IBD (Crohn’s & UC): ABFM practice questions

4 board-style questions on ibd (crohn’s & uc) in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 26-year-old man presents with bloody diarrhea, tenesmus, and lower abdominal cramping for the past 6 weeks. He has 8 to 10 bloody stools per day. Colonoscopy reveals continuous erythematous, edematous, and friable mucosa extending from the rectum to the splenic flexure, with a clear demarcation between involved and uninvolved segments. The terminal ileum appears normal. Biopsies show crypt abscesses and chronic inflammation limited to the mucosa and submucosa. Which of the following is the most likely diagnosis?

  1. Ulcerative colitis
  2. Clostridioides difficile colitis
  3. Ischemic colitis
  4. Crohn's disease

Sample question 2

A 30-year-old woman with known Crohn's disease involving the terminal ileum has had two moderate flares in the past year despite adherence to mesalamine 4 g daily. She now presents with worsening right lower quadrant pain, non-bloody diarrhea (6 stools per day), and fatigue. CRP is 28 mg/L and fecal calprotectin is 620 mcg/g. CT enterography shows active inflammation and wall thickening of the terminal ileum with no abscess, fistula, or stricture. What is the most appropriate change in her management?

  1. Refer for immediate surgical resection of the terminal ileum
  2. Initiate a biologic agent such as infliximab or adalimumab, with or without an immunomodulator
  3. Increase the mesalamine dose to 4.8 g daily
  4. Add oral budesonide for long-term maintenance therapy

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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