[MCQ] Inflammatory bowel disease- Part 3

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[MCQ] Inflammatory bowel disease- Part 3

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Congratulations - you have completed [MCQ] Inflammatory bowel disease- Part 3. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which of the following about investigative features of Ulcerative colitis (UC) is false ?

A	Barium enema shows fine mucosal granularity
B	“Collar-button” ulcers seen in barium enema
C	Loss of haustration occurs in early disease
D	Colon can become short & narrowed

Question 1 Explanation:

Loss of haustration occur in patients with long-standing disease. “Collar-button” ulcers indicate deep ulcerations with penetration into mucosa.

Question 2

Which of the following statements about complications of Ulcerative colitis (UC) is false ?

A	Toxic megacolon means a transverse colon with diameter >6 cm, with loss of haustration
B	Toxic megacolon can be triggered by electrolyte abnormalities and narcotics
C	In toxic colitis and severe ulcerations, bowel may perforate without first dilating
D	UC patients never develop anal fissures, perianal abscesses

Question 2 Explanation:

UC patients occasionally develop anal fissures, perianal abscesses, or hemorrhoids, but occurrence of extensive perianal lesions should suggest CD

Question 3

Which of the following statements about clinical features of Crohn’s disease (CD) is false ?

A	Can be of fibrostenotic-obstructing or penetrating-fistulous pattern
B	Most common site of inflammation is caecum
C	Presentation may mimic acute appendicitis
D	Radiographic “string sign” refers to narrowed intestinal lumen

Question 3 Explanation:

In CD, the most common site of inflammation is terminal ileum.

Question 4

Radiographic “String sign” in CD is due to ?

A	Oedema of bowel wall
B	Thickening of bowel wall
C	Fibrosis of bowel wall
D	All of the above

Question 4 Explanation:

Transmural inflammation of CD causes decreased luminal diameter & limited distensibility. Radiographic “string sign” represents long areas of circumferential inflammation & fibrosis causing long segments of luminal narrowing. Edema, bowel wall thickening & fibrosis of bowel wall account for the radiographic “string sign” of a narrowed intestinal lumen.

Question 5

Which of the following is not a feature of pain in CD ?

A	Colicky
B	Precedes defecation
C	Relieved by defecation
D	Continues after defecation

Question 5 Explanation:

Pain is colicky, precedes and is relieved by defecation.

Question 6

Right lower quadrant abdominal inflammatory mass in CD is composed of ?

A	Inflamed bowel
B	Adherent and indurated mesentery
C	Enlarged abdominal lymph nodes
D	Enlarged abdominal lymph nodes

Question 6 Explanation:

Abdominal mass in CD is composed of inflamed bowel, adherent and indurated mesentery, and enlarged abdominal lymph nodes.

Question 7

Radiographic “string sign” of a narrowed intestinal lumen in CD is due to ?

A	Edema of bowel wall
B	Bowel wall thickening
C	Fibrosis of bowel wall
D	All of the above

Question 7 Explanation:

Edema, bowel wall thickening, and fibrosis of the bowel wall within the mass account for the radiographic “string sign” of a narrowed intestinal lumen. “String sign” represents long areas of circumferential inflammation and fibrosis, resulting in long segments of luminal narrowing

Question 8

Factors recognized to exacerbate CD include ?

A	Intercurrent infections
B	Cigarette smoking
C	Non-steroidal anti-infl ammatory drugs
D	All of the above

Question 8 Explanation:

Factors recognized to exacerbate CD include intercurrent infections (both upper respiratory tract & enteric infections, including C. difficile), cigarette smoking & non-steroidal anti-inflammatory drugs

Question 9

Which of the following statements about clinical features of Crohn’s disease (CD) is false ?

A	Pneumaturia may be present
B	Fecaluria may be present
C	Enterocutaneous fistulas may be present
D	Enterocholedocal fistulas may be present

Question 9 Explanation:

Severe inflammation of ileocecal region may lead to microperforation and fistula formation to adjacent bowel, skin, urinary bladder, to abscess cavity in mesentery, or vagina.

