A 20-year-old woman has visited her family physician due to occasional bouts of bloody diarrhea over the past several weeks, a phenomenon that she experienced 2 years prior as well
Her physician has diagnosed her with ulcerative colitis based on her history and visualization of the affected region by colonoscopy and sigmoidoscopy. Which of the following pathophysiological phenomena is most likely to underlie the client's health problem?
A)
Fissures and crevices developing in the mucosa that are seen as a characteristic "cobblestone" appearance
B)
Erosion of the endothelial lining of the distal small intestine by a combination of genetic, autoimmune, and environmental factors
C)
Compromise of the mucosal layer of the large intestinal surface by the effects of H. pylori
D)
Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated
Ans:
D
Feedback:
The etiology and course of ulcerative colitis involves mucosal hemorrhages developing into crypt abscesses, with consequent necrosis and ulceration. "Cobblestone" appearance of intestinal mucosa is associated with Crohn disease. Ulcerative colitis is confined to the colon and rectum, and H. pylori is not commonly implicated in the etiology.
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