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 23-year-old man presents to the office complaining of weight loss and fatigue for the past 2 months. He states that he has been experiencing foul-smelling, light-colored stools but thinks it is because he hasn’t been eating well, recently. He has a past medical history significant for cystic fibrosis, which is well-controlled medically. He denies any shortness of breath, chest or abdominal pain, nausea, vomiting, or melena. On physical examination, his skin is pale and dry. Which of the following would be the most likely etiology of a malabsorption syndrome giving rise to this patient’s current condition?
ADecreased recycling of bile acids
BPancreatic insufficiency
CAutoimmune damage to parietal cells
DChronic damage to intestinal mucosa
EDamage to intestinal brush border
A 63-year-old man comes to the physician with a 4-week history of fatigue, crampy abdominal pain, watery diarrhea, and pain in his mouth and gums. He returned from a 2-week trip to the Dominican Republic 2 months ago. He has smoked one pack of cigarettes daily for 45 years. Examination shows three 1.5-cm, painful ulcers in the mouth. Abdominal examination shows mild tenderness to palpation in the right lower quadrant without guarding or rebound. His hemoglobin concentration is 11.2 g/dL, mean corpuscular volume is 75 fL, and leukocyte count is 11,900/mm³. Colonoscopy shows a cobblestone mucosa. A photomicrograph of a biopsy specimen is shown. Which of the following is the most likely diagnosis?
ABehcet disease
BTropical sprue
CUlcerative colitis
DCrohn disease
EWhipple disease
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