Repeated USMLE Questions Step 2 CK- 338

A 27 year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years.  His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova.

What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn's disease in this patient?

A- History of diarrhea and weight loss

B- Family history of inflammatory bowel syndrome

C- Smoking cessation

D- Negative stool analysis

E- Having first attack in his twenties

Answer






Incidence and severity of ulcerative colitis are related to smoking cessation. This relation does not occur in cases of Crohn’s disease. Other choices are found in both ulcerative colitis and Crohn’s disease.

The correct answer is C