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USMLE Step 2, Question #126
Revision #4: 2/21/2009 4:49:27 PM
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A 19-year-old college student has chronic bouts of abdominal pain and diarrhea. On many occasions she has seen blood in her stool. Her sister has the same condition. Which of the following is a feature of the most likely diagnosis in this case?
A. Cobblestone mucosa
B. Crypt absceses and ulcers
C. Noncaseating granulomas
D. Skip lesions
E. Transmural involvement of the small bowel
See Explanation
B is the correct answer.
(67% of users answered this question correctly)
This patient has symptoms of inflammatory bowel disease. The presence of bloody stools and a positive family history should make you lean toward ulcerative colitis over Crohn's. Crohn's disease is marked by transmural involvement, skip lesions, noncaseating granulomas, and cobblestone mucosa. UC is marked by mucosal inflammation, continuous involvement usually in the descending colon and rectum, crypt abscesses and ulcers and a friable mucosa with pseudopolyp formation.
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