Question 10

In Crohn’s disease (CD), intestinal malabsorption can cause all except ?

A	Hyperoxaluria
B	Hypocalcemia
C	Hypomagnesemia
D	Hypokalemia

Question 11

Diarrhea in active CD is caused by ?

A	Bacterial overgrowth
B	Bile-acid malabsorption
C	Intestinal inflammation
D	All of the above

Question 11 Explanation:

Causes of diarrhea in active CD include bacterial overgrowth in obstructive stasis or fistulization, bile-acid malabsorption due to diseased or resected terminal ileum & intestinal inflammation with decreased water absorption, increased secretion of electrolytes and decreased rectal compliance.

Question 12

Which of the following about CD is false ?

A	Epigastric pain
B	H. pylori negative gastritis
C	Second part of duodenum more commonly involved
D	None of the above

Question 13

Which of the following statements about investigations of Crohn’s disease (CD) is false ?

A	Elevated ESR
B	Elevated CRP
C	Leucopenia
D	Hypoalbuminemia

Question 13 Explanation:

Laboratory abnormalities in CD include elevated ESR & CRP, hypoalbuminemia, anemia & leukocytosis

Question 14

Endoscopic features of Crohn’s disease (CD) is false ?

A	Rectal sparing
B	Aphthous ulcerations & skip lesions
C	Fistulas
D	None of the above

Question 14 Explanation:

Endoscopic features of CD include rectal sparing, aphthous ulcerations, fistulas, and skip lesions.

Question 15

Earliest macroscopic findings of colonic CD is ?

A	Aphthous ulcers
B	Longitudinal stellate, serpiginous, & linear ulcers
C	Fistulas
D	Polyps

Question 15 Explanation:

Earliest macroscopic findings of colonic CD are aphthous ulcers which are small, multiple ulcers separated by normal intervening mucosa.

Question 16

Which out of the following is the first-line test for evaluation of suspected CD and its complications ?

A	USG
B	MRI
C	CT enterography
D	Endoscopy

Question 16 Explanation:

CT enterography permits visualization of entire small bowel for inflammation associated with CD by displaying mural hyperenhancement, interloop sinus tracts, mesenteric fat stranding, engorged

Question 17

Which of the following statements about complications of Crohn’s disease (CD) is false ?

A	Serosal adhesions common
B	Free perforation common in duodenum
C	Systemic glucocorticoid therapy increase risk of intraabdominal & pelvic abscesses
D	Perianal disease common

Question 17 Explanation:

Perforation occur usually in ileum but occasionally in jejunum.

Question 18

Which of the following antibody reactivity to antigens is associated with CD ?

A	Bacterial flagellin (CBir1
B	Outer membrane porin C (OmpC)
C	Bacterial sequence I2 (anti-I2)
D	All of the above

Question 18 Explanation:

Presence of antibody reactivity to antigens like oligomannan (ASCA, anti-Saccharomyces cerevisiae antibody), E. coli outer membrane porin C (OmpC), bacterial (Pseudomonas fluorescens) sequence I2 (anti-I2), and bacterial flagellin (CBir1) are associated with CD

Question 19

Autoantibody found in cases of UC is ?

A	Anti dsDNA
B	cANCA
C	pANCA
D	Antimitochondrial
E	pANCA positivity is found in about 60 - 70% of UC patients and 5 - 10% of CD patients

Question 20

Which of the following statements about serological diagnosis of IBD is false ?

A	pANCA (+) in 5-10% of UC & 60-70% of CD patients
B	5-15% of Iº relatives of UC patients are pANCA (+)
C	pANCA positivity is associated with pancolitis, early surgery, and primary sclerosing cholangitis
D	pANCA in CD is associated with colonic disease

Question 20 Explanation:

pANCA positivity is found in about 60–70% of UC patients and 5–10% of CD patients

Question 21

Which of the following about ASCA in IBD is false ?

