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Ulcerative colitis flare — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Ulcerative colitis flareUSMLE Step 3

A 28-year-old man has 6 weeks of bloody diarrhea, urgency, and crampy lower abdominal pain. Stool cultures and C difficile testing are negative. Colonoscopy shows continuous friable inflammation from rectum to sigmoid colon with superficial ulceration. Which of the following is the most likely diagnosis?

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Correct answer: C — Ulcerative colitis

Continuous mucosal inflammation beginning in the rectum with bloody diarrhea is typical of ulcerative colitis.

Reference: ACG Ulcerative Colitis Guideline