Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Pedram Argani, M.D. and prepared by Jeremy Vincent M.D.
Case 1: This is a 48 year old male who has HIV and develops toxic megacolon after treatment with antibiotics.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 525: Case 1
This is a 48 year old male who has HIV and develops toxic megacolon after treatment with antibiotics.images/vincent/5517_01.jpg
images/vincent/5517_02.jpg
images/vincent/5517_03.jpgCorrect
Answer: Pseudomembranous colitis
Histology: The bowel was markedly dilated, leading to full thickness bowel wall necrosis in areas. The mucosa shows alternating areas of viable bowel and epithelial necrosis and pseudomembranes, consisting of fibrin, mucus, and neutrophils. These are the typical features of pseudomembranous colitis associated with Clostridium difficile.
Discussion: Ischemia and E coli 0157:H7 food poisoning may yield a similar morphologic pattern of mucosal necrosis in the colon; therefore, attention to the clinical features is helpful in making this distinction. Ischemic colitis usually involves a segmental area of bowel which is affected by a blocked artery. Idiopathic inflammatory bowel disease would be associated with signs of chronicity such as crypt distortion, basal plasmacytosis, or metaplasia. None of these findings are present in the current case. Cytomegalovirus infection may locally cause ischemia due to capillary occlusion, but this should be associated with characteristic viral cytopathic effect in endothelial cells, stromal cells, or epithelial cells.
Incorrect
Answer: Pseudomembranous colitis
Histology: The bowel was markedly dilated, leading to full thickness bowel wall necrosis in areas. The mucosa shows alternating areas of viable bowel and epithelial necrosis and pseudomembranes, consisting of fibrin, mucus, and neutrophils. These are the typical features of pseudomembranous colitis associated with Clostridium difficile.
Discussion: Ischemia and E coli 0157:H7 food poisoning may yield a similar morphologic pattern of mucosal necrosis in the colon; therefore, attention to the clinical features is helpful in making this distinction. Ischemic colitis usually involves a segmental area of bowel which is affected by a blocked artery. Idiopathic inflammatory bowel disease would be associated with signs of chronicity such as crypt distortion, basal plasmacytosis, or metaplasia. None of these findings are present in the current case. Cytomegalovirus infection may locally cause ischemia due to capillary occlusion, but this should be associated with characteristic viral cytopathic effect in endothelial cells, stromal cells, or epithelial cells.
