Patchy lesions or skip lesions are common features of which of the following?

PGICH Noida NO-2025

Medical & Surgical Nursing

Easy

Appeared in: PGICH Noida NO-2025

Explanation

Crohn's disease is a type of inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract from the mouth to the anus.
A hallmark feature of Crohn's disease is the presence of 'skip lesions,' where diseased segments of the bowel are separated by areas of normal, healthy tissue.
The inflammation in Crohn's disease is transmural, meaning it penetrates the full thickness of the bowel wall, which can lead to a 'cobblestone' appearance and complications like fistulas and strictures.

Option A: Hepatitis A is an acute viral infection that causes inflammation of the liver (hepatitis), not the intestines. Its symptoms include jaundice, fatigue, and nausea, and it does not produce intestinal lesions.
Option B: Ulcerative colitis is another major form of IBD, but it is defined by continuous inflammation that starts in the rectum and extends proximally through the colon. It does not feature skip lesions.
Option C: Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine, specifically atrophy of the villi. This results in malabsorption, not the patchy, transmural inflammation of Crohn's disease.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathognomonic features of Inflammatory Bowel Disease (IBD) as background academic context rather than a clinical decision trigger.
Differentiating between Crohn's disease and Ulcerative Colitis is vital for nurses as it dictates patient education, monitoring, and management of specific complications. For example, Crohn's patients are at higher risk for fistulas and nutritional deficiencies.
Nursing care for Crohn's disease focuses on managing symptoms, providing nutritional support (e.g., high-calorie, low-residue diets during flare-ups), administering medications, and offering psychosocial support for a chronic condition.
What if? If a patient's colonoscopy report described 'continuous inflammation with pseudopolyps extending from the rectum to the splenic flexure,' the diagnosis would be Ulcerative Colitis, not Crohn's disease. The key differentiator is the continuous versus patchy pattern of inflammation.

How to Approach the Question

First, identify the key pathological terms in the question stem: 'Patchy lesions' or 'skip lesions'.
Recognize that these are classic descriptors for a specific pattern of inflammation in the gastrointestinal tract.
Evaluate the options. Two are major inflammatory bowel diseases (IBD): Ulcerative colitis and Crohn's disease. The other two have different primary sites of pathology (liver and small intestine villi).
Recall the fundamental difference between the two main IBDs: Crohn's disease is characterized by segmental, 'skipping' inflammation, whereas Ulcerative colitis involves continuous inflammation.
Based on this core knowledge, directly associate the term 'skip lesions' with Crohn's disease.
Eliminate the other options as their pathologies do not match the description of patchy lesions in the bowel.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 92-94

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 803-805