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gi pathology > Alimentary Tract Pathology > Flashcards

Alimentary Tract Pathology Flashcards

1
Q

What types of cells are present in the mucosa of the small bowel?

A

Goblet cells
Columnar absorptive cells
Endocrine cells

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2
Q

The myenteric plexus is formed of what?

A

Meissener’s plexus

Auerbach’s plexus

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3
Q

Where is Meissener’s plexus located?

A

Base of the submucosa

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4
Q

Where is Auerbach’s plexus located?

A

Between inner (circular) and outer (longitudinal) layers of muscularis propria

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5
Q

What is the definition of idiopathic inflammatory bowel disease?

A

Chronic inflammatory conditions from inappropriate and persistent activation of mucosal immune system in presence of NORMAL intraluminal flora

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6
Q

Which diseases make up the largest portion of Idiopathic bowel disease?

A

Crohn’s disease

Ulcerative Colitis

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7
Q

Where is Crohns disease spread limited to?

A

Any part of GIT

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8
Q

Where is Ulcerative colitis disease spread limited to?

A

Limited to colon

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9
Q

What is the cause of idiopathic inflammatory bowel disease?

A

Exaggerated immune response vs gut flora
Genetics
?Defects in the mucosal barrier

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10
Q

What gene mutation is associated with Crohns disease?

A

NOD2

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11
Q

What gene mutation is associated with Ulerative Colitis?

A

HLA

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12
Q

How is IBD diagnosed?

A

Clinical history
Radiograph examination
?pANCA

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13
Q

A positive pANCA test is more likely in which IBD patients?

A

Ulcerative Colitis

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14
Q

Ulcerative colitis is most common in which age groups?

A

20-30yrs, 70-80yrs

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15
Q

Ulcerative colitis can often be localised where?

A

Rectum (proctitis)

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16
Q

Ulcerative colitis more commonly spreads in which way?

A

Proximal

“backwash ileitis”

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17
Q

What is the histological presentation of Ulcerative Colitis?

A

NO GRANULOMAS
Inflamed mucosa, crypts
Crypt absesses, disarray
Mucosal atrophy

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18
Q

Atypical flat epithelium caused by UC can lead to what?

A

Adenomatous change leading to invasive cancer

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19
Q

How does pancolitis effect cancer rates?

A

If greater than 10 years - it increases the likelihood 20-30x

20
Q

What is toxic dilation?

A

Colonic swelling due to gas production in ulcerative colitis

21
Q

What are the complications of Ulcerative Colitis?

A

Haemorrhage
Perforation
Toxic dilation

22
Q

Crohn’s disease is more common in which group

A

Women
20-30 years
White
Jewish

23
Q

How do GIT lesions differ in Crohns disease and ulcerative colitis?

A

Ulcerative colitis - lesions spread out from a point

Crohns disease - lesions skip from point to point

24
Q

How does Crohns disease effect the GIT?

A

Granular serosa
Wrapping mesenteric fat
Thickened, fibrotic mesentery
Lumen narrowing, wall thickened

25
Q

What is the histological presentation of Crohn’s disease?

A 
NON-CASEATING GRANULOMAS
Cryptitis/crypt abscesses
Deep ulceration
'chain of pearl' inflammation
Fibrosis
26
Q

How do granulomas appear in UC vs CD?

A

UC - no granulomas

CD - non-caseating granulomas

27
Q

Long term features of Crohn’s disease

A 
Malabsorption
Strictures
Fistulas, abscesses
Perforation
5x increased cancer risk
28
Q

How does inflammation appear in UC vs CD?

A

UC - Mucosa only

CD - Transmural

29
Q

Ischaemic enteritis is caused by what?

A

Acute occlusion of 1 of the 3 major enteric vessels

30
Q

Which part of the LI is most vulnerable to acute ischaemia?

A

Splenic flexure

31
Q

Histological presentation of acute intestinal ischaemia

A 
Oedema
Interstitial haemorrhage
Sloughing necrosis
Indistinct nuclei
(Initial) absence of inflammation
32
Q

Which part of the GIT is most commonly effected by radiation colitis?

A

Rectum (pelvic radiotherapy)

33
Q

Which cells are targeted by radiation colitis?

A

Actively dividing cells
Blood vessels
Crypt epithelium

34
Q

Symptoms of radiation colitis

A 
(Mimics IBD)
Anorexia
Abdominal cramps
Diarrhoea
Malabsorption
35
Q

What is the cause of appendicitis?

A

Obstruction

36
Q

Large Bowel Neoplasia can be what?

A

Dysplasia (adenoma)

Malignancy

37
Q

What are the main types of adenoma (polyps)?

A

Tubular
Villous
Tubulovillous

38
Q

What is the histological presentation of low grade dysplasia?

A

Increased nuclear no.
Increased nuclear size
Reduced mucin

39
Q

What is the histological presentation of high grade dysplasia?

A

Carcinoma in situ
Crowded, irregular
Not YET invasive

40
Q

The majority of colorectal carcinomas are what?

A

Adenocarcinoma

41
Q

What are the risk factors for colorectal adenocarcinoma?

A

Lifestyle
Family history
IBD (UC & CD)
Genetics (FAP, HNPCC, Peutz-Jeghers)

42
Q

Pancolitis increases the risk of what?

A

Colorectal cancer (20-30x)

43
Q

Why does right sided bowel cancer tend to present late?

A

More water in bolus on right, so it moves round any blockage more easier than on left (descent)
(Less symptomatic)

44
Q

How does right side colorectal adenocarcinoma present?

A 
Polypoid
Anaemia
Vague pain
Weakness
Obstruction
(less severe)
45
Q

How does left side colorectal adenocarcinoma present?

A

Annular
Bleeding
Changed bowel habit
Obstruction

gi pathology (20 decks)

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