IBD

A 46-year-old woman presents with a three-week history of abdominal pain and diarrhea. There is no history of fever, weight loss, vomiting, foreign travel, or diet change. She currently does not smoke or drink alcohol. She was diagnosed with stage I COPD four weeks ago. On examination, there is no evidence of respiratory distress, and she is warm and well perfused. Her abdomen is soft, but there is mild tenderness generally. A rectal examination shows a small amount of red blood mixed into the stools but no other abnormalities. What is the most likely diagnosis?

A 24-year-old man has been admitted with an exacerbation of Crohn's disease. Despite prednisolone and mesalazine therapy for the past 3 weeks, he is still passing 6-7 watery stools per day. He has lost a considerable amount of weight during this period. On examination, he is apyrexial, hemodynamically stable and his abdomen is soft and non-tender. What is the most appropriate next step?

Which one of the following features is least associated with ulcerative colitis?

A 29-year-old man is diagnosed with Ulcerative colitis one month ago. When initially reviewed he was passing on average four loose stools a day with some visible blood. He was started on oral mesalazine and a review appointment was made for today. Unfortunately, there has been no significant change in his symptoms. He is still passing around four bloody stools a day although he remains systemically well. What is the most appropriate course of action?

A 24-year-old woman presents with a flare of ulcerative colitis. She tells you that she has been opening her bowels on average 7 times a day and that in the last 24 hours she has noticed blood mixed in with the stools. On examination, the blood pressure is 100/60 mmHg, heart rate 95 beats per minute, respiratory rate 16/min, oxygen saturation 96%, and temperature 37.9 ºC. The abdomen is soft, with only a localized tenderness in the left iliac fossa. Hb 102 g/L Male: (135-180) Female: (115 - 160) WBC 13.2 * 109/L (4.0 - 11.0) Na 140 mmol/L (135 - 145) K 3.8 mmol/L (3.5 - 5.0) Urea 4.6 mmol/L (2.0 - 7.0) Creatinine 95 µmol/L (55 - 120) CRP 35 mg/L (< 5) How should this patient be managed?

A 25-year-old man presents with bloody diarrhoea associated with systemic upset. A diagnosis of ulcerative colitis is suspected. Which part of the bowel is most likely to be affected?

Which one of the following factors is most responsible for the increased rate of colorectal cancer in patients with ulcerative colitis?

A 24-year-old man has been admitted with an exacerbation of Crohn's disease. Despite prednisolone and mesalazine therapy for the past 3 weeks he is still passing 6-7 watery stools per day. He has lost a considerable amount of weight during this period. On examination, he is apyrexial, hemodynamically stable and his abdomen is soft and non-tender. What is the most appropriate next step?

A 26-year-old man is investigated for diarrhea and weight loss. A bowel biopsy shows findings consistent with Crohn's disease. Which one of the following factors is likely to be the most important aetiological factor? A diet with an increased ratio of omega-3 to omega-6 polyunsaturated fatty acids 2% 54% 1% 3% 40%

Which one of the following is least associated with the development of colorectal cancer in patients with ulcerative colitis?

A 27-year-old woman is diagnosed 6 weeks ago with Ulcerative colitis. She is currently passing 3-4 loose motions a day which normally contains a small amount of blood. She remains systemically well with no fever or significant abdominal pain. A colonoscopy is performed which shows inflammatory changes in the ascending, transverse and descending colon . Bloods show the following: * Hb 142 g/L *Platelets 323 * 109/l * WBC 8.1 * 109/l *CRP 22 mg/l What is the most appropriate first-line medication to induce remission?

A 23-year-old man is investigated for chronic diarrhoea associated with raised inflammatory markers. A bowel biopsy is taken. Which one of the following findings is most suggestive of ulcerative colitis?

Crohn's disease is associated with each one of the following findings, except:

A 36-year-old man is reviewed in the clinic. He has recently been started on mesalazine 400mg TDS for ulcerative colitis. Which one of the following adverse effects is least likely to be attributable to mesalazine?

A 35-year-old lady presents with right upper quadrant pain. She has also noticed that her skin seems slightly yellower over the last week or so and you notice a yellow tinge to her sclera. On further questioning, she complains of the itching of her arms. Her only past medical history of note includes ulcerative colitis for which she takes mesalazine. Given her presentation, what is the best investigation to diagnose the most likely underlying condition?