QuestionSBA
QuestionChoice
The peak incidence of ulcerative colitis is in people aged 15-25 years and in those aged 55-65 years. It is more common in men. The three symptoms described in the stem are the typical presenting features. Others include urgency and tenesmus.
10005326
a
Ulcerative Colitis
QuestionChoice
Symptoms of IBS are abdominal discomfort or pain that is relieved by defecation OR associated with altered bowel frequency or stool form which is present here. However, the diagnostic criteria is of these symptoms and at least two of: altered stool passage (e.g. straining or urgency), abdominal bloating, or symptoms made worse by eating or passage of mucous. Two of these are not present in this case.
10005327
b
Irritable bowel syndrome (IBS)
QuestionChoice
This is a diagnosis which more commonly causes constipation. Classically, acute appendicitis presents as progressive peri-umbilical pain that moves to the right iliac fossa and not cramping. Nausea and one to two episodes of vomiting are also common, and not present in this case.
10005329
d
Acute appendicitis
QuestionChoice
This can present with abdominal pain. However, the most common features are abdominal bloating and vomiting (often bilious) not mentioned here. They may also experience a failure to pass flatus or stool, rather than loose stool as in this case.
10005328
c
Small bowel obstruction
QuestionChoice
This is a condition most commonly seen in those aged between 15 and 40. However, it is more common in females. The typical presentation is most often non-bloody diarrhoea although blood can be seen in rarer advanced Crohn's colitis. The right iliac fossa is where abdominal pain is most often described in Crohn's, rather than the left as in this case.
10005330
e
Crohn's disease
Concept
Chapter
2693
3732
Ulcerative Colitis
Topic
136
Gastroenterology
13612
A normally well 19-year-old male presents to the GP with a three-week history of insidious onset crampy left iliac fossa abdominal pain, bloody diarrhoea 12-14 times per day and significant weight loss.

Which of the following is the most likely diagnosis?
a