Systemic paediatrics: ulcerative colitis extraintestinal disease: 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: ulcerative colitis extraintestinal disease

Sample item

A 12-year-old has bloody diarrhoea, urgency and tenesmus. Colonoscopy shows continuous friable inflammation from the rectum up to the splenic flexure, and serum p-ANCA is positive. Which extraintestinal complication is characteristically more frequent in this disease than in Crohn disease?

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

The answer and the reasoning

D. Primary sclerosing cholangitis

Ulcerative colitis is a continuous colonic disease starting at the rectum, often with p-ANCA. Primary sclerosing cholangitis is the characteristic hepatobiliary association. Oxalate stones, gallstones and B12 deficiency belong to ileal Crohn disease.

Option by option

  • A. Vitamin B12 deficiency from ileal disease

    B12 deficiency follows terminal ileal disease or resection, which is typical of Crohn disease.

  • B. Calcium oxalate renal stones

    Oxalate stones follow fat malabsorption from small bowel Crohn disease.

  • C. Pigment gallstones

    Pigment gallstones follow ileal disease and bile salt loss, again typical of Crohn disease.

  • D. Primary sclerosing cholangitis (correct)

    Correct. Primary sclerosing cholangitis is characteristically associated with ulcerative colitis.

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, Primary sclerosing cholangitis. Ulcerative colitis is a continuous colonic disease starting at the rectum, often with p-ANCA.

Why is "Vitamin B12 deficiency from ileal disease" not the answer?

B12 deficiency follows terminal ileal disease or resection, which is typical of Crohn disease.

Why is "Calcium oxalate renal stones" not the answer?

Oxalate stones follow fat malabsorption from small bowel Crohn disease.

Why is "Pigment gallstones" not the answer?

Pigment gallstones follow ileal disease and bile salt loss, again typical of Crohn disease.

What concept does this question test?

It tests Systemic paediatrics: ulcerative colitis extraintestinal disease in Pediatrics. Primary sclerosing cholangitis is the characteristic hepatobiliary association. Oxalate stones, gallstones and B12 deficiency belong to ileal Crohn disease.

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 Systemic paediatrics: ulcerative colitis extraintestinal disease?

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.