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4 Cards in this Set
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- Back
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A 23 year old female returns from vacationing in Mexico and develops cramps and bloody diarrhea. She was on Abx 2 weeks ago for bronchitis and takes ibuprofen 2-3x per week and is on OCPs. She smokes 1/2 pack cigarettes/day. Sigmoidoscopy shows erythematous, abnormal appearing mucosa. Stool studies and biopsies are pending. Differential diagnosis at this point includes all of the following EXCEPT:
A. Ischemic colitis B. Crohn's disease C. Lymphocytic colitis D. C diff colitis E. infectious colitis F. ulcerative colitis |
C. Lymphocytic colitis
This is a microscopic colitis that does not manifest with gross changes and can only be seen on histology (in her case, there are gross changes on colonoscopy). |
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The pathogenesis of IBD is thought to involve all of the following except:
A. environmental factors (intestinal bacterial, tobacco, NSAIDs, etc.) B. Anxiety C. Genetic factors (CARD15, family hx) D. dysregulated mucosal immunity |
B. Anxiety
Remember the three things: Immune dysregulation, Genetic factors, and Environmental triggers |
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Features that help distinguish IBD from IBS include all of the following EXCEPT:
A. Grossly inflammed mucosa on endoscopy B. Nocturnal symptoms C. Weight loss D. Abdominal pain or diarrhea E. Anemia and or elevated platelet count |
D. Abdominal pain or diarrhea
*both have the abdominal symptoms, but everything else is a severe presentation (more consistent with IBD) |
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Features that help distinguish CD from UC include all of the following EXCEPT:
A. crypt abscess B. small bowel involvement C. fistula D. granuloma E. skip lesions |
A. crypt abscess
A sign of chronic disease, can be seen in both CD and UC. The rest of the findings (small bowel involvement, fistula, granuloma, and skip lesions are all consistent with CD). |
