A 35-year-old Caucasian female presents with anemia, malaise, bloating, and diarrhea. Past genetic testing revealed that this patient carries the HLA-DQ2 allele. The physician suspects that the patient's presentation is dietary in cause. Which of the following findings would definitively confirm this diagnosis?
ACT scan showing inflammation of the small bowel wall
BBiopsy of the duodenum showing atrophy and blunting of villi
CBiopsy of the colon showing epithelial cell apoptosis
DEsophageal endoscopy showing lower esophageal metaplasia
ELiver biopsy showing apoptosis of hepatocytes
A 36-year-old man is brought to the emergency department 3 hours after the onset of progressively worsening upper abdominal pain and 4 episodes of vomiting. His father had a myocardial infarction at the age of 40 years. Physical examination shows tenderness and guarding in the epigastrium. Bowel sounds are decreased. His serum amylase is 400 U/L. Symptomatic treatment and therapy with fenofibrate are initiated. Further evaluation of this patient is most likely to show which of the following findings?
AElevated serum IgG4 levels
BSalt and pepper skull
CSeparate dorsal and ventral pancreatic ducts
DDecreased serum ACTH levels
EEruptive xanthomas
A 21-year-old female presents to her obstetrician because she has stopped getting her period, after being irregular for the last 3 months. Upon further questioning, the patient reveals that she has had a 17 lb. unintended weight loss, endorses chronic diarrhea, abdominal pain, and constipation that waxes and wanes. Family history is notable only for an older brother with Type 1 Diabetes. She is healthy, and is eager to gain back some weight. Her OBGYN refers her to a gastroenterologist, but first sends serology laboratory studies for IgA anti-tissue transglutaminase antibodies (IgA-tTG). These results come back positive at > 10x the upper limit of normal. Which of the following is the gastroenterologist likely to find on endoscopy and duodenal biopsy?
AFriable mucosal pseudopolyps with biopsy notable for crypt abscesses
BCobblestoning with biopsy showing transmural inflammation and noncaseating granulomas
CVillous atrophy with crypt lengthening and intraepithelial lymphocytes
DFoamy macrophages, which stain PAS positive
ENormal appearing villi and biopsy
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