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GI -S > Alimentary Tract Pathology > Flashcards

Alimentary Tract Pathology Flashcards

1
Q

What are the three cell types in the small intestine?

A

Goblet Cells
Columnar absorptive cells
Endocrine cells

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2
Q

Where is Meissener’s Plexus and Auerbach Plexus

A

Meissener’s Plexus = base of the sub mucosa

Auerbach Plexus = between the inner circular and the outer longitudinal layers of the muscularis propria

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3
Q

What gene mutation is associated with CD?

A

NOD2

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4
Q

What gene mutation is associated with UC?

A

HLA

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5
Q

Whats the basic suspected cause of IBD?

A

Strong immune response against normal flora with defects in the epithelial barrier function in genetically susceptible individuals.

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6
Q

What antibody can you use in diagnosis of IBD?

What is its limitations?

A

perinuclear AntiNeutrophilic Cytoplasmic Antibody (pANCA)

Positive in 75% of UC patients
BUT only 11% of CD patients

NOT diagnostic

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7
Q

Can the appendix be involved in Ulcerative Colitis?

A

Yes

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8
Q

What is the definitive histological difference between UC and CD

A 
UC = No granulomas
CD = granulomas
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9
Q

What are strictures in UC compared to Crohn’s?

A 
CD = Variable
UC = late/rare
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10
Q

How do pseudopolyps and ulcers in CD and UC compare?

A

Pseudopolyps are marked in both UC and CD

Ulcers in CD are deep and linear
Ulcers in UC are superficial

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11
Q

How does the fibrosis in CD compare to UC?

A

Moderate in CD

Mild in UC

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12
Q

Concerning ischaemic enteritis, how do acute and gradual occlusion compare?

A

Acute of 1 of the 3 major supply vessels leads to infarction.
Gradual occlusion can have little effect- anastomotic circulation

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13
Q

What areas are at risk from acute ischaemia?

A

Splenic flexure and sigmoid

Watershed areas

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14
Q

What is the histology of acute ischaemia?

A

Oedema
Interstitial haemorrhage
Sloughing necrosis of mucosa (ghost outlines)
Nuclei indistinct
Initial absence of inflammation
1-4 days = bacteria -> gangrene and perforation
Vascular dilatation

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15
Q

What are the features of Chronic ischaemia?

A 
Mucosal inflammation
Ulceration
Submucosal inflammation
Fibrosis
Stricture
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16
Q

Explain radiation colitis

A

Abdominal irradiation can impair the normal proliferative activity of the small and large bowel epithelium
Usually rectum-pelvic radiotherapy
Damage depends on dose
Targets actively dividing cells (esp. blood vessels and crypt epithelium)

17
Q

What are the symptoms of radiation colitis?

A

Anorexia, abdominal cramps, diarrhoea and malabsoption

Chronic disease will mimic IBD

18
Q

What is the histology of radiation colitis?

A 
Bizarre cellular changes
Inflammation = crypt abscesses and eosinophils
Later = Arterial stenosis
Ulceration
Necrosis
Haemorrhage
Perforation
19
Q

What happens to the appendix as we age?

A

Prominent lymphoid tissue regresses with age

Fibrous obliteration

20
Q

What organisms may obstruct the appendix and what can this cause?

A

Feocolith or Enterobius Vermicularis

Increased intraluminal pressure -> ischaemia

21
Q

What is the macro and microscopic histology of appendicitis?

A

Macroscopically:
Fibrinopurulent exudate, perforation, abscess

Microscopically:
Active suppurative inflammation in the wall and puss in the lumen
Acute gangrenous full thickness necrosis +/- perforation

22
Q

What structures does dysplasia in the colon usually form?

A

Adenoma’s (polyps):

  • Tubular (90% in colon)
  • Villous
  • Tubulovillous

50% are solitary
Prevelence = 30% at post mortem

23
Q

Dysplasia in adenoma’s are divided into two.

What are the histological features of each?

A

Low Grade Dysplasia:

  • Increased nuclear number
  • Increased nuclear size
  • Reduced Mucin

High Grade Dysplasia:

  • Carcinoma in situ
  • Crowded
  • Very irregular
  • Not yet invasive
24
Q

What are the risk factors of colorectal carcinoma?

A

Lifestyle
Family
IBD (UC and CD)
Genetics: FAP, HNPCC, Peutz-Jeghers

25
Q

What are the features of right sided adenocarcinoma of the colon?

A 
Exophytic/polypoid
Anaemia
Vague pain
weakness
Obstuction
26
Q

What are the features of left sided adenocarcinoma of the colon?

A

Annular (napkin ring lesions)
Bleeding (fresh/altered blood PR)
Altered bowel habit
Obstruction

GI -S (29 decks)

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