WBR0569: 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 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 has 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 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?
|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 thst 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?
|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.
|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 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.
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:
|EducationalObjectives= Smoking appears to have a protective role against [[ulcerative colitis]].
Smoking seems 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.


Reference:
Calkins BM. A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci. 1989;34(12):1841-1854.
|AnswerA=Caucasian race
|AnswerA=Caucasian race
|AnswerAExp=Caucasian race is considered a risk factor for ulcerative colitis.
|AnswerAExp= Being of the Caucasian race is considered a risk factor for [[ulcerative colitis]].
|AnswerB=High-fat, low-starch diet
|AnswerB=High-fat, low-starch diet
|AnswerBExp=High fat diet is considered a risk factor for ulcerative colitis.
|AnswerBExp=A high fat diet is considered a risk factor for [[ulcerative colitis]].
|AnswerC=Sedentary lifestyle
|AnswerC=Sedentary lifestyle
|AnswerCExp=In contrast to sedentary lifestyle, exercise is considered protective of ulcerative colitis.
|AnswerCExp=Rather, exercise is considered protective against [[ulcerative colitis]].
|AnswerD=Cigarette smoking
|AnswerD=Cigarette smoking
|AnswerDExp=Cigarette smoking is presumed to have a protective role against ulcerative colitis.
|AnswerDExp=Cigarette smoking is presumed to have a protective role against [[ulcerative colitis]].
|AnswerE=Alcohol consumption
|AnswerE=Alcohol consumption
|AnswerEExp=Alcohol consumption is considered a risk factor for ulcerative colitis.
|AnswerEExp=Alcohol consumption is considered a risk factor for [[ulcerative colitis]].
|RightAnswer=D
|RightAnswer=D
|WBRKeyword=cigarette, smoke, smoking, nicotine, ulcerative, colitis, protective, inflammatory, bowel, disease, risk, factor
|WBRKeyword=cigarette, smoking, nicotine, ulcerative colitis, protective, inflammatory bowel disease, risk factor, prevention, IBD, GI tract, colon, excretory system,
|Approved=No
|Approved=Yes
}}
}}

Revision as of 19:53, 1 August 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 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 thst 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
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