Uworld: IL-10 improves Ulcerative Colitis?!

[LichenPlanus]

QID 1597 on uworld says: Pt has bloody diarrhea and abdominal cramps and physician correctly diagnosis it as Ulcerative Colitis. Few days later, patient comes back, and there is no inflammation seen, and no symptoms. What contributes to this change?

Answer is IL-10?! Image provided in explanation even shows that IL-10 increase Th2 (which is the inflammatory mediator of UC). Obviously TGF-B and IL-10 downregulate cytokine production/inflammation - but still specifically asking about UC makes it contradictory? I answered IL-12 b/c: IL-12 -> + TH1 -> repress TH2 via IFN gamma

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[Jabbed]

QID 1597 on uworld says: Pt has bloody diarrhea and abdominal cramps and physician correctly diagnosis it as Ulcerative Colitis. Few days later, patient comes back, and there is no inflammation seen, and no symptoms. What contributes to this change?

Answer is IL-10?! Image provided in explanation even shows that IL-10 increase Th2 (which is the inflammatory mediator of UC). Obviously TGF-B and IL-10 downregulate cytokine production/inflammation - but still specifically asking about UC makes it contradictory? I answered IL-12 b/c: IL-12 -> + TH1 -> repress TH2 via IFN gamma

It was definitely ulcerative colitis and not Crohn's?

If not, I see what you mean about the contradiction, but I would've probably ended up putting IL-10/TGF-beta given that they're anti-inflammatory. IL-12 makes sense in terms of Th2 suppression, but IL-12 production would itself produce inflammation and thus contradicts the clinical presentation.

 

[pathologyDO]

It was definitely ulcerative colitis and not Crohn's?

If not, I see what you mean about the contradiction, but I would've probably ended up putting IL-10/TGF-beta given that they're anti-inflammatory. IL-12 makes sense in terms of Th2 suppression, but IL-12 production would itself produce inflammation and thus contradicts the clinical presentation.

Agreed, I would have just assumed to pick IL-10 because it is secreted to end the inflammatory response

 

[RLSGrasshopper]

Not only that, keep in mind that IL-10/TGF-beta dampen the immune system to promote healing

 

[pd1112]

Classic UW games - make you overthink on so many Qs.

 

[Phloston]

QID 1597 on uworld says: Pt has bloody diarrhea and abdominal cramps and physician correctly diagnosis it as Ulcerative Colitis. Few days later, patient comes back, and there is no inflammation seen, and no symptoms. What contributes to this change?

Answer is IL-10?! Image provided in explanation even shows that IL-10 increase Th2 (which is the inflammatory mediator of UC). Obviously TGF-B and IL-10 downregulate cytokine production/inflammation - but still specifically asking about UC makes it contradictory? I answered IL-12 b/c: IL-12 -> + TH1 -> repress TH2 via IFN gamma

It was definitely ulcerative colitis and not Crohn's?

If not, I see what you mean about the contradiction, but I would've probably ended up putting IL-10/TGF-beta given that they're anti-inflammatory. IL-12 makes sense in terms of Th2 suppression, but IL-12 production would itself produce inflammation and thus contradicts the clinical presentation.

Agreed, I would have just assumed to pick IL-10 because it is secreted to end the inflammatory response

Not only that, keep in mind that IL-10/TGF-beta dampen the immune system to promote healing

Classic UW games - make you overthink on so many Qs.

I had the same issue like 3 years ago and had made this thread about it. And I was told off for over-thinking. I still think the question stupid.

http://forums.studentdoctor.net/threads/ulcerative-colitis-question-please-help.953517/

 

[LichenPlanus]

Thanks for the resources Phloston. There is no way this would be a fair question - it's more of a pick-and-choose response/guess what I'm thinking game. No wonder no one can break 280's on boards

 

[seminoma]

I don't follow how this is an unfair or unclear question? If the patient has UC (an inflammatory disease) and then presents with no inflammation, then you know he must have circulating anti-inflammatory cytokines or drugs on board. OP lists the apparently very common misconception that TH2 is non-inflammatory.

 

[scoKraz4]

You have to remember that reactions/signals in the body never work in an "A"--> "B" fashion. Thinking this way is what hurts a lot of peoples critical thinking on this test.