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Ulcerative colitis — MCCQE Part 1 MCQ

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EasyDiarrheaUlcerative colitisMCCQE Part 1

A 25-year-old man has 6 weeks of bloody diarrhoea, urgency and crampy lower abdominal pain; stool cultures are negative and colonoscopy shows continuous rectal inflammation. Which of the following is the most appropriate next step?

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Correct answer: E — Treat as ulcerative colitis after excluding infection and assess severity

Treat as ulcerative colitis after excluding infection and assess severity is the single best answer because the age, timing, examination findings and investigations in the vignette fit Ulcerative colitis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Association of Gastroenterology IBD guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Association of Gastroenterology IBD guidance