This page is dedicated to organizing various examples of standardized exam questions whose answer is Whipple disease. While this may seem a odd practice, it is useful to see multiple examples of how Whipple disease will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for Whipple disease.
- Histological Findings:
- Foamy macropahges
- PAS positive macrophages
- Macrophages containing rod shaped bacilli
Question # 1
A 45 year old male comes to the clinic with a long history of joint pains in a few different joints. He has been worked up in the past however to definitive diagnosis have been made. He has been taking ibuprofen with partial relief of his pain. He now has developed a fever, diarrhea, and also has lost one weight. He denies any genitourinary or eye symptoms. He does not use any tobacco or alcohol. A physical exam is remarkable for generalized lymphadenopathy and a non-deforming arthritis. A biopsy of the small intestine reveals the presence of PAS positive macrophages. What is a possible diagnosis?
Explanation # 1
Intestinal biopsy showing PAS positive macrophages = Whipple disease
Question # 2
Explanation # 2
TESTABLE FACTS ABOUT THIS TOPIC (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying topic. Often there are specific testable facts regarding some aspect of the topic’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:
- Causal pathogen: Tropheryma whipplei
Page Updated: 02.19.2017