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Cell Path II > Gastrointestinal Pathology > Flashcards

Gastrointestinal Pathology Flashcards

1
Q

what are the mucosal forms in the GIT

A

protective stratified squamous
secretory tubular
absorptive villi
absorptive and protective straight tubular glands

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2
Q

what are the congenital disorders of the mouth

A

cleft lip/palate

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3
Q

what are the inflammatory diseases of the mouth

A

ulcers

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4
Q

what are common infections of the mouth

A

herpes, candida albicans

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5
Q

what is a common tumour of the mouth

A

squamous cell carcinoma

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6
Q

what are the causes of squamous cell carcinoma of the mouth

A

alcohol, tobacco, HPV

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7
Q

What are the diseases of the pharynx

A

pharyngitis, tonsilitis, tumors; nasopharyngeal far east

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8
Q

diseases of the salivary glands

A

obstruction, inflammation, mumps, tumors

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9
Q

normal structure of the oesophagus

A

stratified squamous epithelium, sphincters prevent gastric reflux

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10
Q

what are the diseases of the oesophagus

A

congenital abnormalities, varices, esophagitis, tumors

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11
Q

what are the oesphagus structural disorders

A

achalasia (failure to relax), hiatus hernia (part stomach), diverticula (hollow pouch), laceration

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12
Q

what is achalasia

A

failure to relax

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13
Q

what are the causes of oesophagitis

A

reflux disease, physical, chemical, biological agents

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14
Q

what is GERD

A

reflux of gastric contents into the tubular oesophagus

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15
Q

what are the causes of GERD

A

defect in lower oesophageal sphincter, hiatus hernia, increased intra abdominal pressure, alcohol, medications

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16
Q

effects of reflux oesophagitis

A

cell injury, cell loss at lumen, increased basal proloferation, elongation of connective tissue papillae

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17
Q

what are the complications of reflux oesophagitis

A

bleeding, ulceration, fibrosis (stricture), barretts metaplasa

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18
Q

how is barretts metaplasia diagnosed

A

endoscopic evidence of columnar lining above GE junction
histologic evidence of intestinal metaplasia

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19
Q

what are benign oesphageal tumours

A

leoimyoma, squamous papilloma

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20
Q

what are the malignant tumours of the oesophagus

A

squamous cell carcinoma, adenocarcinoma

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21
Q

causes of adenocarcinoma

A

majority of barretts metaplasia

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22
Q

causes of squamous cell carcinoma

A

tobacco, alcohol, nitrosamines, repeated thermal injuries

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23
Q

disorders of the stomach

A

congenital (pyloric stenosis) , gastritis, ulceration, neoplasia

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24
Q

what is pyloric stenosis

A

hypertrophy of circular muscle at pylorus, obstructing outflow resulting in projectile vomiting

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25
Q

consequences of acute gastritis

A

decreased mucus -> decreased protective barrier
Acute gastric ulceration, vasodilation, neutrophils, haemorrhage

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26
Q

consequences of chronic gastritis

A

mucosal atrophy and intestinal metaplasia usually in the absence of erosions, may become dysplastic

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27
Q

causes of chronic gastritis

A

autoimmune chemicals, helicobacter pylori infection

28
Q

what is autoimmune chronic gastritis

A

Antibodies to parietal cells and intrinsic factor (IF)
* Loss of parietal cells (glandular atrophy) -> loss HCl secretion ->
stimulate gastrin release -> hypergastrinaemia
* Lack IF -> Vit B12 deficiency, anaemia (macrocytic, pernicious)

29
Q

diagnosis for Helicobacter pylori gastritis

A

urea breath test, serology for antibodies, stool antigen test, gastric biopsy,

30
Q

what is Peptic Ulcer Disease (PUD)

A

chronic mucosal ulceration affecting the duodenum or stomach, Nearly all are associated with H. pylori infection; also NSAIDS, smoking

31
Q

complications of PUD

A

– scarring -> strictures / obstruction, 2% patients
– breach of vessel = haemorrhage, 15-20% patients; 25% ulcer deaths
– perforation; 5% patients; 60% ulcer deaths
– malignant transformation occurs rarely

32
Q

what are gastric polyps

A

any mass or nodule that projects above the
level of the surrounding mucosa

33
Q

what are Hyperplastic / Inflammatory polyps

A

reactive lesions associated with chronic gastritis

34
Q

what are the primary gastric tumours

A

gastric adenocarcinoma, primary gastric lymphoma, GI stromal tumours (GIST)

35
Q

causes of Gastric Adenocarcinoma

A

Diet: high salt, smoked foods,
H. pylori , chronic gastritis, genetics (CDH1 gene)