A	ASCA is associated with large bowel CD
B	60-70% of CD, 10-15% of UC patients are ASCA (+)
C	ASCA positivity is associated with increased & early CD complications
D	Saccharomyces cerevisiae is Brewer’s or Baker’s yeast

Question 21 Explanation:

The presence of both Anti-Saccharomyces cerevisiae antibodies (ASCA) IgG and IgA is highly specific for the presence of Crohn’s disease. ASCA is the most sensitive serologic marker of Crohn’s disease. Saccharomyces cerevisiae is Brewer’s or Baker’s yeast.

Question 22

Which of the following about serology of CD is false ?

A	Omp C (+) patients more likely to have internal perforating disease
B	I2 (+) patients more likely to have fibrostenosing disease
C	Anti-CBir1 expression is associated with small-bowel disease, fibrostenosing, and internal penetrating disease
D	None of the above

Question 22 Explanation:

Omp C–positive patients are more likely to have internal perforating disease; and I2 positive patients are more likely to have fibrostenosing disease. Anti-Cbir1 expression is associated with small-bowel disease, fibrostenosing, and internal penetrating disease

Question 23

Cases of IBD that cannot be categorized as UC or CD are termed ?

A	Indeterminate colitis
B	Lymphocytic colitis
C	Diversion colitis
D	Collagenous colitis

Question 23 Explanation:

Cases of IBD that cannot be categorized as UC or CD are called indeterminate colitis. IBD cases cannot be distinguished between UC & CD in ~15% of cases.

Question 24

Which of the following is independently associated with disabling CD after 5 years ?

A	Age at diagnosis below 40 years
B	ASCA positivity
C	pANCA positivity
D	Rectal involvement

Question 24 Explanation:

Features of CD that have been shown to be independently associated with subsequent disabling CD after 5 years are initial requirement for glucocorticoid use, age at diagnosis below 40 years and presence of perianal disease at diagnosis

Question 25

All of the following are true for CD except ?

A	Abdominal mass
B	pANCA positivity
C	Response to antibiotics
D	Recurrence after surger

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See all quizzes of Peptic Ulcer Disease at here:

1.Which of the following about investigative features of
Ulcerative colitis (UC) is false ?
A. Barium enema shows fine mucosal granularity
B. “Collar-button” ulcers seen in barium enema
C. Loss of haustration occurs in early disease
D. Colon can become short & narrowed

2. Which of the following statements about complications of
Ulcerative colitis (UC) is false ?
A. Toxic megacolon means a transverse colon with diameter >6 cm, with loss of haustration
B. Toxic megacolon can be triggered by electrolyte abnormalities and narcotics
C. In toxic colitis and severe ulcerations, bowel may perforate without first dilating
D. UC patients never develop anal fissures, perianal abscesses UC patients occasionally develop anal fissures, perianal abscesses, or hemorrhoids, but occurrence of extensive perianal lesions should suggest CD.
3. Which of the following statements about clinical features of
Crohn’s disease (CD) is false ?
A. Can be of fibrostenotic-obstructing or penetrating-fistulous pattern
B. Most common site of inflammation is caecum
C. Presentation may mimic acute appendicitis
D. Radiographic “string sign” refers to narrowed intestinal lumen
In CD, the most common site of inflammation is terminal ileum.
4. Radiographic “String sign” in CD is due to ?
A. Oedema of bowel wall
B. Thickening of bowel wall
C. Fibrosis of bowel wall
D. All of the above

5.Which of the following is not a feature of pain in CD ?
A. Colicky
B. Precedes defecation
C. Relieved by defecation
D. Continues after defecation
Pain is colicky, precedes and is relieved by defecation.
6. Right lower quadrant abdominal inflammatory mass in CD is
composed of ?
A. Inflamed bowel
B. Adherent and indurated mesentery
C. Enlarged abdominal lymph nodes
D. All of the above

7. Radiographic “string sign” of a narrowed intestinal lumen in
CD is due to ?
A. Edema of bowel wall
B. Bowel wall thickening
C. Fibrosis of bowel wall
D. All of the above

