A 28-year-old woman presents with bloody diarrhea, crampy abdominal pain, and tenesmus for 4 months. Colonoscopy shows continuous mucosal inflammation beginning at the rectum extending to the splenic flexure with loss of haustral folds and pseudopolyps. Biopsy shows crypt architectural distortion and crypt abscesses. This is most consistent with:

• A Ulcerative colitis ✓
• B Crohn disease
• C Ischemic colitis
• D Infectious colitis

Explanation

Ulcerative colitis is characterized by continuous mucosal and submucosal inflammation beginning in the rectum and extending proximally. Key histological features include crypt architectural distortion (branching, shortening), crypt abscesses (neutrophils within crypts), and Paneth cell metaplasia in the left colon. Crohn disease, by contrast, shows transmural skip lesions with granulomas, fissuring ulcers, and can affect any part of the GI tract from mouth to anus.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.