Ulcterative colitis associated features include all except:
**Core Concept**
Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) characterized by chronic inflammation and ulceration of the colonic mucosa. It is associated with various extraintestinal manifestations due to the systemic nature of the disease.
**Why the Correct Answer is Right**
Ulcerative colitis is known to be associated with various extraintestinal manifestations, including arthritis, skin manifestations (such as erythema nodosum and pyoderma gangrenosum), eye problems (like conjunctivitis and uveitis), and liver disease (primary sclerosing cholangitis). These manifestations occur due to the immune system's dysregulation and the release of inflammatory cytokines.
**Why Each Wrong Option is Incorrect**
* **Option A:** Ankylosing spondylitis is actually more commonly associated with Crohn's disease than ulcerative colitis. While both IBDs can be associated with spondyloarthropathies, ankylosing spondylitis is a hallmark of Crohn's disease.
* **Option B:** Primary sclerosing cholangitis (PSC) is indeed associated with ulcerative colitis, particularly in patients with long-standing disease. PSC is a chronic liver disease characterized by inflammation and fibrosis of the bile ducts.
* **Option C:** Osteoporosis is a common complication of long-standing inflammatory bowel disease, including both Crohn's disease and ulcerative colitis. It occurs due to malabsorption of calcium and vitamin D, as well as the systemic effects of inflammation.
**Clinical Pearl / High-Yield Fact**
Remember that the extraintestinal manifestations of IBD can be a clue to the underlying disease, with ankylosing spondylitis more commonly associated with Crohn's disease and primary sclerosing cholangitis with ulcerative colitis.
**Correct Answer: A. Ankylosing spondylitis.**