WBR0175
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Gastrointestinal |
| Prompt | [[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?]] |
| Answer A | AnswerA::Inflammation of duodenum only |
| Answer A Explanation | 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. |
| Answer B | AnswerB::Inflammation of ileum only |
| Answer B Explanation | AnswerBExp::Patients with tropical sprue do not typically have inflammation of the ileum only. |
| Answer C | AnswerC::Inflammation of jejunum only |
| Answer C Explanation | 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. |
| Answer D | AnswerD::Inflammation of all segments of small bowel only |
| Answer D Explanation | AnswerDExp::Patients with tropical sprue usually have inflammation of all segments of small bowel. |
| Answer E | AnswerE::Inflammation of all segments of small bowel and large bowels. |
| Answer E Explanation | AnswerEExp::Typically, patients with tropical sprue have small bowel involvement. Large bowels are not usually involved in tropical sprue. |
| Right Answer | RightAnswer::D |
| Explanation | [[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.
Educational Objective: Patients with tropical sprue have inflammation of the entire small bowels. Reference:
Baker SJ. Tropical sprue. Br Med Bull. 1972;28(1):87-91. |
| Approved | Approved::No |
| 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 |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |