skip to main content

Acute severe ulcerative colitis with C. difficile risk — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardDiarrheaAcute severe ulcerative colitis with C. difficile riskMCCQE Part 1

A 29-year-old woman with ulcerative colitis presents with 8 bloody stools daily, fever, tachycardia, and abdominal pain after recent antibiotics. CRP is elevated and abdominal radiograph shows colonic dilation of 5.5 cm without perforation. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Stool testing for Clostridioides difficile toxin or PCR

In a severe colitis flare, C. difficile must be tested because it can mimic or worsen inflammatory bowel disease and changes management. Barium enema risks perforation in acute severe colitis. Faecal calprotectin does not distinguish infection sufficiently in this setting. Capsule endoscopy is unsafe and unhelpful in suspected severe colitis.

Reference: Canadian Association of Gastroenterology IBD guidance