Inflammatory Bowel Disease - Clinical Features and Diagnosis MCQs
Inflammatory Bowel Disease - Clinical Features and Diagnosis is part of the Inflammatory Bowel Disease section of Medicine. Practise 15 exam-style MCQs for NEET PG, FMGE, INI-CET and NEET SS, each with the correct answer and a detailed explanation.
About Inflammatory Bowel Disease - Clinical Features and Diagnosis MCQs
Distinguishing ulcerative colitis from Crohn disease through transmural inflammation, noncaseating granulomas and sigmoidoscopy findings, while tracing primary sclerosing cholangitis links and extraintestinal features, drives these Inflammatory Bowel Disease - Clinical Features and Diagnosis MCQs — high-yield NEET PG material for INI-CET.
Sample Inflammatory Bowel Disease - Clinical Features and Diagnosis MCQs with answers
Sample MCQ #1
A 44 year old man has a diagnosis of Ulcerative Colitis. He was incidentally found to have positive anti smooth muscle antibodies by the GP who sent an autoimmune screen. Which is the next recommended test for this patient?
ACT of the abdomen
BColonoscopy
CEndoscopy
DLiver function tests
Show Answer & Explanation ▾
✓ Correct Answer: D. Liver function tests
A positive anti smooth muscle antibody test is suggestive of autoimmune hepatitis . Liver function tests may demonstrate elevated levels of bilirubin, AST and ALT. A liver biopsy may then be warranted. Reference: Harrison's Principles of Internal Medicine, 21 st Ed, Ch: 326 Pg: 2482
Sample MCQ #2
A 44 year old man has a diagnosis of Ulcerative Colitis. He was incidentally found to have positive anti smooth muscle antibodies by the family doctor who sent an autoimmune screen. Which is the next recommended test for this patient?
ACT of the abdomen
BColonoscopy
CEndoscopy
DLiver function tests
Show Answer & Explanation ▾
✓ Correct Answer: D. Liver function tests
The features are suggestive of autoimmune hepatitis. Liver function tests may demonstrated elevated levels of bilirubin, AST and ALT. A liver biopsy may then be warranted. Reference : Harrison's Principles of Internal Medicine 21 st ed, Ch:341 , Pg: 2613-2615
Sample MCQ #3
A 43 year old man has recurrent episodes of bloody diarrhea and lower abdominal cramping. Histologic evaluation of a biopsy from flexible sigmoidoscopy reveals acute inflammation without architectural distortion consistent with ulcerative colitis.Which of the following conditions is associated with the condition?
APrimary biliary cirrhosis
BSclerosing cholangitis
CErythema nodosum
DRenal calculi
Show Answer & Explanation ▾
✓ Correct Answer: B. Sclerosing cholangitis
75% of patients with primary sclerosing cholangitis have inflammatory bowel disease, especially ulcerative colitis. Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown etiology. In the absence of underlying bile duct abnormalities, a generalized beading and stenosis of the intrahepatic and extrahepatic biliary tree characterize PSC. PSC is usually progressive, leading to cirrhosis, portal hypertension, and liver failure.Typically, a cholestatic jaundice picture is seen with the liver function tests. Reference : Harrison's Principles of Internal Medicine, 21 st ed, ch: 344, Pg: 2627-2628
Sample MCQ #4
A 24 year old man presents with a 10 month history of weight loss, oral ulceration and diarrhoea. A flexible sigmoidoscopy is performed and a colonic biopsy was taken. Which of the following histological features would favour a diagnosis of Crohn's disease over ulcerative colitis?
ALymphocyte infiltrate in muscularis externa
BMetaplastic polyps
CCaseating granulomata
DCrypt of lieberkuhn abscesses
Show Answer & Explanation ▾
✓ Correct Answer: A. Lymphocyte infiltrate in muscularis externa
Crohn's disease is characterized by transmural inflammation (inflammation of all layers of the gut), fissures, preservation of crypt architecture and non caseating granulomata. Ulcerative colitis is typified by mucosal inflammation, general inflammatory cell infiltration, goblet cell mucus depletion and crypt abscesses. Reference: Harrison's Principles of Internal Medicine 21 st Ed, Ch: 326 Pg:2474-2475
Sample MCQ #5
Which of the following features seen on barium studies is typical of both ulcerative colitis and Crohn's disease?
