Crohn’s Disease: The Daily PANCE Blueprint
A 28-year-old female presents with a 6-month history of abdominal pain, diarrhea, and weight loss. She also reports occasional rectal bleeding and fatigue. On physical examination, there is tenderness in the right lower quadrant of the abdomen. Laboratory tests show anemia and elevated inflammatory markers. Colonoscopy reveals patchy areas of inflammation in the ileum and colon with some areas of normal mucosa in between. Which of the following is most suggestive of Crohn’s disease rather than ulcerative colitis?
A. Continuous colonic involvement
B. Rectal bleeding
C. Transmural inflammation
D. Limited to the mucosa
E. Bloody diarrhea
Answer and topic summary
The answer is C. Transmural inflammation
Transmural inflammation is most suggestive of Crohn’s disease rather than ulcerative colitis. Crohn’s disease can affect any part of the gastrointestinal tract from mouth to anus and is characterized by inflammation that extends through the entire thickness of the bowel wall (transmural). This feature can lead to complications such as fistulas, strictures, and abscesses.
High Yield (Crohn’s Disease vs. Ulcerative Colitis):
Crohn’s Disease:
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- Location: Can affect any part of the gastrointestinal tract from mouth to anus.
- Histology: Transmural inflammation.
- Inflammation: Transmural, leading to complications like strictures and fistulas.
- Symptoms: Abdominal pain, diarrhea (sometimes bloody), weight loss, fatigue.
- Endoscopic Findings: Skip lesions, cobblestone appearance.
Ulcerative Colitis:
-
-
- Location: Limited to the colon and rectum.
- Histology: Inflammation limited to the mucosa.
- Inflammation: Continuous involvement starting from the rectum.
- Symptoms: Bloody diarrhea, abdominal pain, urgency, tenesmus.
- Endoscopic Findings: Continuous inflammation, loss of haustral folds.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
