{"id":1187,"date":"2021-10-06T13:51:00","date_gmt":"2021-10-06T13:51:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=1187"},"modified":"2025-10-01T11:40:30","modified_gmt":"2025-10-01T19:40:30","slug":"usmle-step-1-question-of-the-day-diverticulum-formation","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Diverticulum Formation"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#A_Increased_intraluminal_pressure_at_points_of_vascular_penetration\" >A. Increased intraluminal pressure at points of vascular penetration<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#B_Failure_of_involution_of_the_vitelline_duct\" >B. Failure of involution of the vitelline duct<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#C_Telescoping_of_a_proximal_colon_segment_into_a_distal_segment\" >C. Telescoping of a proximal colon segment into a distal segment<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#D_Erosion_of_adjacent_loops_of_bowel_due_to_full_thickness_granulomatous_inflammation\" >D. Erosion of adjacent loops of bowel due to full thickness granulomatous inflammation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#E_Outpouchings_surrounding_a_vestigial_lymphoid_structure\" >E. Outpouchings surrounding a vestigial lymphoid structure<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 55-year-old man with alternating episodes of loose stools and constipation over the past several months, with associated cramping abdominal pain. Can you figure it out?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 55-year-old man presents to his primary care physician due to changes in his bowel habits. The patient reports he has been experiencing alternating episodes of loose stools and constipation over the past several months, with associated cramping abdominal pain. The patient\u2019s past medical history is significant for&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hypertension\" target=\"_blank\" rel=\"noreferrer noopener\">hypertension<\/a>,&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Hyperlipidemia\" target=\"_blank\" rel=\"noreferrer noopener\">hyperlipidemia<\/a>, and diabetes. His past surgical history is notable for an appendectomy at age 18. His temperature is 37\u00b0C (98.6\u00b0F), pulse is 98\/min, respirations are 18\/min and blood pressure is 137\/94 mmHg. BMI is 36 kg\/m<sup>2<\/sup>. Physical examination shows a distended abdomen without focal tenderness, rebound, or guarding. A fecal occult blood test is positive. The patient undergoes a colonoscopy that demonstrates outpouchings of the colonic mucosa and submucosa in the descending colon. Which of the following best describes the pathophysiology of this disease process?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Increased intraluminal pressure at points of vascular penetration<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Failure of involution of the vitelline duct<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Telescoping of a proximal colon segment into a distal segment<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Erosion of adjacent loops of bowel due to full thickness granulomatous inflammation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Outpouchings surrounding a vestigial lymphoid structure<\/strong>Scroll down to find the answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Everybody loves Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kizbJZ9cdLg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><strong><em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><u><em><strong>\u2192 Reinforce your understanding with more self-assessment items on Osmosis.<\/strong>\u00a0<\/em><\/u><\/a><\/em><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Increased_intraluminal_pressure_at_points_of_vascular_penetration\"><\/span>A. Increased intraluminal pressure at points of vascular penetration<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s USMLE\u00ae Step 1 Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Failure_of_involution_of_the_vitelline_duct\"><\/span>B. Failure of involution of the vitelline duct<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>This answer describes the pathophysiology of a&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Meckel_diverticulum\" target=\"_blank\" rel=\"noreferrer noopener\">Meckel&#8217;s diverticulum<\/a>, which contains all layers of the colonic wall, not just the mucosa and submucosa.<a href=\"https:\/\/www.osmosis.org\/learn\/Meckel_diverticulum\" target=\"_blank\" rel=\"noreferrer noopener\">Meckel\u2019s diverticulum<\/a>&nbsp;is a remnant of the omphalomesenteric (vitelline) duct, and it is the most common congenital malformation of the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Gastrointestinal_system_anatomy_and_physiology\" target=\"_blank\" rel=\"noreferrer noopener\">gastrointestinal tract<\/a>. It usually presents in pediatric patients with painless hematochezia, or it is discovered incidentally during colonoscopy at the terminal ileum.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Telescoping_of_a_proximal_colon_segment_into_a_distal_segment\"><\/span>C. Telescoping of a proximal colon segment into a distal segment<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>This answer describes the pathophysiology of&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Intussusception\" target=\"_blank\" rel=\"noreferrer noopener\">intussusception<\/a>, which occurs when a lead point (such as a Meckel&#8217;s diverticulum, lymphoid tissue, or tumor) causes the proximal end of bowel to peristalse into the more distal end.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Intussusception\" target=\"_blank\" rel=\"noreferrer noopener\">Intussusception&nbsp;<\/a>can present with colicky abdominal pain in both pediatric patients and adults, although it is much more common in the pediatric population.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Intussusception\" target=\"_blank\" rel=\"noreferrer noopener\">Intussusception&nbsp;<\/a>is unlikely in this patient without an identifiable lead point visualized on colonoscopy.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Erosion_of_adjacent_loops_of_bowel_due_to_full_thickness_granulomatous_inflammation\"><\/span>D. Erosion of adjacent loops of bowel due to full thickness granulomatous inflammation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>This answer describes fistula formation due to&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Crohn's_disease\" target=\"_blank\" rel=\"noreferrer noopener\">Crohn&#8217;s disease<\/a>, which results in full thickness inflammation of all layers of the colon or small bowel. While Crohn\u2019s disease can present with hematochezia or a positive fecal occult blood test, it is generally associated with additional constitutional symptoms such as weight loss, arthralgias and fever.