American Board of Internal Medicine (ABIM) Certification Practice Exam

Which condition is indicated by elevated levels of a p-ANCA test?

1. Coronary artery disease

2. Ulcerative colitis

3. Diabetes Mellitus

4. Hypertension

The correct answer is: Ulcerative colitis

Elevated levels of p-ANCA (perinuclear anti-neutrophil cytoplasmic antibodies) are most commonly associated with certain autoimmune diseases and inflammatory conditions, particularly ulcerative colitis. This condition is a form of inflammatory bowel disease characterized by chronic inflammation of the colon and rectum. The positive p-ANCA test can help in the diagnosis and management of this disease, especially when considering differential diagnoses in patients with gastrointestinal symptoms. The association of p-ANCA with ulcerative colitis is linked to the immune response in which antibodies target certain components within neutrophils, leading to the destruction of mucosal cells in the colon. While other conditions may also present with elevated levels of p-ANCA, such as certain vasculitides, ulcerative colitis is the primary association recognized in clinical practice, making it a key indicator when interpreting test results.