GI & Hepatobiliary Practice Questions

A 25-year-old female presents with a 4-month history of intermittent abdominal pain, non-bloody diarrhea, and unintentional weight loss. She also reports a painful, tender lump near her anus. Colonoscopy reveals multiple discrete ulcerations with normal intervening mucosa ('skip lesions') in the terminal ileum and ascending colon, along with transmural inflammation. Which of the following histopathologic findings is most characteristic of this patient's condition?

A 62-year-old male presents to the emergency department with a 2-day history of severe left lower quadrant abdominal pain, fever (101.5°F, 38.6°C), and chills. He reports constipation but no rectal bleeding. Physical examination reveals tenderness and guarding in the left lower quadrant. Laboratory tests show leukocytosis with a left shift. A CT scan of the abdomen and pelvis shows colonic diverticula with wall thickening and pericolonic fat stranding in the sigmoid colon. What is the most appropriate initial management for this patient?

A 28-year-old female experiences bloating, abdominal cramps, and watery diarrhea approximately 30-60 minutes after consuming dairy products. Her symptoms consistently resolve when she avoids milk, cheese, and ice cream. Physical examination is unremarkable. Which of the following is the most likely underlying mechanism for her symptoms?