A 24-year-old woman comes to the physician because of progressively worsening episodes of severe, crampy abdominal pain and nonbloody diarrhea for the past 3 years. Examination of the abdomen shows mild distension and generalized tenderness. There is a fistula draining stool in the perianal region. Immunohistochemistry shows dysfunction of the nucleotide oligomerization binding domain 2 (NOD2) protein. This dysfunction most likely causes overactivity of which of the following immunological proteins in this patient?
AInterferon-γ
Bβ-catenin
CIL-1β
DIL-10
ENF-κB
A 24-year-old woman presents to the clinic with chronic abdominal discomfort and cramping. She seeks medical attention now as she is concerned about the diarrhea that she has developed that is occasionally mixed with tiny streaks of blood. Her medical history is significant for lactose intolerance and asthma. She has a family history of wheat allergy and reports that she has tried to make herself vomit on several occasions to lose weight. After counseling the patient about the dangers of bulimia, physical examination reveals the rectum is red, inflamed, tender, and a perirectal abscess is seen draining purulent material. Colonoscopy demonstrates scattered mucosal lesions involving the colon and terminal ileum. A complete blood count is given below: Hb%: 10 gm/dL Total count (WBC): 12,500/mm3 Differential count: Neutrophils: 50% Lymphocytes: 40% Monocytes: 5% ESR: 22 mm/hr What is the most likely diagnosis?
AUlcerative colitis
BCeliac disease
CIrritable bowel syndrome
DCrohn’s disease
ELaxative abuse
A 22-year-old woman presents to the emergency department with a 3-day history of fever and abdominal pain. She says that the pain is located in the left lower quadrant of the abdomen and feels crampy in nature. The pain has been associated with bloody diarrhea and joint tenderness. She has no past medical history but says that she returned 2 weeks ago from vacation in Asia where she tried many new foods. Her family history is significant for multiple cancers in close relatives. Physical exam reveals swollen ulcers on her legs, and colonoscopy reveals contiguous ulcerations from the rectum through the descending colon. Which of the following is associated with the most likely cause of this patient's symptoms?
ANoncaseating granulomas
BSevere aortic stenosis
CGram-negative rod
DHLA-DQ2 positivity
EPerinuclear anti-neutrophil cytoplasmic antibodies
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