WBR0569

Author	[[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pathology
Sub Category	SubCategory::Gastrointestinal
Prompt	[[Prompt::A 25-year-old Caucasian male presents to the physician's office with complaints of of bloody diarrhea and abdominal pain. The patient explains that he consumes a high-fat, low-starch diet and has a sedentary lifestyle. Additionally, the patient reports that he is a cigarette smoker and occasional consumer of alcohol. An abdominal x-ray demonstrates a loss of haustra, endoscopy displays a formation of pseudopolyps, and biopsies of the GI tract illustrate mucosal and submucosal inflammation in the colon, involving the rectum. Which of the following factors plays a presumably protective role against the patient's condition?]]
Answer A	AnswerA::Caucasian race
Answer A Explanation	[[AnswerAExp::Being of the Caucasian race is considered a risk factor for ulcerative colitis.]]
Answer B	AnswerB::High-fat, low-starch diet
Answer B Explanation	[[AnswerBExp::A high fat diet is considered a risk factor for ulcerative colitis.]]
Answer C	AnswerC::Sedentary lifestyle
Answer C Explanation	[[AnswerCExp::Rather, exercise is considered protective against ulcerative colitis.]]
Answer D	AnswerD::Cigarette smoking
Answer D Explanation	[[AnswerDExp::Cigarette smoking is presumed to have a protective role against ulcerative colitis.]]
Answer E	AnswerE::Alcohol consumption
Answer E Explanation	[[AnswerEExp::Alcohol consumption is considered a risk factor for ulcerative colitis.]]
Right Answer	RightAnswer::D
Explanation	[[Explanation::Ulcerative colitis (UC), an inflammatory bowel disease, is characterized by mucosal and submucosal inflammation of the colon, almost always involving the rectum. Risk factors associated with UC include genetic elements, such as Caucasian race and positive family history, and environmental factors, such as high fat diet, sedentary lifestyle, alcohol consumption. In contrast, appendectomy and smoking have been demonstrated to be protective against UC. The role of nicotine in cigarettes appears to play a protective role against UC. Educational Objective: Smoking appears to have a protective role against ulcerative colitis. References: Calkins BM. A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci. 1989;34(12):1841-1854.]]
Approved	Approved::Yes
Keyword	WBRKeyword::Cigarette, WBRKeyword::Smoking, WBRKeyword::Nicotine, WBRKeyword::Ulcerative Colitis, WBRKeyword::Protective, WBRKeyword::Inflammatory Bowel Disease, WBRKeyword::Risk Factor, WBRKeyword::Prevention, WBRKeyword::IBD, WBRKeyword::GI Tract, WBRKeyword::Colon, WBRKeyword::Excretory System
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::