This page is dedicated to organizing various examples of standardized exam questions whose answer is toxic megacolon. While this may seem a odd practice, it is useful to see multiple examples of how toxic megacolon 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.
Question # 1
A 45 year old male with a 20 year past history of ulcerative colitis currently weights 95 lbs and has had many recent hospitalizations for exacerbations of his disease. Currently he is on high dose steroids and immuran for a recent relapse. For the past day he has been complaining of abdominal pain and has a temperature of 103.5°F and a leukocytosis. He is ill and toxic appearing. A physical exam reveals a tender abdomen (particularly in the epigastric area), and he has muscle guarding and rebound tenderness. A KUB reveals a massively distended transverse colon, and gas is observed in the walls of the colon.
Explanation: history of ulcerative colitis + massively distended transverse colon = toxic megacolon
Page Updated: 03.06.2017