WBR0569
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Gastrointestinal |
| Prompt | [[Prompt::A 25 year old Caucasian male, with an unremarkable past medical history, presents to the physician's office complaining of bloody diarrhea and abdominal pain. The patient explains that he follows a high-fat low, starch diet and follows a sedentary lifestyle. The patient reports he is a cigarette smoker and occasional consumer of alcohol. Following appropriate work-up, the patient undergoes abdominal xray that shows loss of haustra. Endoscopy that shows formation of pseudopolyps. Biopsies of the GI tract show mucosal and submucosal inflammation in the colon involving the rectum. Which of the following has a presumable protective role against the patient's condition?]] |
| Answer A | AnswerA::Caucasian race |
| Answer A Explanation | AnswerAExp::Caucasian race is considered a risk factor for ulcerative colitis. |
| Answer B | AnswerB::High-fat, low-starch diet |
| Answer B Explanation | AnswerBExp::High fat diet is considered a risk factor for ulcerative colitis. |
| Answer C | AnswerC::Sedentary lifestyle |
| Answer C Explanation | AnswerCExp::In contrast to sedentary lifestyle, exercise is considered protective of 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) is an inflammatory bowel disease characterized by mucosal and submucosal inflammation of the colon that almost always involves the rectum. Definite risk factors of UC are still controversial, but studies have described several risk factors including 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 observed to be protective against UC. The role of nicotine in cigarettes seems to play an important role in the protection against UC. Nicotine therapy is postulated to be beneficial for patients with UC; but physicians must nonetheless not encourage smoking for patients with UC. Educational Objective: Smoking seems to have a protective role against ulcerative colitis. Reference:
Calkins BM. A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci. 1989;34(12):1841-1854. |
| Approved | Approved::No |
| Keyword | WBRKeyword::cigarette, WBRKeyword::smoke, WBRKeyword::smoking, WBRKeyword::nicotine, WBRKeyword::ulcerative, WBRKeyword::colitis, WBRKeyword::protective, WBRKeyword::inflammatory, WBRKeyword::bowel, WBRKeyword::disease, WBRKeyword::risk, WBRKeyword::factor |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |