NBME 21

nbme21/Block 2/Question#12

A 66-year-old woman comes to the physician because ...

Diverticulitis

Login to comment/vote.

 +0  upvote downvote
submitted by porky_pork_chop(0),

My reasoning was that it’d be diverticulitis due to the more acute history of presentation: “fever, chills, LLQ pain for 1 day.” Crohn’s should have a longer timeline of presentation; although the skip lesions made this one really tricky. Not sure how the gross pathology photograph plays in though ...


 +0  upvote downvote
submitted by nuts4med(0),

I was thinking Chron’s because of the narrowing of the lumen and the picture seemed like there was creeping fat. Now that I think about it though, the LLQ and constipation should have led towards diverticulitis pretty quickly.


 +0  upvote downvote
submitted by logical_champion(0),

I think it is good to note the demographics. The patient is female and old. That, along with the constipation, made me lean more towards diverticulitis. IBD usually develops in younger persons.


 +0  upvote downvote
submitted by vonhippelindau(0),

I picked Crohn’s too. I think the severe constipation over 5 years distracted me.

haliburton  i think it is critical to remember that constipation is what caused the diverticulosis.