WBR0175: Difference between revisions

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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Pathology
|MainCategory=Pathology
Line 20: Line 20:
|MainCategory=Pathology
|MainCategory=Pathology
|SubCategory=Gastrointestinal
|SubCategory=Gastrointestinal
|Prompt=A 45 year old male patient presents to the physician's office complaining of diarrhea and stools that have been difficult to flush since several weeks. Upon further questioning, the patient also reports he has been having abdominal cramps and has been losing weight recently despite normal appetite. Following routine work-up, endoscopy is scheduled and the diagnosis of tropical sprue is made. What is the most likely endoscopic finding in this patient's condition?
|Prompt=A 45-year-old male presents to the physician's office with complaints of diarrhea and stools that have been difficult to flush since several weeks. Upon further questioning, the patient also reports abdominal cramps and weight loss despite normal appetite. Upon endoscopy, you diagnose the patient with tropical sprue. Which of the following endoscopic findings is most likely observed based upon this patient's condition?
|Explanation=Tropical sprue is an intestinal disease of unknown etiology, most likely to be a manifestation of an infectious process. The most common regions of distribution of tropical sprue are - as the name suggests - tropical areas, such as the Caribbeans, South America, and India. The most common symptoms are chronic diarrhea and steatorrhea. Other associated findings are features of malabsorption, such as fatigue, weight loss, abdominal colics, glossitis, angular stomatitis, anemia, and hypoproteinemia. The disease is diagnosed endoscopically, showing evidence of inflammation of the entire small bowels.
|Explanation=Tropical sprue is an intestinal disease of unknown etiology, most likely a manifestation of an infectious process. The most common regions of distribution are the Caribbeans, South America, and India. Patients with tropical sprue frequently present with chronic diarrhea and steatorrhea. Other findings associated with tropical sprue, such as fatigue, weight loss, abdominal colics, glossitis, angular stomatitis, anemia, and hypoproteinemia, are often also indicative of malabsorption. The disease is diagnosed endoscopically, displaying features of inflammation involving the entire small bowel.


Educational Objective:
|EducationalObjectives= Patients with tropical sprue have inflammation of the entire small bowels.
Patients with tropical sprue have inflammation of the entire small bowels.
|References= Baker SJ. Tropical sprue. Br Med Bull. 1972;28(1):87-91.
 
|AnswerA=Inflammation exclusive to the duodenum
Reference:
|AnswerAExp=Patients with tropical sprue do not typically have inflammation exclusive to the duodenum. Patients with celiac disease, however, usually experience inflammation of the distal duodenum or the proximal jejunum.
Baker SJ. Tropical sprue. Br Med Bull. 1972;28(1):87-91.
|AnswerB=Inflammation exclusive to the ileum
|AnswerA=Inflammation of duodenum only
|AnswerBExp=Patients with tropical sprue do not typically have inflammation exclusive to the ileum.
|AnswerAExp=Patients with tropical sprue do not typically have inflammation of the duodenum only. Patients with celiac disease, however, have inflammation usually of the distal duodenum or the proximal jejunum.
|AnswerC=Inflammation exclusive to the jejunum
|AnswerB=Inflammation of ileum only
|AnswerCExp=Patients with tropical sprue do not typically have inflammation exclusive to the jejunum. Patients with celiac disease, however, usually experience inflammation of the distal duodenum or the proximal jejunum.
|AnswerBExp=Patients with tropical sprue do not typically have inflammation of the ileum only.
|AnswerD=Inflammation of the entire small bowel
|AnswerC=Inflammation of jejunum only
|AnswerCExp=Patients with tropical sprue do not typically have inflammation of the jejunum only. Patients with celiac disease, however, have inflammation usually of the distal duodenum or the proximal jejunum.
|AnswerD=Inflammation of all segments of small bowel only
|AnswerDExp=Patients with tropical sprue usually have inflammation of all segments of small bowel.
|AnswerDExp=Patients with tropical sprue usually have inflammation of all segments of small bowel.
|AnswerE=Inflammation of all segments of small bowel and large bowels.
|AnswerE=Inflammation of the entire small and large bowels.
|AnswerEExp=Typically, patients with tropical sprue have small bowel involvement. Large bowels are not usually involved in tropical sprue.
|AnswerEExp=Frequently, patients with tropical sprue have inflammation of the entire small bowel. Large bowel inflammation is not typically involved in tropical sprue.
|RightAnswer=D
|RightAnswer=D
|WBRKeyword=tropical, sprue, inflammation, inflamed, inflame, small, bowel, bowels, intestine, jejunum, duodenum, ileum, large, colon
|WBRKeyword=tropical, sprue, inflammation, inflamed, inflame, small, bowel, bowels, intestine, jejunum, duodenum, ileum, large, colon
|Approved=No
|Approved=Yes
}}
}}

Revision as of 19:21, 10 July 2014
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 45-year-old male presents to the physician's office with complaints of diarrhea and stools that have been difficult to flush since several weeks. Upon further questioning, the patient also reports abdominal cramps and weight loss despite normal appetite. Upon endoscopy, you diagnose the patient with tropical sprue. Which of the following endoscopic findings is most likely observed based upon this patient's condition?]]
Answer A AnswerA::Inflammation exclusive to the duodenum
Answer A Explanation AnswerAExp::Patients with tropical sprue do not typically have inflammation exclusive to the duodenum. Patients with celiac disease, however, usually experience inflammation of the distal duodenum or the proximal jejunum.
Answer B AnswerB::Inflammation exclusive to the ileum
Answer B Explanation AnswerBExp::Patients with tropical sprue do not typically have inflammation exclusive to the ileum.
Answer C AnswerC::Inflammation exclusive to the jejunum
Answer C Explanation AnswerCExp::Patients with tropical sprue do not typically have inflammation exclusive to the jejunum. Patients with celiac disease, however, usually experience inflammation of the distal duodenum or the proximal jejunum.
Answer D AnswerD::Inflammation of the entire small bowel
Answer D Explanation AnswerDExp::Patients with tropical sprue usually have inflammation of all segments of small bowel.
Answer E AnswerE::Inflammation of the entire small and large bowels.
Answer E Explanation AnswerEExp::Frequently, patients with tropical sprue have inflammation of the entire small bowel. Large bowel inflammation is not typically involved in tropical sprue.
Right Answer RightAnswer::D
Explanation [[Explanation::Tropical sprue is an intestinal disease of unknown etiology, most likely a manifestation of an infectious process. The most common regions of distribution are the Caribbeans, South America, and India. Patients with tropical sprue frequently present with chronic diarrhea and steatorrhea. Other findings associated with tropical sprue, such as fatigue, weight loss, abdominal colics, glossitis, angular stomatitis, anemia, and hypoproteinemia, are often also indicative of malabsorption. The disease is diagnosed endoscopically, displaying features of inflammation involving the entire small bowel.

Educational Objective: Patients with tropical sprue have inflammation of the entire small bowels.
References: Baker SJ. Tropical sprue. Br Med Bull. 1972;28(1):87-91.]]

Approved Approved::Yes
Keyword WBRKeyword::tropical, WBRKeyword::sprue, WBRKeyword::inflammation, WBRKeyword::inflamed, WBRKeyword::inflame, WBRKeyword::small, WBRKeyword::bowel, WBRKeyword::bowels, WBRKeyword::intestine, WBRKeyword::jejunum, WBRKeyword::duodenum, WBRKeyword::ileum, WBRKeyword::large, WBRKeyword::colon
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