Card 11 / 33: A 25 year old man has had intermittent diarrhea for the past year. Over the past 3 months his diarrhea has increased in frequency and he is waking at night to move his bowels. Lately he has noted blood in the stool with some mucus. He has quite a bit of urgency to move his bowels and notes that the volume of stool output is quite small. He denies significant abdominal pain except for some mild left lower quadrant discomfort associated with a bowel movement. His physical examination is normal. He has no fever. His serum ASCA (anti-saccharomyces cereversiae antibody) level is undetectable and pANCA (peri-nuclear antineutrophil cytoplasmic antibody) level is elevated. Which of the following is the most likely colonoscopic finding?
A)
Normal rectum
B)
Deep ulcers in the colon
C)
Normal vascular markings
D)
Diffuse and circumferential pinpoint ulcers in the colon
E)
Pinpoint ulcers in ileum
Answer:
D) Diffuse and circumferential pinpoint ulcers in the colon
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Gastrointestinal Pathophysiology Exam 2006
Author:
Dr.Tamsin KnoxProfessor
Tufts University School of Medicine
USA
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