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A 25-year-old white man presents with diarrhea, weight loss of 4.5 kg (10.0 lb) over the preceding 2 months, and RLQ pain. On examination, his temperature is 38.2°C (100.7°F), heart rate is 82/min, and blood pressure is 110/70 mm Hg. Abdominal examination reveals mild tenderness with no rebound tenderness, and a mass is palpated in the RLQ. His stool tests positive for occult blood. Subsequent colonoscopy reveals erythematous, friable mucosa with ulcerations in a longitudinal distribution. The ulcerations are segmental and interspersed with intervening normal mucosa. Colonic biopsies show a dense inflammatory infiltrate with neutrophils and mononuclear cells.
The patient should be informed of which of the following?
(A) Antibiotics have been shown to benefit patients with his condition
(B) Appendectomy should be scheduled
(C) Curative proctocolectomy with ileoanal anastomoses is indicated at this time
(D) Toxic megacolon is a frequent complication of his disease
(E) Trial of a gluten-free diet is indicated

Ex-USMLE Forums Staff
753 Posts
The correct answer is A

Yes, this is Crohn's Disease (CD) but the correct answer is A not C.
Surgical bowel resection is curative in UC not CD.
Antibiotics such metronidazole and ciprofloxacin are often used in CD patients together with mesalamine and immunosuppression.
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