ACobblestone mucosa
BPseudopolyps
CRose-thorn ulcers
DSkip lesions
Show Answer & Explanation ▾
✓ Correct Answer: B. Pseudopolyps
Pseudopolyps are seen in both ulcerative colitis and Crohn's disease. The remainder of options listed are features of Crohn's disease rather than ulcerative colitis. Reference: Harrison's Principles of Internal Medicine, 21 st Ed, Ch: 326 Pg: 2475-2477
Sample MCQ #6
A 26-year-old woman had ulcerative colitis (UC) for seven years and was prescribed mesalazine 1.5 g per day. She smokes upto 20 cigarettes per day and is 10 weeks pregnant. She complaines of worsening symptoms with six bloody stools per day. Which one of the following statements is correct?
AAzathioprine is relatively contraindicated.
BInitiation of an elemental diet risks fetal malnutrition.
COral corticosteroids are contraindicated.
DOral mesalazine therapy should be withdrawn.
Show Answer & Explanation ▾
✓ Correct Answer: A. Azathioprine is relatively contraindicated.
The effect of pregnancy on ulcerative colitis is variable. In general, the health of a mother with UC is the best predictor of the outcome of the pregnancy. Hence drug treatment is preferred to leaving active disease untreated. Azathioprine should not generally be started during pregnancy, but it is only relatively contraindicated . However, azathioprine is concentrated in breastfeeding. In the context of pregnancy, an elemental diet does not risk maternal and/or fetal malnutrition. Oral corticosteroids and mesalazine are not contraindicated in pregnancy. Additional folate supplementation should be given. Topical 5- ASA is also not contraindicated. Reference: Harrison's Principles of Internal Medicine 21 st Ed, Ch: 326, Pg: 2488
Sample MCQ #7
A 25-year-old man has been admitted with severe ulcerative colitis. He has been on high-dose steroids intravenously for three days but there have been no signs of improvement. The gastroenterology team have decided to commence cyclosporine. Which of the following is a recognized adverse effect of cyclosporine?
AEczema
BHypertension
CNephrotic syndrome
DPsoriasis
Show Answer & Explanation ▾
✓ Correct Answer: B. Hypertension
The side effects of cyclosporine include - Hypertension Nephrotoxicity Gum hypertrophy Hirsutism Convulsions The indications for cyclosporine use include - Eczema, psoriasis, rheumatoid arthritis, IBD. Reference: Harrison's Principles of Internal Medicine 21 st ed, Ch: 313 Pg: 2328
Sample MCQ #8
A 44 year old man has 5 year history of bloody diarrhoea mixed with mucus. He had lost 2 stones in weight over this time. Flexible sigmoidoscopy showed loss of vascular appearance, erythema, and superficial ulceration consistent with ulcerative colitis. Which one of the following features is associated with the condition?
ARheumatoid arthritis
BOsteomalacia
CMegaloblastic anaemia
DEpiscleritis
Show Answer & Explanation ▾
✓ Correct Answer: D. Episcleritis
The extraintestinal manifestations of Inflammatory Bowel Disease include- Ocular - Episcleritis , uveitis Rheumatological - Ankylosing spondylitis, peripheral migratory arthritis Dermatological - Erythema nodosum, pyoderma gangrenosum Primary sclerosing cholangitis – most common in ulcerative colitis Nephrolithiasis ( calcium oxalate stones - most common)- most common in crohn's disease (CD) T erminal ileum is the most commonly involved site in CD. Megaloblastic anaemia occurs in CD as vitamin B12 is absorbed in the terminal ileum. Reference: Harrison's Principles of Internal Medicine 21 st Ed, Ch: 326, Pg: 2480-2482
What you can practise in Inflammatory Bowel Disease - Clinical Features and Diagnosis
15 Inflammatory Bowel Disease - Clinical Features and Diagnosis MCQs on Inflammatory Bowel Disease, Features, Diagnosis — each with detailed explanations
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What do Inflammatory Bowel Disease - Clinical Features and Diagnosis MCQs cover?
Distinguishing ulcerative colitis from Crohn disease through transmural inflammation, noncaseating granulomas and sigmoidoscopy findings, while tracing primary sclerosing cholangitis links and extraintestinal features, drives these Inflammatory Bowel Disease - Clinical Features and Diagnosis MCQs — high-yield NEET PG material for INI-CET.
How many Inflammatory Bowel Disease - Clinical Features and Diagnosis questions are there, and which exams do they cover?
MedLadder includes 15 curated MCQs for Inflammatory Bowel Disease - Clinical Features and Diagnosis under Medicine (Inflammatory Bowel Disease), covering NEET PG, FMGE, INI-CET and NEET SS preparation.
