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Gastro quiz

Total questions: 24

Worksheet time: 12mins

Name
Class
Date
1.

When was Ulcerative Colitis first named as a distinct disease?

a)

1875

b)

1905

c)

1935

d)

1965

2.

Which disorder is more common among adults in the United States: UC or CD?

a)

Ulcerative Colitis

b)

Crohn’s Disease

3.

Which disorder is more common among children in the United States: UC or CD?

a)

Ulcerative Colitis

b)

Crohn’s Disease

4.

What is the incidence of Ulcerative Colitis (newly-diagnosed cases) in the United States?

a)

1 to 20 per 100,000

b)

100 to 200 per 100,000

c)

1,000 to 2,000 per 100,000

d)

10,000 to 20,000 per 100,000

5.

When photomicrograph depicts Ulcerative Colitis?

a)
b)
6.

Which coronal CT image depicts Ulcerative Colitis?

a)
b)
c)
d)
7.

The antibody associated with Ulcerative Colitis classically targets all but which molecule?

a)

Myeloperoxidase

b)

Proteinase 3

c)

Lactoferrin

d)

Cathepsin G

8.

You are about to prescribe an initial treatment to a patient newly-diagnosed with moderate-to-severe UC. Which do you choose?

a)

Infliximab

b)

Hyperbaric Oxygen

c)

Tofacitinib

d)

Mesalamine

9.

You suspect your patient has Ulcerative Colitis. A positive titer for which antibody would most aid in your diagnosis?

a)

Anti-endomysial

b)

p-ANCA

c)

ASCA

d)

IgA tTG

10.

Your patient receives a barium enema and the following image is recorded. What pathology is noticeable in the descending colon?

a)

Lead pipe appearance due to bowel thickening

b)

Lead pipe appearance due to loss of haustra

c)

String sign due to bowel thickening

d)

String sign due to loss of haustra

11.

You suspect your patient has an IBD. Which clinical presentation would bring UC to the top of your differential?

a)

LLQ pain with bloody diarrhea

b)

LLQ pain with non-bloody diarrhea

c)

RLQ pain with bloody diarrhea

d)

RLQ pain with non-bloody diarrhea

12.

You obtain a liver biopsy from your UC patient. What is the best description of what you see?

a)

Non-granulomatous inflammation

b)

Crypt abscesses

c)

Concentric periductal fibrosis

d)

Normal tissue

13.

True or False: Smoking has been shown to be protective against ulcerative colitis.

a)

True

b)

False

14.

Ulcerative colitis is a disease of colonic inflammation. Which part of the colon is always involved in UC?

a)

Ascending Colon

b)

Descending Colon

c)

Sigmoid Colon

d)

Rectum

15.

You know that crypt abscesses (shown below) are diagnostic for UC. What makes up the infiltrate?

a)

Eosinophils

b)

Neutrophils

c)

RBCs

d)

Basophils

16.

The immune response of UC, shown in the image, is mediated by what type of T-cell?

a)

Th1 cells

b)

Th2 cells

c)

Th17 cells

d)

Treg cells

17.

A 30-year-old man comes to the physician because of a 1-year history of bouts of diarrhea and abdominal pain, often associated with a low-grade fever. He has unintentionally lost 20 lbs over the past 8 months. Endoscopy reveals well-differentiated, focal patches of ulcerated lesions interspersed between normal appearing bowel mucosa in the duodenum and ileum. Which of the following is the most likely diagnosis?

a)

Chronic mesenteric ischemia

b)

Crohn disease

c)

Small bowel adenocarcinoma

d)

Ulcerative colitis

18.

A 35-year-old man comes to the physician because of a 3-month history of back pain and buttock pain that has acutely worsened during the past week. He describes a throbbing, aching pain over his lower back. He denies a history of trauma. He has a history of Crohn disease. Medications include sulfasalazine. His vital signs are within normal limits. He cries out in pain upon palpation of the anterior superior iliac spines. Which of the following is the most likely cause of this patient’s pain?

a)

Herniated disc

b)

Sacroiliac fracture

c)

Sacroiliitis

d)

Spinal canal stenosis

19.

A 30-year-old man comes to the physician because of the development of severe pain upon defecation for the past 5 days. He denies bright red blood per rectum. He has a history of intermittent crampy abdominal pain and a 15-lb unintentional weight loss over the past 6 months. He reports that he recently has been getting "canker sores" in his mouth which are painful and unresponsive to over-the-counter remedies. On exam, the patient is found to have a perirectal abscess. All of the following are true about this patient’s likely diagnosis EXCEPT:

a)

Malabsorption of bile acid contributes to significant weight loss.

b)

Pathology always involves the rectum.

c)

Severe narrowing of the intestinal lumen is associated with a positive "string sign" on radiographic imaging.

d)

Ulcers have an interwoven, "cobblestone" appearance on gross pathology.

20.

Match the following gastrointestinal complication to the associated disease (Ulcerative colitis (UC), Crohn disease (CD)).

A. Colovesical fistula B. Fibrotic strictures C. Malabsorption of fat-soluble vitamins D. Toxic megacolon

a)

Ulcerative colitis: A, B, D; Crohn’s disease: C

b)

Ulcerative colitis: A, B; Crohn’s disease: C, D

c)

Ulcerative colitis: C, D; Crohn’s disease: A, B

d)

Ulcerative colitis: D; Crohn’s disease: A, B, C

21.

Which of the following nutritional deficiencies is LEAST likely in a 40-year-old man with a long history of Crohn disease?

a)

Iron

b)

Vitamin A

c)

Vitamin B12

d)

Vitamin D

22.

Which clinical variant of arthritis would be most likely in an HLA-B27-positive young man with a history of ulcerative colitis?

a)

Migratory polyarthritis

b)

Monoarticular arthritis

c)

Reactive arthritis

d)

Rheumatoid arthritis

23.

A patient with symptoms consistent with inflammatory bowel disease receives an upper endoscopy and colonoscopy. A surgical biopsy from an affected portion of bowel shows diffuse ulceration, abscesses within colonic crypts, increased cellularity and basal lymphoid aggregates. Which of the following findings is most likely positive in this patient?

a)

Carcinoembryonic antigen

b)

Cytoplasmic anti-neutrophil cytoplasmic antibodies

c)

Perinuclear anti-neutrophil cytoplasmic antibodies

d)

anti-Saccharomyces cerevisiae antibodies

24.

Match the degree of bowl wall ulceration to the correct disease. A: Transmural B: Mucosa and submucosa only

a)

Crohn’s disease: A; Ulcerative colitis: A

b)

Crohn’s disease: A; Ulcerative colitis: B

c)

Crohn’s disease: B; Ulcerative colitis: A

d)

Crohn’s disease: B; Ulcerative colitis: B