealment Bloom's Level: Understand

Question 5

Which statement best describes the global pattern of IBD, according to the 2017 Lancet review and the 2025 Nature analysis?

  1. IBD became common first in early industrialized regions and is now rising in many newly industrialized countries in Asia, Africa, and South America.
  2. IBD occurs only in Western countries.
  3. IBD rates are falling everywhere in the world.
  4. IBD is equally common in every country and always has been.
Show Answer

The correct answer is A. IBD incidence has leveled off in much of North America and Europe but has been rising in newly industrialized countries since 1990. Option B is the "Western-only" myth the chapter grades as Hype.

Concept Tested: Global IBD Rise Bloom's Level: Understand

Question 6

In the Leicestershire studies, first- and second-generation South Asians had similar ulcerative colitis risk, and South Asians had higher ulcerative colitis rates than Europeans living in the same county. What is the most careful interpretation?

  1. South Asians are genetically protected from all forms of IBD.
  2. IBD is higher in South Asians everywhere in the world.
  3. Ulcerative colitis was more common among South Asians in that region and era, which suggests genes and shared environment both may matter, but the data are older and regional.
  4. Traditional South Asian food causes ulcerative colitis.
Show Answer

The correct answer is C. The data show higher ulcerative colitis (but lower Crohn's) in one English county in the 1970s and 1980s. Option B overgeneralizes: the findings don't cover all countries or all forms of IBD, and a 2018 pooled analysis wasn't statistically significant.

Concept Tested: Migration and IBD Risk Bloom's Level: Understand

Question 7

Aarav, a 15-year-old with ulcerative colitis, is preparing for a doctor's visit. He has been skipping lunch to avoid restroom trips and drinks an herbal tea his grandfather recommends. Based on the MedlinePlus tips in the chapter, what should he do?

  1. Mention only his main symptom so the visit stays short.
  2. Leave out the tea, since home remedies aren't medicine.
  3. Wait until he has a flare before bringing anything up.
  4. Write down his symptoms and questions, list everything he takes (including the tea), and tell the doctor about skipping lunch.
Show Answer

The correct answer is D. MedlinePlus recommends listing all medicines, herbs, and supplements and being truthful about habits and symptoms. Option B is a common mistake: home remedies are exactly the kind of information that helps keep treatment safe.

Concept Tested: Talking to Your Doctor Bloom's Level: Apply

Question 8

At a family dinner, Riya's aunt says, "Just eat more ghee and stop worrying." Which reply best uses the conversation moves from Section 19.9?

  1. "You don't know anything about Crohn's."
  2. "I know you want me to feel better. Crohn's is an immune condition my doctor treats with medicine. Could you help me find recipes that are easy on my stomach during flares?"
  3. "Okay, I'll stop my medicine and try the ghee."
  4. "Crohn's comes from eating Western food, so just eat the way we used to."
Show Answer

The correct answer is B. It acknowledges the aunt's care, gives one clear fact, and offers her a helpful role. Option C is dangerous because no one should stop or change a medicine without their care team.

Concept Tested: Family Communication Bloom's Level: Apply

Question 9

The 2009 IBD stigma survey found that people who felt more stigmatized had worse quality of life. Which is the strongest limitation of this finding for families like Riya's?

  1. The study used mice instead of people.
  2. The study proved that stigma causes Crohn's disease.
  3. The sample was too large to analyze.
  4. It was a one-time survey of mostly White adults recruited online, so it can't show cause or represent teens or South Asian families well.
Show Answer

The correct answer is D. A cross-sectional survey shows correlation, and a sample that is about 97% White adults says little about teens from other backgrounds. Option B reverses the logic: the study looked at stigma and outcomes, not at what causes Crohn's, and couldn't prove cause anyway.

Concept Tested: Quality of Life Bloom's Level: Analyze

Question 10

In the 2025 CDC survey, unmet need for counseling among students with persistent sadness was 38.4% for Asian American students and 27.1% for White students. Which conclusion is best supported?

  1. Some groups may face extra barriers to care, but the data can't show which barriers, and "Asian American" combines many different communities.
  2. South Asian families do not believe in therapy.
  3. Asian American students have more depression than any other group.
  4. The difference proves that stigma is the only barrier.
Show Answer

The correct answer is A. The survey asked whether students needed counseling and didn't get it, not why, and it used a broad "Asian" category with a wide margin of uncertainty. Option B turns a group statistic into a stereotype about families, which the data can't support.

Concept Tested: Help-Seeking Barriers Bloom's Level: Analyze