Gastroenterology: intestinal TB versus Crohn disease: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Gastroenterology: intestinal TB versus Crohn disease

Sample item

A patient has ileocaecal thickening and strictures. Which feature favours intestinal tuberculosis over Crohn disease?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Caseating granulomas and transverse ulcers

Intestinal TB shows caseation, confluent large granulomas, transverse ulcers, patulous ileocaecal valve and evidence of TB elsewhere. Crohn disease shows longitudinal ulcers, skip lesions, cobblestoning and fistulae. The distinction matters because steroids can worsen TB, so a therapeutic trial of ATT is often given in endemic regions.

Option by option

  • A. Caseating granulomas and transverse ulcers (correct)

    Correct. Caseation and transverse ulcers suggest TB.

  • B. Non-caseating small granulomas only

    Small non-caseating granulomas favour Crohn disease.

  • C. Longitudinal ulcers with perianal fistulae

    Longitudinal ulcers and perianal fistulae favour Crohn disease.

  • D. Skip lesions and cobblestoning

    Skip lesions and cobblestoning favour Crohn disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Caseating granulomas and transverse ulcers. Intestinal TB shows caseation, confluent large granulomas, transverse ulcers, patulous ileocaecal valve and evidence of TB elsewhere.

Why is "Non-caseating small granulomas only" not the answer?

Small non-caseating granulomas favour Crohn disease.

Why is "Longitudinal ulcers with perianal fistulae" not the answer?

Longitudinal ulcers and perianal fistulae favour Crohn disease.

Why is "Skip lesions and cobblestoning" not the answer?

Skip lesions and cobblestoning favour Crohn disease.

What concept does this question test?

It tests Gastroenterology: intestinal TB versus Crohn disease in General Medicine. Crohn disease shows longitudinal ulcers, skip lesions, cobblestoning and fistulae. The distinction matters because steroids can worsen TB, so a therapeutic trial of ATT is often given in endemic regions.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: intestinal TB versus Crohn disease?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.