Gastrointestinal pathology: inflammatory bowel disease: practice question

A Pathology 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.

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Pathology · Gastrointestinal pathology: inflammatory bowel disease

Sample item

A 28-year-old man has bloody diarrhoea. Colonoscopy shows continuous inflammation starting at the rectum, extending proximally, with no skip areas. Biopsy shows crypt abscesses and crypt distortion confined to the mucosa and submucosa without granulomas. What is the diagnosis?

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

The answer and the reasoning

B. Ulcerative colitis

Ulcerative colitis is a continuous mucosal inflammation beginning in the rectum, with crypt abscesses, crypt architectural distortion and no granulomas. Crohn disease is transmural with skip lesions, granulomas, fistulae and strictures, and can involve any part of the gut. Ulcerative colitis raises the risk of colorectal cancer and of primary sclerosing cholangitis.

Option by option

  • A. Crohn disease

    Crohn disease has skip lesions, transmural inflammation and often non-caseating granulomas.

  • B. Ulcerative colitis (correct)

    Correct. Continuous rectal-onset mucosal disease without granulomas is typical.

  • C. Ischaemic colitis

    Ischaemic colitis is segmental, often at watershed areas, in older patients with vascular risk.

  • D. Infectious colitis from Shigella

    Infectious colitis has an acute course and different histology, such as preserved crypt architecture.

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 Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Ulcerative colitis. Ulcerative colitis is a continuous mucosal inflammation beginning in the rectum, with crypt abscesses, crypt architectural distortion and no granulomas.

Why is "Crohn disease" not the answer?

Crohn disease has skip lesions, transmural inflammation and often non-caseating granulomas.

Why is "Ischaemic colitis" not the answer?

Ischaemic colitis is segmental, often at watershed areas, in older patients with vascular risk.

Why is "Infectious colitis from Shigella" not the answer?

Infectious colitis has an acute course and different histology, such as preserved crypt architecture.

What concept does this question test?

It tests Gastrointestinal pathology: inflammatory bowel disease in Pathology. Crohn disease is transmural with skip lesions, granulomas, fistulae and strictures, and can involve any part of the gut. Ulcerative colitis raises the risk of colorectal cancer and of primary sclerosing cholangitis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Gastrointestinal pathology: inflammatory bowel disease?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.