IBD Flashcards
Which of the following features in IBD is of most concern?
A. Bloody diarrhea.
B. Rebound tenderness.
A
Which of the following is a histological feature of ulcerative colitis?
A. Noncaseating granuloma.
B. Crypt abscess.
C. Transmural inflammation.
D. Skip lesions.
B
25 year old male with history of abdominal pain and diarrhea. Diagnosed 3 years ago with anterior uveitis. He has anemia. Which of the following supports Crohn’s diagnosis?
A. No perianal findings.
B. Continuous bowel inflammation.
C. Noncaseating granuloma.
C
Patient with fecal discharge from his skin, he underwent an appendectomy 3 months ago since he had pain in the RLQ. Which of the following is the most likely diagnosis?
A. UC.
B. CD.
B
32 year old male came to the clinic complaining of fresh bleeding per rectum. Other than chronic constipation, he has no chronic medical conditions and takes no meds. What would be the most common cause of his lower GI bleeding?
A. Diverticulosis.
B. Benign polyps.
C. Hemorrhoids.
D. IBD.
C
A 58 year old male presented to the clinic with 1 week history of jaundice, dark urine, and vague upper abdominal pain. He has lost 4.5 kgs over the past month despite having a good appetite. He has a 25-year history of ulcerative colitis that has been in remission since he began taking daily mesalamine 8 years ago. He had no increase in stool frequency and no rectal bleeding. He has a 3 year history of abnormal liver function test that has been attributed to fatty liver disease and has no been evaluated further. On physical examination, he is obese and has mild jaundice. Abdominal examination shows only scars from cholecystectomy. CT scan of the abdomen shows mildly dilated peripheral intra-hepatic ducts. Mild dilation of the common hepatic duct, and normal common bile duct. Liver function test is shown below.
ALP 586, AST 190, total bilirubin 70, ALT 212.
Which of the following is the most likely diagnosis?
A. Choledocholithiasis.
B. Sclerosing cholangitis.
C. Primary biliary cirrhosis.
D. Acute hepatitis B infection.
B
A 25 year old man came to the ER due to 3 month history of abdominal pain and diarrhea. Bowel movements occur 3-4 times a day, and he has noticed blood in his stool. The patient has no fever but displays “low energy”. He was diagnosed with anterior uveitis 3 years ago but has no other medical problems and takes no medications. His parents and 2 siblings are alive and healthy. Vital signs are normal, abdomen is tender and bowel sounds are hyperactive. The perianal are appears normal. Lab investigations showed mild anemia and elevated ESR.
Which of the following features would most favor the diagnosis of CD?
A. Absence of perianal abnormalities.
B. Noncaseating granulomas on biopsy.
C. Continuous inflammation on colonoscopy.
D. Inflammatory pseudopolyps on colonoscopy.
B
A 38 year old man came for periodic examination. He has been diagnosed with UC 10 years ago and is currently asymptomatic. His last colonoscopy, preformed at the time of diagnosis, showed mildly active extensive colitis extending to the hepatic flexure. There is no family history of of colon cancer or colon polyps. His only medication is mesalamine. On physical examination, vital signs are normal, abdominal examination is normal. Lab studies, including a CBC, liver chemistry studies and CRP are normal.
Which of the following is the most appropriate colonoscopy interval for this patient?
A. Now, and every 5 years.
B. Now, and every 1-2 years.
C. Every 5 years starting at age 40.
D. Every 10 years starting at age 40.
B
A 21 year old male presents with complaints of feculent discharge from a small skin opening in his right lower quadrant for the past 8 weeks. He underwent an appendectomy 4 months ago after presenting with acute right lower quadrant pain with fevers and CT scan evidence of appendicitis.
Which of the following is the most likely diagnosis?
A. CD.
B. Behcet’s disease.
C. UC.
D. TB enteritis.
A
Which of the following is not a complication of UC?
A. Megacolon.
B. Neoplasm.
C. Fistula.
C
Which of the following is a feature of UC rather than CD?
A. Skip lesions.
B. Transmural.
C. Crept abscess.
C
All of the following are extra-abdominal manifestations of IBD, except?
A. Erythema nodosum.
B. Ankylosing spondylitis.
C. Episcleritits.
D. Thromboembolic disease.
E. Sacroilitis.
A
All of the following are correct regarding UC, except?
A. Affects men more than woman.
B. Mild disease affects 60% of patients and consists of less than 4 bowel motions per day, with the disease limited to rectum in 80%.
C. In severe disease there is usually hypoalbuminemia and mildly deranged LFT’s.
D. Loperamide and other antidirrhoeal agents should be avoided as they increase the risk of toxic megacolon.
E. Toxic megacolon is usually treated conservatively unless the bowel is wider than 6 cm or the patient is severely ill.
A
A 62 year old woman complains of diarrhea, weight loss and abdominal pain with malaise and fever. She has oral ulcers, red itchy eyes and tender nodules on her shins. She has tenderness in the right iliac fossa and a vague right iliac fossa mass.
What is the most likely diagnosis?
A. Ileocaecal TB.
B. CD.
C. Appendicular abscess.
D. Ovarian mass.
E. UC.
B
Which of the following extra-intestinal conditions is seen more commonly with UC rather than CD?
A. Gallstones.
B. Renal stones.
C. Uveitis.
D. Primary sclerosing cholangitis.
E. Erythema nodosum.
D
In a patient with UC the risk of developing colon cancer is greatest with?
A. Proctitis.
B. Left sided colitis.
C. Early onset.
D. Poor compliance with therapy.
E. Annual relapses.
C
Which is following is not caused by IBS?
A. Rectal bleeding.
B. Abdominal pain.
C. Constipation.
D. Bloating.
A
Which of the following can lead to colon cancer?
A. UC.
B. CD.
C. Diverticulitis.
A
A 28 year old man presented to the ER with history of bloody diarrhea for five months. It is associated with lower abdominal pain and 15 kgs weight loss since his symptoms started. No history of nausea, vomiting or hematemesis. Initial work up revealed: Hb 10, PLT 480, CRP 60, fecal calprotectin 700. Urgent colonoscopy showed continuous inflammation extending from the rectum till the mucosa which is proximal to the hepatic flexure. Biopsy confirmed UC.
What is the best description of the disease distribution?
A. Pancolitis.
B. Distal colitis.
C. Extended colitis.
D. Proctosigmoidits.
C
