8. Dzs of Lower GI Pathology

Question 1

LO1: GSE pathogenesis

Answer 1

1) cytotoxic and autoAb formation -> increase T cell-> villous atrophy->tissue damage-> loss of mucosal and brush border-> malabsorption, diarrhea

Question 2

LO1: GSE Histo

Answer 2

1) villous blunting
2) lymphoplasmacytosis of lamina propria
3) Increase intraepithelial lymphs

Question 3

GSE associations

Answer 3

1) Class II HLA-DQ2 and DQ8
2) DM1, thyroiditis, Sjogren’s
3) IgA to TTG
4) anti-endomysial Ab
5) Dermatitis herpetiformis
6) EAT Lymphoma

Question 4

LO2: Whipple’s Dx and Clinical

Answer 4

1) Tissue biopsy w presence of bacilli + for PAS stain
Triad
2) Diarrhea
3) wt loss
4) malabsorption

Question 5

Main causes of diarrhea (6)

Answer 5

1) bx enterocolitis
2) Pseudomembranous colitis
3) viral gastroenteritis
4) Parasitic enterocolitis
5) Ischemic colitis
6) Microscopic colitis

Question 6

LO4: Ischemic colitis

Answer 6

Clinical

1) older w/ CV dz
2) Young-marathoners and women on OC
3) Can be caused by hernia or volvulus

Question 7

LO4: Ischemic Colitis Dx (8)

acute transmural infarct

Answer 7

1) severe abd pn
2) tenderness
3) n/v
4) bloody diarrhea
5) no BS
6) rigid abd
7) shock
8) sepsis