Systemic paediatrics: Crohn disease histology: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: Crohn disease histology

Sample item

A 13-year-old has 6 months of abdominal pain, diarrhoea, weight loss, growth delay and a perianal fissure. Colonoscopy shows patchy ulcers with normal mucosa between them. Which histological finding is most characteristic?

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

The answer and the reasoning

D. Transmural inflammation with non-caseating granulomas

Crohn disease causes skip lesions of transmural inflammation anywhere from mouth to anus, with non-caseating granulomas in a proportion of cases. Perianal disease, growth failure and strictures or fistulae are common. Ulcerative colitis is continuous and mucosal.

Option by option

  • A. Eosinophilic infiltrate with preserved crypt architecture

    A predominantly eosinophilic infiltrate with preserved crypts suggests eosinophilic gastroenteropathy or allergic colitis.

  • B. Continuous mucosal inflammation with crypt abscesses

    Continuous mucosal inflammation with crypt abscesses is the picture of ulcerative colitis.

  • C. Caseating granulomas with Langhans giant cells

    Caseating granulomas with Langhans giant cells point to intestinal tuberculosis.

  • D. Transmural inflammation with non-caseating granulomas (correct)

    Correct. Transmural inflammation with non-caseating granulomas is typical of 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.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Transmural inflammation with non-caseating granulomas. Crohn disease causes skip lesions of transmural inflammation anywhere from mouth to anus, with non-caseating granulomas in a proportion of cases.

Why is "Eosinophilic infiltrate with preserved crypt architecture" not the answer?

A predominantly eosinophilic infiltrate with preserved crypts suggests eosinophilic gastroenteropathy or allergic colitis.

Why is "Continuous mucosal inflammation with crypt abscesses" not the answer?

Continuous mucosal inflammation with crypt abscesses is the picture of ulcerative colitis.

Why is "Caseating granulomas with Langhans giant cells" not the answer?

Caseating granulomas with Langhans giant cells point to intestinal tuberculosis.

What concept does this question test?

It tests Systemic paediatrics: Crohn disease histology in Pediatrics. Perianal disease, growth failure and strictures or fistulae are common. Ulcerative colitis is continuous and mucosal.

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 Systemic paediatrics: Crohn disease histology?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.