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FHHD > Gastrointestinal Pathology > Flashcards

Gastrointestinal Pathology Flashcards

1
Q

What part of the body is affected by zenker’s diverticulum

A

Oesophagus

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2
Q

What causes zenker’s diverticulum

A
  • Weakness in muscle wall

- Pseudo-diverticulum

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3
Q

What are the symptoms of zenker’s diverticulum

A
  • Halitosis
  • Dysphagia
  • Regurgitation
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4
Q

What part of the body does Achalasia happen in

A

oesophagus

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5
Q

What causes Achalasia

A
  • Failure to relax the lower esophageal spinster (LES)
  • Functional obstruction
  • Failure of peristaltic mechanism preventing opening of cardiac sphincter
  • Reduced number of ganglionic cells in the myenteric plexus
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6
Q

How does achalasia present in young people

A

Dysphagia

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7
Q

What are the different types of oesphagitis

A
  • Infective oesophagitis
  • Drug induced oesophagitis
  • Reflux oesophagitis (GORD - gastro-oesophageal reflux disorder)
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8
Q

What can cause infective oesophagitis

A

Bacteria, virus, fungi, parasites

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9
Q

Drug induced oesophagitis

A

Aspirin, ibuprofen, doxycycline

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10
Q

What are the symptoms of oesophagitis

A
  • Sliding hiatus hernia
  • Delayed gastric emptying
  • Dysphagia
  • Heart burn
  • Regurgitation of stomach contents
  • Stricture of Barretts oesophagus can occur as a result
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11
Q

What is Barrett’s oesophagus

A

Replacement of distal oesophageal squamous epithelium by metaplastic columnar epithelium.

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12
Q

What causes Barrett’s oesophagus

A

Due to long standing GORD with ulceration and inflammation of squamous epithelia

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13
Q

What are the clinical presentations of Barrett’s oesophagus

A
  • Band of red, velvety mucosa at GEJ
  • Microscopically; intestinal-type epi
  • Metaplasia can progress to dysplasia
  • Increased risk of adenocarcinoma
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14
Q

Where in the oesophagus do adenocarcinomas form and what is associated with it

A

lower 1/3 and associated with GORD and Barrett’s

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15
Q

Where in the oesophagus do squamous carcinomas form and what is associated with it

A

upper 2/3 of oesophagus and associated with smoking and alcohol

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16
Q

What part of the body does gastritis occur in

A

the stomach

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17
Q

What is gastritis

A

Inflammation/irritation of the stomach linings

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18
Q

What can cause Gastritis

A

NSAIDs - blocks prostaglandin synthesis
Stress - decreased blood flow to the mucosa, severe burns, trauma and ITU
- Zollinger-ellison syndrome
- H-pylori associated chronic gastritis

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19
Q

Where does peptic ulcer disease most commonly occur

A

in the duodenum

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20
Q

What is a peptic ulcer

A

This is a breach of the mucosa extending through the muscularis mucosa into deeper layers

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21
Q

What is peptic ulcer disease associated with

A

H-Pylori infection

22
Q

What are the 2 types of gastric cancer

A

Intestinal and Diffuse carcinomas

23
Q

Where do intestinal carcinomas form

A
  • Gland forming columnar epithelium

- Polypoid growth

24
Q

What are diffuse carcinomas also known as and why are they called diffuse carcinomas

A

Single signet cell ring

Called diffuse carcinomas as their growth diffuses through the intestine

25
Q

What are krunkenburg tumours

A

These are tumours that start in the stomach and develop into ovarian cancers as well

26
Q

What is Celiac disease caused by

A

T cell mediated inflammatory disorder that causes sensitivity to the gliadin protein component of gluten (diffuse enteritis)

27
Q

Describe the histology of celiac disease

A

Damage to the surface epithelium, reverts to normal with gluten withdrawal

28
Q

How is nutrients absorption affected by celiac disease

A

it is impaired

29
Q

What can appendicitis caused by

A

Obstruction of the appendices lumen by a fecalith, calculus, tumour or worms.

This increases intraluminal pressure, oedema and exudate due to bacterial invasion leads to schema

30
Q

What is a mucocoele and a pseudomyxoma peritonea

A

tumours of the appendix that are either benign or slow growing

31
Q

Where does diverticular disease often form

A

Distal colon

32
Q

What is the main symptom of diverticular disease

A

Chronic constipation - increased intraluminal pressure

33
Q

What is diverticular disease associated with

A

low fibre diets - slow transit of food through colon

34
Q

Describe the histology of diverticular disease

A

Outpouchings of the colon

35
Q

What is peritonitis

A

Infection of the inner lining of the stomach/ perforation of the stomach

36
Q

Describe the features of ulcerative colitis

A 
Lesions continuous - mucosal
Rectum always involved
Malignant change
Often intensely vascular
Terminal ileum involved in <10%
Ulcerated mucosa
37
Q

Describe the features of Crohn’s disease

A 
Skip lesions - transmural 
Rectum normal in 50%
Terminal ileum involved in 30%
Discretely ulcerated mucosa
Malignant change less common
38
Q

Name some of the extra-intestinal manifestations in IBD

A

Eye Disorders - Conjunctivitis and Uveitis

Joint - Polyarthropathies

Liver - Sclerosing cholangitis and cholangiocarcinoma

Erythema nodosum and pyoderma gangernosum

39
Q

Why are dentist likely to see signs of crohn’s

A

Around 60% of patients with crohn’s present with oral manifestations and this may also be the first sign of the disease

40
Q

What are polyps

A

Tumourous masses that protrude into gut lumen

41
Q

What does neoplastic mean

A

this means that this structure is something that can become cancerous

42
Q

What types of non-neoplastic polyps are there

A

Hyperplastic
Juvenile
Peutz-Jeghers

43
Q

Describe juvenile polyps

A

Usually focal and sporadic
1-3cm rounded
Pedunculated with mystically dilated glands
Found in the rectum

44
Q

Describe Peutz-Jeghers polyps

A

Large

Pedunculated and lobulated with barbarising smooth muscle around the glands

45
Q

What are the different types of neoplastic polyp and describe them

A

Tubular - small and pedunculated

Villous - large and remain sessile

Tubulovillous

46
Q

Where are colorectal cancers most commonly found

A
  • Caecum and ascending colon

- Recto-sigmoid colon

47
Q

What is the clinical presentations of a right colon cancer

A

iron deficiency and weight loss - late symptoms

48
Q

What are the clinical presentations of a left colon cancer

A

dark red blood in stool, increased freq of bowel, abdominal pain

49
Q

What are the clinical presentations of a cancer in the rectum

A

deep red blood in stool, tenesmus

50
Q

Mutations in which genes form colorectal cancers

A

First mutation happens in the APC gene (tumour suppressor), triggering the formation of non-malignant adenomas called polyps.

This APC mutation is followed by mutations in KRAS, TP53 and finally DCC genes

51
Q

What different stages of histology happens in the formation of a colorectal carcinoma

A

Nomral colon
Hyperproliferative epithelium
Adenoma
Carcinoma

FHHD (21 decks)

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