Diseases of the Lower GI: Pathology

Question 1

What is the specific molecule in gluten that is involved in celiac?

Answer 1

Gliadin (a glycoprotein extract from gluten)

Question 2

Loss of the villar surface is a result of ____________.

Answer 2

T-cell infiltration

Question 3

There are two clinical presentations of celiac disease: ______________.

Answer 3

• classical: bulky diarrhea, flatulence, weight loss, anemia, growth failure in children
• atypical: infertility, arthritis, GI upset, dental enamel defects

Question 4

The three findings that pathologists look for in diagnosing celiac are _______________.

Answer 4

(1) villous blunting, (2) increased epithelial lymphocytes, and (3) lymphoplasmacytosis of the lamina propria

Question 5

True or false: those with severe symptoms almost always have intense villous blunting.

Answer 5

False. Histologic severity doesn’t always correlate with symptom severity.

Question 6

What is the big buzzword that pathologists use for describing celiac intestine?

Answer 6

“Scalloping”

Question 7

What lymphoma are those with celiac at risk for?

Answer 7

EAT Lymphoma

Enteropathy-associated T-cell lymphoma

Question 8

The Gram-positive bacilli in _______________ get absorbed by intestinal macrophages. Why is this a bigger problem?

Answer 8

Whipple disease; because these organism-laden macrophages block lymphatic drainage

Question 9

The villi in those with Whipple disease will be ____________.

Answer 9

distended with macrophages

Question 10

The incubation period for giardia is ___________.

Answer 10

7-14 days

Question 11

Giardia most often colonizes the ____________.

Answer 11

duodenum

Question 12

What bacteria is often the cause of enterocolitis from raw milk?

Answer 12

Campylobacter

Question 13

True or false: all E. coli causes bloody diarrhea.

Answer 13

False.

Question 14

Pseudomembranous colitis is often referred to as ______________, but not all PC is caused by that organism.

Answer 14

Clostridium difficile colitis

Question 15

The most common antibiotic causes of pseudomembranous colitis are ___________.

Answer 15

3rd-generation cephalosporins and clindamycin

Question 16

The most common viral cause of childhood diarrhea is __________. What is mechanism?

Answer 16

rotavirus; the virus enters and destroys mature enterocytes leading to loss of absorptive function

Question 17

Which organism is the most common cause of amoebic dysentery?

Answer 17

Entamoeba histolytica

Question 18

What are “watershed areas”?

Answer 18

Areas where one blood supply ends and another begins –vulnerable to ischemic injury

Question 19

True or false: those with microscopic colitis usually have weight loss.

Answer 19

False.

Question 20

In what bowel disorder does intestinal epithelium slough off?

Answer 20

Collagenous microscopic colitis; the thickened collagen layer is brittle and forms a poor base for the epithelial tissue.

Question 21

Helper-T 1 is common in ________, while helper-T 2 is more common in ____________.

Answer 21

CD; UC

Question 22

____________ presents with superficial ulcers that are bigger.

Answer 22

Ulcerative colitis

Question 23

UC is associated with what liver pathology?

Answer 23

Primary sclerosing cholangitis

Question 24

The 25-year risk of adenocarcinoma in those with IBD is ________.

Answer 24

10%

Question 25

Abnormally shaped crypts (i.e., not round) are characteristic of __________.

Answer 25

chronic IBD (I think Crohn’s)

Question 26

The “bear-claw” microscopic sign is a feature of ___________.

Answer 26

Crohn’s

Question 27

What kind of bacteria is the bacteria that produces typhoid?

Answer 27

Gram-negative rod (Salmonella typhimurium)

Question 28

_______________ produces “flask-shaped” ulcers in the intestinal mucosa.

Answer 28

Amoebic dysentery

Question 29

What is Ascaris lumbricoides?

Answer 29

A roundworm that infects the colon

Question 30

What evidence suggests that bacteria play a role in IBD?

Answer 30

Antibiotics can ameliorate the symptoms in some with IBD

Question 31

Crypt distortion is a feature of ______________.

Answer 31

active colitis

Question 32

The distinction between diverticula and true diverticula is ________________.

Answer 32

that true diverticula have muscularis mucosa