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Outpouchings_surrounding_a_vestigial_lymphoid_structure\"><\/span>E. Outpouchings surrounding a vestigial lymphoid structure<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong><a href=\"https:\/\/www.osmosis.org\/learn\/Diverticulosis_and_diverticulitis\" target=\"_blank\" rel=\"noreferrer noopener\">Diverticula<\/a>&nbsp;can form around the appendix resulting in an increased risk of obstruction and subsequent&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Appendicitis\" target=\"_blank\" rel=\"noreferrer noopener\">appendicitis<\/a>; however this patient\u2019s appendix has been removed, and his&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Diverticulosis_and_diverticulitis\" target=\"_blank\" rel=\"noreferrer noopener\">diverticula<\/a>&nbsp;are noted in the more distal colon, away from the site of the appendix.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?w=700\" alt=\"\" class=\"wp-image-760\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The patient in this vignette presents with alternating<strong>&nbsp;constipation, diarrhea,&nbsp;<\/strong>and<strong>&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Biliary_colic\" target=\"_blank\" rel=\"noreferrer noopener\">colicky abdominal pain<\/a><\/strong>&nbsp;with a colonoscopy that reveals<strong>&nbsp;outpouchings&nbsp;<\/strong>of the<strong>&nbsp;mucosa and submucosa<\/strong>. Together, these findings are consistent with a diagnosis of&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Diverticulosis_and_diverticulitis\" target=\"_blank\" rel=\"noreferrer noopener\">diverticulosis<\/a>.<\/strong>&nbsp;Diverticulosis is the presence of multiple&nbsp;<strong>false diverticula<\/strong>, or pseudodiverticula, which occur only when the&nbsp;<strong>mucosa and submucosa<\/strong>&nbsp;outpouch. They are thought to be due to prolonged&nbsp;<strong>increased intraluminal pressure<\/strong>&nbsp;from&nbsp;<strong>diets poor in fiber<\/strong>&nbsp;at the weakest points of the gastrointestinal tract, where the vasa recta<strong>&nbsp;<\/strong>perforate the muscularis externa<strong>.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Diverticulosis_and_diverticulitis\" target=\"_blank\" rel=\"noreferrer noopener\">Diverticula<\/a>&nbsp;<\/strong>may also bleed intermittently, resulting in anemia or a positive fecal occult blood test, or they may become infected, resulting in diverticulitis.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Diverticula, diverticulosis, &amp; diverticulitis - causes, symptoms &amp; pathology\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/TL9_WKuNfu0?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">In contrast to false diverticula, true diverticula, such as a&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Meckel_diverticulum\" target=\"_blank\" rel=\"noreferrer noopener\">Meckel&#8217;s diverticulum<\/a><\/strong>&nbsp;or inherited diverticula of the appendix, contain&nbsp;<strong>all layers&nbsp;<\/strong>of the bowel wall. True diverticula are much less common in comparison to false or pseudodiverticula.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" height=\"558\" width=\"1024\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/diverticula.jpg?w=1024\" alt=\"Illustration of diverticula - small outpouchings along the walls of a hollow structure.\" class=\"wp-image-1190\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/diverticula.jpg 1386w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/diverticula.jpg?resize=300,163 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/diverticula.jpg?resize=768,418 768w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/diverticula.jpg?resize=1024,558 1024w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/www.osmosis.org\/learn\/Diverticulosis_and_diverticulitis\" target=\"_blank\" rel=\"noreferrer noopener\">Diverticulosis<\/a><\/strong>&nbsp;is an example of a&nbsp;<strong>false diverticulum<\/strong>&nbsp;that only contains the mucosa and submucosa. It is thought to be due to prolonged&nbsp;<strong>increased intraluminal pressure<\/strong>&nbsp;at the weakest points of the gastrointestinal tract due to&nbsp;<strong>low dietary fiber intake<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span><strong>References<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Curry, M. (2017, May 18). Rosen&#8217;s Emergency Medicine: Concepts and Clinical Practice. Retrieved from&nbsp;<a href=\"https:\/\/www.us.elsevierhealth.com\/rosens-emergency-medicine-concepts-and-clinical-practice-9780323354790.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.us.elsevierhealth.com\/rosens-emergency-medicine-concepts-and-clinical-practice-9780323354790.html.<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases.&nbsp;<em>Gastroenterology<\/em>. 2009;136(3):741\u2010754.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19166855\/\" target=\"_blank\" rel=\"noreferrer noopener\">doi:10.1053\/j.gastro.2009.01.015<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sagar J, Kumar V, Shah DK. Meckel&#8217;s diverticulum: a systematic review [published correction appears in J R Soc Med. 2007 Feb;100(2):69].&nbsp;<em>J R Soc Med<\/em>. 2006;99(10):501\u2010505. doi:<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17021300\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1258\/jrsm.99.10.501<\/a><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><strong>_________________________<\/strong><br><br><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis today! Access your&nbsp;<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\/md\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/health-medicine-try-it-now.png?w=700\" alt=\"The most powerful platform for learning medicine and the health sciences Try it now button.\" class=\"wp-image-363\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/health-medicine-try-it-now.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/health-medicine-try-it-now.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><em><sub>The United States Medical Licensing Examination (USMLE\u00ae) is a joint program of the Federation of State Medical Boards (FSMB\u00ae) and National Board of Medical Examiners (NBME\u00ae). Osmosis is not affiliated with NBME nor FSMB.&nbsp;<\/sub><\/em><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 55-year-old man with alternating episodes of loose stools and constipation over the past several months, with associated cramping abdominal pain. Can you figure it out? A 55-year-old man presents to his primary care physician [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":1189,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[27,20,1369,44],"tags":[],"class_list":["post-1187","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Diverticulum Formation - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-diverticulum-formation\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Diverticulum Formation - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case involves a 55-year-old man with alternating episodes of loose stools and constipation over the past several months, with associated cramping abdominal pain. Can you figure it out? 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Can you figure it out? A 41-year-old woman comes to the physician complaining of excessive fatigue for the last 2 weeks. 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