8.Factors recognized to exacerbate CD include ?
A. Intercurrent infections
B. Cigarette smoking
C. Non-steroidal anti-infl ammatory drugs
D. All of the above

9. Which of the following statements about clinical features of
Crohn’s disease (CD) is false ?
A. Pneumaturia may be present
B. Fecaluria may be present
C. Enterocutaneous fistulas may be present
D. Enterocholedocal fistulas may be present

10. In Crohn’s disease (CD), intestinal malabsorption can cause
all except ?
A. Hyperoxaluria
B. Hypocalcemia
C. Hypomagnesemia
D. Hypokalemia

11. Diarrhea in active CD is caused by ?
A. Bacterial overgrowth
B. Bile-acid malabsorption
C. Intestinal inflammation
D. All of the above

12. Which of the following about CD is false ?
A. Epigastric pain
B. H. pylori negative gastritis
C. Second part of duodenum more commonly involved
D. None of the above
13. Which of the following statements about investigations of
Crohn’s disease (CD) is false ?
A. Elevated ESR
B. Elevated CRP
C. Leucopenia
D. Hypoalbuminemia

14.Endoscopic features of Crohn’s disease (CD) is false ?
A. Rectal sparing
B. Aphthous ulcerations & skip lesions
C. Fistulas
D. None of the above

15. Earliest macroscopic findings of colonic CD is ?
A. Aphthous ulcers
B. Longitudinal stellate, serpiginous, & linear ulcers
C. Fistulas
D. Polyps

16. Which out of the following is the first-line test for evaluation of
suspected CD and its complications ?
A. USG
B. MRI
C. CT enterography
D. Endoscopy

17.Which of the following statements about complications of
Crohn’s disease (CD) is false ?
A. Serosal adhesions common
B. Free perforation common in duodenum
C. Systemic glucocorticoid therapy increase risk of
intraabdominal & pelvic abscesses
D. Perianal disease common
18. Which of the following antibody reactivity to antigens is
associated with CD ?
A. Bacterial flagellin (CBir1)
B. Outer membrane porin C (OmpC)
C. Bacterial sequence I2 (anti-I2)
D. All of the above
19. Autoantibody found in cases of UC is ?
A. Anti dsDNA
B. cANCA
C. pANCA
D. Antimitochondrial

20. Which of the following statements about serological diagnosis
of IBD is false ?
A. pANCA (+) in 5-10% of UC & 60-70% of CD patients
B. 5-15% of Iº relatives of UC patients are pANCA (+)
C. pANCA positivity is associated with pancolitis, early surgery, and primary sclerosing cholangitis
D. pANCA in CD is associated with colonic disease pANCA positivity is found in about 60–70% of UC patients and 5–10% of CD patients.
21. Which of the following about ASCA in IBD is false ?
A. ASCA is associated with large bowel CD
B. 60-70% of CD, 10-15% of UC patients are ASCA (+)
C. ASCA positivity is associated with increased & early CD
complications
D. Saccharomyces cerevisiae is Brewer’s or Baker’s yeast.

22. Which of the following about serology of CD is false ?
A. Omp C (+) patients more likely to have internal perforating
diseas

B. I2 (+) patients more likely to have fibrostenosing disease
C. Anti-CBir1 expression is associated with small-bowel disease,
fibrostenosing, and internal penetrating disease
D. None of the above

23. Cases of IBD that cannot be categorized as UC or CD are
termed ?
A. Indeterminate colitis
B. Lymphocytic colitis
C. Diversion colitis
D. Collagenous colitis

24. Which of the following is independently associated with
disabling CD after 5 years ?
A. Age at diagnosis below 40 years
B. ASCA positivity
C. pANCA positivity
D. Rectal involvement

25. All of the following are true for CD except ?
A. Abdominal mass
B. pANCA positivity
C. Response to antibiotics
D. Recurrence after surgery

[MCQ] Inflammatory bowel disease- Part 3

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[MCQ] Inflammatory bowel disease- Part 3

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