36
Q

what are the types of gastric adenocarcinoma

A
  1. intestinal type
    - Gland formations
    – Mucus secreting cells
    – Moderately differentiated
  2. diffuse type
    – Poorly differentiated
    – Little or no gland formation
    – Signet ring cells
37
Q

disorders of the small and large intestines

A
  • Malabsorption
    – Coeliac disease
  • Inflammatory disorders
    – Crohn’s disease
    – Ulcerative colitis
  • Vascular disorders
  • Diverticular Disease
  • Polyps and Tumours
38
Q

congenital disorders of the intestine

A

Diverticula, meconium ileus, hirschsprung disease

39
Q

what are diverticulum

A

abnormal hollow pouch communicating with the lumen of the structure from which it has arisen.– small sac-like structure in the wall of the intestines
– -> inflammation, ulceration, perforation, bacterial overgrowth

40
Q

what are meckel diverticulum

A

tubular diverticulum in ileum
– Rule of 2s

41
Q

what is meconium ileus

A

small intestine obstruction, viscous meconium, cystic fibrosis

42
Q

what is hirschsprung disease

A

ganglionosis in muscle wall and submucosa-> lack of coordinated peristalsis: constipation, repeat obstruction

43
Q

causes of malabsorption in the intestine

A

– Pancreatic disorders eg cystic fibrosis (CF)
– Biochemical disorders eg lactose intolerance
– Surgical resection
– Infection
– Tropical Sprue: tropics, bacterial?
– Coeliac disease

44
Q

what is coeliac disease

A
  • Immune mediated enteropathy
  • Sensitivity to gliadin portion of gluten
    – Wheat, rye, barley
  • Mechanisms of toxicity unknown
    – Tissue injury as a result of immune response
    – T-cell mediated chronic inflammatory reaction
45
Q

morphology of coeliac disease

A

Villus atrophy and crypt hyperplasia on deudenal or jeujenal biopsy +/- intraepithelial lymphocytes

46
Q

Crohn’s disease presentation

A

Intermittent attacks of mild diarrhoea, abdominal pain* 20% acute: right lower quadrant (RLQ) pain, bloody diarrhoea

47
Q

crohns disease gross morphology

A
  • Strictures
  • Cobblestone appearance
  • Fissures-> perforation
  • Thickened wall
  • Inflammation, fibrosis
  • Luminal narrowing
48
Q

microscopic features of crohns disease

A

crypt abscess
ulceration
noncaseating granuloma
transmural inflammation
thickening of wall

49
Q

what is ulcerative colitis

A

chronic relapsing inflammatory disorder
attacks of bloody and stringy mucous diarrhoea and cramps

50
Q

how long does ulcerative colitis last

A

days/weeks/months

51
Q

genetic disposition of ulcerative colitis

A

HLA DR2

52
Q

microscopic features of ulcerative colitis

A

diffuse superficial inflammation, crypt abscess, absence of granulomas

53
Q

what are the differences between crohns disease and ulcerative colitis?

A

chrons: skip lesion, transmural inflammation, ganulomas, fissures and fistulae, slightly raised cancer risk
UC: rare skip lesion, mucosal inflammation, no granulomas, rare fissures, significantly raised cancer risk

54
Q

complications of crohns disease

A

malabsorption, fistula, anal lesions, perforation, haemorrhage, increased risk of adenocarcinoma

55
Q

complications of ulcerative colitis

A

blood loss, electrolyte disturbance, toxic dilation, colorectal cancer, liver, skin, eye, join involvement

56
Q

what are some vascular disorders of the bowel

A

occlusive ischaemia and non occlusive ischaemia

57
Q

causes of non occlusive ischaemia of the bowel

A

hypotension, vasoconstriction, shock, dehydration

58
Q

what are diverticula

A

herniations of mucosa into the intestinal wall

59
Q

complications of diverticular disease

A

perforation, haemorrhage, fistulae

60
Q

what are the tumours of the colon and rectum

A

polyps, familial adenomatous polyposis, hereditary non polyposis colon cancer - lynch syndrome

61
Q

what is a polyp

A

mass or nodule that projects above the surrounding mucosa

62
Q

types of non neoplastic polyps

A

inflammatory (common in IBD)
hyperplastic (age)

63
Q

types of neoplastic polyps

A

tubular, villous, tubulovillous

64
Q

familial adenomatous polyposis is causes by mutations in what gene?

A

APC gene

65
Q

untreated familial adenomatous polyposis results in…

A

colorectal adenocarcinoma 100%

Cell Path II (7 decks)

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