GASTROENTEROLOGY ARTICLE OF THE WEEK
May 17, 2007
Abreu MT, Harpaz N. Diagnosis of colitis: Making the initial diagnosis. Clin Gastroenterol Hepatol 2007;5:295-301.
1. Features that are usually present on colonic biopsies done early during the course of infectious colitis include
a. Crypt branching
b. edema
c. chronic lymphocytic infiltrates
d. cryp abscesses
e. mucin depletion
f. neutrophillic infiltration
g. shortening of the crypts
2. Features on colonic biopsies done on a patient on the 2nd day of “actue” bloody diarrhea that suggests underlying IBD include:
a. separation of the crypts by a dense inflammatory infiltrate
b. inflammatory infiltrate consisting mainly of neutrophils
c. Plasma cells, lymphocytes, histiocytes and eosinophils in the lamina propria
d. crypt abscesses
e. Paneth’s cells noted in sigmoid biopsies
True or False
3. Perianal disease is more common in patients with ileal Crohn’s disease
4. An episode of bacterial gastroenteritis is associated with a 2 to 4 fold risk of developing IBD
5. Outpatients with new onset bloody diarrhea should be treated empirically with ciprofloxacin once stool cultures are collected
6. A significant number of Paneth’s cells in the sigmoid may indicate the presence of IBD
7. Fecal lactoferrin or calprotectin levels are useful in distinguishing IBD from infectious colitis
8. Biopsies from the cecum normally show an increase in inflammatory cells as well as widely spaced crypts
9. Capillary microthrombi and extravasation of red cells into the lamina propria are typical histologic findings of C. difficile colitis