This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: NEET 2018, Subject name: Surgery
All of the following are true about ulcerative colitis except: 
Select and explain. 
A. Steroid dependent cases needs surgery, B. The highest risk of UC requiring surgery in 1st year, C. 20% end up in colectomy, D. Extra-intestinal problems of UC are managed medically
D: Extra-intestinal problems of UC are managed medically
Answer: D: Extra-intestinal problems of UC are managed medically 
Explanation: Extraintestinal manifestations of ulcerative colitis: Migratory polyahritis Sacroiliitis Ankylosing spondylitis Uveitis Skin lesions Primary Sclerosing Cholangitis (PSC) Peri cholangitis Indication for Sx in UC: 1. Severe refractory fulminating disease 2. Chronic disease with a. Anaemia b. Frequent stools c. Tenesmus (cramping rectal pain) 3. Steroid-dependent disease 4. Remission cannot be maintained 5. Neoplastic change 6. Extra intestinal manifestations - PSC 7. Severe haemorrhage or stenosis causing obstruction rarely Sx of choice: 1. Subtotal colectomy & ileostomy - Emergency (20%) 2. Proctocolectomy and permanent end ileostomy 3. Proctocolectomy with ileoanal pouch. 4. Subtotal colectomy and ileorectal anastomosis