USMLE Step 1

USMLE Step 1 QUESTION of the DAY!

A 29 year-old male has noticed increasing amounts of bloody diarrhea. He also notes mild abdominal pain and multiple sore joints. Radiologically after barium, the rectum and descending colon demonstrate lead pipe colon. What is likely to be associated with this man’s disease?

A) positive string sign
B) skip lesions
C) HLA A3
D) HLA B27
E) Low risk of cancer

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Answer: D) HLA B27. This man has Ulcerative Colitis. UC is an inflammatory bowel disease that begins at the rectum and descending colon. Characteristics include crypt abscesses, pseudopolyps, lead pipe colon, and a high risk of colon cancer and toxic megacolon. Clinically there is a lot of blood (from ulcers) and only mild pain. There is an association between UC and human leukocyte antigen (HLA) B27. Answers A, B, & E are characteristics of Crohn’s disease, the other inflammatory bowel disease.


USMLE Step 1 D.O.C. of the DAY!

Drug of choice for

Legionella causing Legionnaire’s disease

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Erythromycin


USMLE Step 1 Fact of the Day!

Von Willebrand Disease
-deficiency of von Williebrand factor (VWF)
-VWF carries factor VIII (also a deficiency of factor VIII)
-Autosomal dominant
-Characteristics: easy bleeding or bruising
Increased menstrual bleeding
Increased PTT and bleeding time
TX: VWF or purified factor VIII