Alimentary tract pathology Flashcards

1
Q

What are the notes of mention for the hiistology of the small bowel?

A

The mucosa has innumerable villi
There are goblet cells, columnar absorbitive cells and endocrine cells
Also crypts have 4 cell types - stem, goblet, paneth, endocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What cell types are found in the crypts within the large bowel?

A

goblet, endocrine and stem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the chronic and acute causes for dysfunction of the GI tract immune system?

A

chronic disease and acute life threatening conditions including ecoli and salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is peristalsis mediated?

A

intinsic - myenteric plexus and extrinsic by the autonomic nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is idiopathic inflammatory bowel disease?

A

Chronic inflammatory conditions resulting from inappropriate and persistent activation of the mucosal immune system driven by the presence of normal intraluminal flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where can crohns disease effect in the GI tract?

A

any part from mouth to anus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where can ulcerative coltits effect in the GI tract?

A

the large bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the genes linked in genetics to crohn’s disease and ulcerative colitis?

A

NOD2

HLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the antibody pANCA role in inflammatory bowel disease?

A

75%+ in ulcerative colitis but only 11% in crohn’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the epidemiology of ulcerative colitis?

A

Male=female, peaks at 20-30 and 70-80 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is proctitis?

A

ulcerative colitis limited to the rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is pancolitis?

A

ulcerative colitis spanning the entire colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is backwash ileitis?

A

ulcerative colitis with inflammation seen in the distal ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does ulcerative colitis spread?

A

rectum –> proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Does crohns or ulcerative colitis have granulomas?

A

crohns - non caseating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Does crohns or ulcerative colitis have skip lesions with a patchy distribution?

17
Q

Explain the epidemiology of crohn’s disease

A

female predominant, effects anywhere from mouth to anus and also have peaks at ages 20-30 and 60-70 with the majority being found in the small intestine

18
Q

What are the long term features of crohn’s disease?

A

increased cancer risk
malabsorption
strictures, fistulas, abscesses and perforation

19
Q

What can acute occlusion of one of the 3 main vessels of the gut lead to?

A

infarction - can lose part of the bowel

20
Q

What are predisposing conditions for ischaemic enteritis?

A

arterial thrombosis eg oral contraceptives, atherosclerosis

arterial embolism and non occlusive ischaemia eg shock and dehydration

21
Q

Where is particular;y vulnerable in acute ischaemia?

A

splenic flexure

22
Q

Explain the difference between arterial and venous appearance in acute ischaemia?

A

arterial is sharp whereas venous is a gradual fade

23
Q

What can ischaemia lead to?

A

necrosis and gangrene accompanied by oedema and indistinct nuclei

24
Q

What can chronic ischaemia lead to?

A

ulceration, fibrosis and stricture

25
What parts of the gut tube histologically are effected in chronic ischaemia by inflammation?
mucosa and submucosa
26
What is radiation colitis?
abdominal irradiation impairing the normal proliferative activity of the small and large bowel epithelium, usually with rectum-pelvic radiotherapy targeting blood vessels and crypts
27
symptoms of radiation colitis?
anorexia, abdominal cramps, diarrhoea and malabsorption
28
What are the 2 knock-on effects of acute inflammation of the appendix?
obstruction | increased intraluminal pressure - ischaemia
29
What is seen both macroscopically and microscopically in appendicitis?
exudate, perforation and abscess | inflammation, necrosis and gangrene
30
What are the 2 grades of large bowel dysplasia and differentiate them
low - increased nuclear size and number with reduced mucin | high - carcinoma in situ, crowded and irregular
31
What are the 3 types of adenoma in large bowel dysplasia?
tubular villous tubulovillous
32
what are the majority of carcinoma in the large bowel cell type?
adenocarcinoma usually of pre-existing polyps
33
What are risk factors for adenocarcinoma of the large bowel?
lifestyle family history genetics eg FAP, HNPCC IBD
34
Symptoms of right and left sided bowel neoplasia?
``` right = anaemia, vague pain, weakness left = blood from rectum, altered bowel habit ```
35
What are the 2 scales used to stage large bowel cancer for prognosis?
TNM | Dukes - A,B,C1,C2