IBD IBD Diagnosis and Imaging

Question 1

Which endoscopic finding is considered the gold standard for diagnosing Crohn's disease of the terminal ileum?

Accepted Answer

Cobblestone mucosa with linear ulcers

Answer

Cobblestone mucosa with linear ulcers separated by areas of relatively normal mucosa (skip lesions) is the classic endoscopic appearance of Crohn's disease.

Question 2

What is the preferred imaging modality for evaluating small bowel involvement in Crohn's disease?

Accepted Answer

CT enterography (CTE) or MR enterography (MRE)

Answer

CT enterography and MR enterography provide superior luminal and mural detail for assessing small bowel Crohn's disease extent, complications, and activity.

Question 3

Which fecal biomarker is most useful for monitoring intestinal inflammation and mucosal healing in IBD?

Accepted Answer

Fecal calprotectin

Answer

Fecal calprotectin is a sensitive, non-invasive marker of intestinal inflammation that correlates well with endoscopic disease activity and mucosal healing.

Question 4

On colonoscopy, the finding of 'backwash ileitis' can occur in which IBD condition?

Accepted Answer

Extensive ulcerative colitis (pancolitis)

Answer

Backwash ileitis occurs in severe pancolitis UC when reflux of colonic contents causes mild ileal inflammation, distinguishable from Crohn's ileitis by its limited extent and diffuse pattern.

Question 5

Which serological marker combination pattern is most consistent with ulcerative colitis?

Accepted Answer

pANCA positive, ASCA negative

Answer

pANCA positivity with ASCA negativity has the highest specificity for ulcerative colitis in serological IBD differentiation panels.

IBD - Inflammatory Bowel Disease Practice Test

IBD - Inflammatory Bowel Disease Practice Test

IBD IBD Diagnosis and Imaging