PANCE Gastrointestinal (GI) And Nutrition Practice Test

Which finding is most characteristic of Crohn's disease on colonoscopy?

Cobblestone appearance with skip lesions Isolated mucosa limited to left colon Continuous mucosal inflammation from rectum Involves the small intestine exclusively

Correct Answer:

Cobblestone appearance with skip lesions

Explanation:

Crohn disease on colonoscopy is best recognized by a patchy, transmural inflammatory pattern that creates a cobblestone mucosa with skip lesions—areas of diseased mucosa separated by normal-appearing segments. This segmental involvement reflects full-thickness inflammation, leading to deep ulcers and fissures that sculpt the mucosal surface into a characteristic cobbled look. In contrast, ulcerative colitis shows continuous mucosal inflammation starting at the rectum, and statements about isolated left-colon disease or exclusive small-bowel involvement don’t capture the typical colonoscopic pattern of Crohn’s.

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