Inflammatory Bowel Disease

Explanation: The major symptoms are abdominal pain, diarrhoea and weight loss. Ddiarrhea, which is usually watery and does not contain blood or mucus.

Reference: Davidson 23rd; P-814

Explanation: histological features of Ulcerative colitis are: Inflammation limited to mucosa, crypt distortion, cryptitis, crypt abscesses, loss of goblet cells,

Reference: Davidson 23rd, Box-4.4

Reference: Davidson 23rd; P-777
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-816

Stem Breakdown:

Abdominal pain, bloody diarrhoea, and tenesmus: These are classic symptoms of ulcerative colitis (UC), which is an inflammatory bowel disease affecting the colon.
Continuous inflammation from the rectum to the sigmoid colon: UC is characterised by continuous inflammation starting in the rectum and extending proximally, often limited to the colon.
Option Analysis:

A) Ulcerative colitis: This is the correct diagnosis. Davidson and Harrison describe ulcerative colitis as a chronic inflammatory condition of the colon characterised by continuous inflammation, starting at the rectum and extending proximally. Bloody diarrhoea, abdominal pain, and tenses are hallmark symptoms. UC is often limited to the mucosa and submucosa of the colon, distinguishing it from Crohn's disease.
B) Crohn’s disease: Crohn's disease can affect any part of the gastrointestinal tract and is characterised by "skip lesions" (areas of normal bowel between inflamed segments). It also often involves transmural (full-thickness) inflammation, which can lead to complications like fistulas and strictures. The continuous inflammation seen in this patient is more typical of UC.
C) Irritable bowel syndrome (IBS): IBS causes abdominal pain and altered bowel habits (diarrhoea or constipation), but it does not cause bloody diarrhoea or visible inflammation on colonoscopy. IBS is a functional gastrointestinal disorder, not an inflammatory disease.
D) Diverticulitis: Diverticulitis presents with localised left lower quadrant pain, fever, and leukocytosis, typically without bloody diarrhoea or continuous inflammation on colonoscopy.

Immune-related adverse events should be considered in all patients who present acutely unwell following immunotherapy treatments for cancer. Although the other options are on the differential diagnosis list, severe IRAEs are oncological emergencies, and prompt recognition and management are vital. This is a grade 3 colitis and should be treated with IV methylprednisolone in the first instance. Investigations such as bloods, stool samples, radiological imaging and flexible sigmoidoscopy or colonoscopy are also appropriate.

Explanation: The area most commonly affected is the Ileal or ileocolonic region

Reference: Davidson 23rd Fig. 21.52

Reference: Davidson 23rd; P-813

Reference: Davidson 23rd; P-813
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Explanation: Ulcerative colitis is associated with PSC

Reference: Davidson 23rd; P-818

Reference: Davidson 23rd; P-816

Reference: Davidson 23rd; P-814

Explanation: The cardinal symptoms are rectal bleeding with passage of mucus and bloody diarrhoea.