• Card 17 / 34: A 22 year-old woman comes to the emergency room with crampy left lower quadrant abdominal pain, 10-12 small volume bloody bowel movements daily with urgency to move her bowels, and a 5 lb weight loss in the past 2 weeks. She has a low grade temperature and a mildly tender abdomen on physical exam. She has a colonoscopy which shows pinpoint ulcerations and friable mucosa throughout the entire colon in a continuous distribution. Biopsies are taken from the colon. Multiple stool cultures are all negative. Which of the following would you most likely find in this patient?
    1.) Anti-saccharomyces cerevisiae antibodies (ASCA)
    2.) Granulomas on histologic analysis
    3.) Fstulae seen on a barium enema
    4.) Peri-nuclear anti-neutrophil cytoplasmic antibodies (P-ANCA)
    5.) Strictures seen on a barium small bowel x-ray

    Answer:
    4.) Peri-nuclear anti-neutrophil cytoplasmic antibodies (P-ANCA)

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Explanation:

Clinical description of case of ulcerative colitis (UC). P-ANCA is more commonly found in UC. The other answers are findings seen in Crohn’s disease.

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Gastrointestinal Pathophysiology Self-Assessment

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Attribution:  Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA
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