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Old 12-03-2012
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Arrow Internal Medicine-Gastrointestinal Q #7

A 35-year-old white woman comes to her physician’s office complaining of loose, bloody stools. Her vital signs are temperature 36.4°C (97.5°F), heart rate 70/min, and blood pressure 114/74 mm Hg. Her physical examination is unremarkable. Further workup, including stool examination, colonoscopy, and rectal biopsy, leads to the diagnosis of ulcerative colitis. Which of the following can exacerbate ulcerative colitis?

(A) An emotional and stressful life event
(B) Consumption of alcohol
(C) Oral contraceptives
(D) Smoking cigarettes
(E) Upper respiratory infection
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Old 12-03-2012
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ans A.....
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Old 12-03-2012
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Should be A
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Old 12-04-2012
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i think its gotta be consumption of alcohol.

option (a) stressful situations would be correct for irritable bowel syndrome
option (d) smoking has actually been shown to be beneficial in terms of ulcerative colitis
and i guess there is no relation between ocp usage and upper respiratory infections with ulcerative colitis
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Old 12-04-2012
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The correct answer is A. A stressful event, such as divorce or death of a loved one, can lead to an exacerbation of underlying inflammatory bowel disease (IBD). Ulcerative colitis is an IBD characterized by recurrent episodic inflammation of the mucosal layer of the colon. It frequently involves the rectum, and may extend in a proximal and continuous fashion to involve other areas of the colon. The mainstay of treatment is topical or oral 5-aminosalicylic acid or topical/systemic corticosteroids. Surgical intervention is reserved for patients who are intractable to medical therapy or who develop an acute complication (e.g., hemorrhage, perforation).

Answer B is incorrect. Alcohol has not been shown to exacerbate IBD.

Answer C is incorrect. According to studies, oral contraceptive use leads to a relative risk of 1.9 in the development of Crohn’s disease. However, again no evidence exists that the use of oral contraceptive pills in a patient with IBD will exacerbate symptoms.

Answer D is incorrect. Unlike Crohn’s dis-ease, where smoking appears to increase risk, cigarette smoking lessens the risk of a patient developing ulcerative colitis.

Answer E is incorrect. An upper respiratory infection has no relation to the development of IBD symptoms. In Crohn’s disease, a gastroin-testinal infection can cause symptoms of diarrhea and abdominal pain, which are often treated with antibiotics.
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Old 12-07-2012
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Haha, wow got a question on my Step 1 SO similar to this.
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