Sample MCQ to ghost rewrite - PLEASE SUBMIT ALONG WITH BID

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A 29-year-old male comes to your office with complaints of periodic bloody diarrhea
with mild abdominal pain for 1 month. He had these symptoms before but it resolves on
its own. He also has mild joint pain in his knees and ankles for 6 months. Also, she
noticed painful oral lesions. During the physical examination, you have found erythema
nodosum on her ankles and two aphthous ulcers approximately 1x1 cm in her mouth
which are mildly tender. You ordered colonoscopy which shows patchy rectosigmoid
inflammation with normal rectosigmoid mucosa 'skip areas' and the biopsy revealed
noncaseating granulomas. Which of the following is most likely diagnosis in the patient?

A. Ulcerative colitis
B. Crohns disease
C. Infectious gastroenteritis
D. Sarcoidosis
E. Behet's disease

Explanation:

The correct answer is B. This patient most likely has Crohns disease based on the
symptoms (of periodic bloody diarrhea with mild abdominal pain over several years,
mild joint pain in his knees and ankles for 6 months) physical examination (erythema
nodosum on her ankles and two aphthous ulcers approximately 1x1 cm in her mouth
which are mildly tender) and colonoscopy findings (shows patchy rectosigmoid
inflammation with normal rectosigmoid mucosa 'skip areas' and the biopsy revealed
noncaseating granulomas).

Ulcerative colitis (A), Infectious gastroenteritis (), and Behet's disease (E) are not
associated with biopsy finding - noncaseating granulomas.

Sarcoidosis (D) is not associated with the symptom of bloody diarrhea and rectosigmoid
inflammation.

Sample rewritten MCQ

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A 50-year-old lady with refractory dilated cardiomyopathy is awaiting an orthotopic
cardiac transplant. Which of the following is correct regarding this procedure?

A. Arrhythmia following an orthotopic cardiac transplantation is a normal phenomenon

and does not suggest acute graft rejection.
B. A biatrial anastomosis is superior to a bicaval anastomosis as it carries a significant
survival benefit.
C. The donor heart is placed in the right side of the chest cavity alongside the
recipients heart.
D. Ischemic stroke and transient ischemic attacks are less common in this procedure as
compared to other cardiac surgeries.
E. Periodic diagnostic right heart catheterization is mandatory for all adults awaiting an
orthotopic cardiac transplantation.
Explanation:
The answer is (E), as right heart catheterization is carried out periodically to assess the
patient's suitability as a recipient, with the frequency of assessment varying from
patient to patient.

In an orthotopic heart transplant, the recipient's heart is replaced by the donor heart;
placing the donor heart to the right of the recipients heart within the chest cavity is
known as a heterotopic heart transplant (C).

Arrhythmias are a common presentation of acute graft rejection following this

procedure (A).

A bicaval anastomosis is considered superior to a biatrial anastomosis, owing to its

better survival rate and lower incidence of complications (B).

Ischemic stroke and transient ischemic attacks are seen more commonly with
transplantation than other cardiac surgeries (D).