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Year 2- GIT > Colon Pathology > Flashcards

Colon Pathology Flashcards

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1
Q

What is peristalsis in the small and large intestine mediated by?

A

Intrinsically- myenteric plexus
Extrinsically- autonomic innervation

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2
Q

Which two plexus’s are found within the myenteric plexus?

A

Meissner’s plexus
Auerbach plexus

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3
Q

Where would you find Meissner’s plexus?

A

Base of submucosa

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4
Q

Where would you find Auerbach plexus?

A

Between circular and longitudal muscularis layers

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5
Q

What is idiopathic inflammatory bowel disease?

A

Chronic inflammatory conditions which results in constant inappropriate activation of the mucosal immune system because of normal intraluminal flora.

->wordy but read, it makes sense :)

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6
Q

What are the two main types of idiopathic inflammatory bowel diseases?

A

Crohn’s disease
Ulcerative colitis

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7
Q

Which part of the GIT can Crohn’s affect?

A

Any

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8
Q

Which part of the body can ulcerative colitis affect?

A

Colon

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9
Q

Why may there be strong immune defences against normal flora in the body in individuals with idiopathic inflammatory bowel disease?

A

May be defects in the epithelial barrier function meaning immune cells are exposed to flora which doesn’t usually happen

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10
Q

Genetics can be a cause for both CD’s and UC.
Which gene mutation can cause CD?

A

NOD2 gene mutation

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11
Q

How can IBD be diagnosed?

A

Requires-
-Clinical history
-Radiographic examination
-Pathological correlation

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12
Q

Which autoimmune antibody can be found in patients with IBD?

A

pANCA (perinuclear antineutrophilic cytoplasmic antibody)

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13
Q

What % of Crohn’s patients are pANCA positive?

A

Only 11%

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14
Q

What % of UC patients are pANCA positive?

A

75%

->think Panko breadcrumbs, if they get stuck in your throat make you go UC!
gal idk i’m trying to help

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15
Q

Which age groups tend to be more likely to get UC?

A

Peaks at 20-30yrs AND 70-80yrs

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16
Q

Where can UC be localised to?

A

Rectum

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17
Q

Which other organ may be affected by UC despite in only affecting the colon?

A

Appendix
Inflammation may also spread backwards towards small intestine

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18
Q

Describe the pathology of UC

A

Inflammation affecting rectum to proximal.
Pseudocysts and ulceration

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19
Q

Why are those with UC at a higher risk of cancer?

A

Epithelial layer gets repaired so many times there starts to be defects. This causes dysplasia, meaning cells divide of their own accord and this is a step towards malignancy.

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20
Q

What are some of the complications of UC?

A

Perforation
Haemorrhage
Toxic dilatation

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21
Q

Are males or females more likely to be affected by Crohn’s?

A

Females

-> think of Amy Dowden, only person I am aware of having Crohn’s, she’s a women…sorry, memory aids!

22
Q

At which age would you be most likely to develop Crohn’s?

A

Any age but peaks at 20-30 and 60-70

23
Q

Where do most cases of Crohn’s first present?

A

Small intestine

24
Q

Describe the pathology of Crohn’s.

A

Granular serosa, dull grey colour
Wrapped in mesentery fat, almost in a protective way
Thickened wall
Narrowed lumen
Ulceration causing ‘cobblestone’ appearance

25
Q

Are there granulomas present in UC?

A

No

26
Q

Are there granulomas present in CD?

A

Yes- non-caseating granulomas

27
Q

What can be a complication of CD in the small intestine?

A

Malabsorption

28
Q

What are some complications of CD?

A

Strictures
Fistulas, abscesses
Perforation
Increased risk of cancer

29
Q

Ischaemic enteritis is another type of IBD.
What happens in it?

A

Impinged blood supply to bowel

->think, ischaemia, lack of blood

30
Q

What can happen as a result of ischaemic enteritis?

A

Bowel can die

31
Q

Where can ischaemic enteritis affect?

A

Small intestine, large intestine or both

32
Q

What can cause infarction in ischaemic enteritis?

A

Occlusion to any one of the main three branches supplying the bowel (coeliac trunk, SMA, IMA)

33
Q

List some of the predisposing conditions which can lead to ischaemic enteritis.

A

-Arterial thrombosis (severe atherosclerosis, oral contraceptives, dissecting aneurysms)
-Arterial embolism (cardiac vegetations, acute atheroembolism, cholesterol embolism).
-Non-occlusive ischaemia (cardiac failure, shock, vasoconstrictives drugs like beta blockers)

34
Q

What happens in radiation colitis?

A

Inflammation of intestines after radiotherapy as can impair normal proliferating nature of the cells.

35
Q

Why does radiotherapy affect the cells in the intestines?

A

It targets rapidly dividing cells, which the colon cells are

36
Q

What are the symptoms of radiative colitis?

A

Anorexia
Abdominal cramps
Diarrhoea
Malabsorption

37
Q

What happens to the appendix with age?

A

It regresses (gets smaller)

38
Q

What is acute appendicits?

A

Inflammation of the appendix

39
Q

What is a common cause of acute appendicitis?

A

-Faecal stone blocking and causing inflammation
-Enterobius vermicularis (type of worm)

40
Q

What can happen to the appendix if it is inflammed?

A

May perforate

41
Q

What is dysplasia?

A

Epithelial cells start dividing in an uncontrolled way

42
Q

How does dysplasia usually present in the GIT?

A

In the form of a polyp/adenoma

43
Q

What would be seen histologically in low grade dysplasia?

A

Increased number of nucelli
Increased nucelli size
Reduced mucin

44
Q

What would be seen histologically in high grade dysplasia?

A

Very crowded
Very irregular
->not yet invasive

45
Q

What are some of the risk factors for colorectal adenocarcinoma?

A

Lifestyle
Family history
IBD
Genetics

46
Q

Describe how a right sided colorectal adenocarcinoma would present.

A

Anaemia
Vague pain
Weakness
Obstruction

47
Q

Describe how a left sided colorectal adenocarcinoma would present.

A

Bleeding
Altered bowel habit
Obstruction

48
Q

What would a left sided colorectal adenocarcinoma look like?

A

Would encircle the circumference of the lumen, making it narrower

49
Q

What would a right sided colorectal adenocarcinoma look like?

A

Exophytic lesions, polypoid

50
Q

What type of staging is used for tumours?

A

TNM

Year 2- GIT (37 decks)

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