GIT/Renal Pathology Flashcards
What is Crohns Disease?
Inflammatory bowel disease characterized by transmural inflammation of the bowel wall, strictures and fistula formation
Which parts of the GIT does Crohns disease affect?
Any part
What develops on the surface of Crohns diseased tissue histologically?
Granuloma formation
What other disease is linked with Crohns disease?
Colorectal cancer
What is a bowel infarction? What are the causes of a bowel infarction?
Irreversible injury to the intestine due to insufficient blood flow. Causes include adhesions causing an bstruction, hernia strangulation, mesentric artery or vein thrombosis/embolism and volvulus.
What are the symptoms associated with a bowel infarction? What occurs if the infarction is left untreated?
Severe abdominal pain, nausea and bloody stools. If the bowel is resected, patient can die from septic shock
What characterises diverticulitis? Where does it occur?
Out-pouching of the layers of bowel wall, commonly occurring in the sigmoid colon.
What are the causes of diverticulitis?
Low fiber diet, chronic constipation can contribute to diverticula formation. Inflammation of diverticula is could diverticulitis.
What are the symptoms of diverticulitis and what complications can occur as a result of this disease?
Can result in left iliac fossa pain (in the case of sigmoid colon)
Complications include intestinal bleeding, fistula formation, bowel perforation and peritoneal infection or bowel obstruction due to strictures.
What are the symptoms and risk factors of colon adenocarcinoma?
Vague symptoms: Blood stools, tiredness, weight loss
Risk factors: Cardiovascular disease, increasing age, family history, alcohol, obesity, western diet
What is shown histologically in colon adenocarcinomas?
Pleomorphism
What problems can result from an adenocarcinoma?
Luminal narrowing- bowel obstruction
Caecal cancers often cause anaemia
What causes acute appendicitis?
Hardened faeces which calcify to form stones obstructing the lumen
What can acute appendicitis lead to?
Obstructed appendix dilates to build up of inflammatory material, comprising its blood supply leading to gangrene and perforation. It can result in peritoneal infection and septic shock.
What are the symptoms and causes of Pancreatitis?
Severe epigastric pain and nausea
Gallstones in bile duct, alcoholism, trauma, autoimmune conditions
What can you observe on the surface of pancreases infected with pancreatitis?
Pale areas of enzymatic fat necrosis and dark patches of haemorrhage
What occurs microscopically in Pancreatitis?
Calcification, widespread cell death, lobular oedema and inflammatory infiltrate around the ducts
What are complications caused by Pancreatitis?
Retroperitoneal bleeding, diabetes, pseudocyst formation, multiple organ failure and shock
What causes Cirrhosis?
Severe alcoholism, viral hepatitis infection, obesity causing steaosis and genetic conditions
What are the complications of cirrhosis?
Bleeding oesophageal varices, splenomegaly, ascites, hepatic encephalopathy, kidney failure, hemorrhoids and development of primary liver cancer
How does cirrhosis affect the size of liver?
Smaller than normal due to functional hepatocytes with non functional areas and regenerative nodules
What is metastases to the liver, and how can it occur?
Secondary liver cancer
can occur through vascular or lymphatic spread
How common is metastases of the liver compared with primary liver tumours? Why?
More common than primary tumours. GIT is drained by portal vein and is a potential route of spread for cancer cells
How large are livers with metastatic disease compared with normal uninfected livers?
Larger than normal due to uninterrupted cell growth
What occurs in adult polycystic kidney disease and how does someone get infected with it?
Involves replacemtn of functional kidney tissue with non functional fluid filled cysts, leading to early renal failure
It is inherited in an autosomal dominant fashion
How large are polycystic kidneys compared with uninfected kidneys?
They are enlarged
What risks are involved with adult polycystic disease?
Increased risk of developing berry aneurysms in the cerebral vasculature
How do renal infarctions appear upon observation? How are they caused?
Pal peripheral based triangular areas caused by segmental renal artery thrombosis, arterial injury or systematic thromboembolism
What occurs in these infarcted areas during the chronic phase
In chronic phase the areas shrink causing capsular contraction and renal cortical fibrosis
What are the symptoms of renal infarction?
Flank pain and haematuria
What happens in benign prostatic hyperplasia?
Enlarged gland compresss and narrows the prostatic segment of the urethra, resulting in chronic bladder outlet obstruction.
This causes bladder wall thickening, trabeculation, bladder diverticulum formation and possibly hydroureter
What are the symptoms of prostatic hyperplasia?
Difficulty urinating
What is uterine leiomyoma?
Benign tumours of smooth muscle extending from uterine layers.
What is the appearance of the tumours in uterine leimyoma/fibroids?
Smooth, well circuscribed appearance and do not invade surrounding tissues. They can be submucosal, mural or subserosal
Some can be pedunculated on a stalk which predisposes to torsion and infarction
What are the symptoms of uterine leiomyoma/fibroids?
They can be asymptomatic
Fibroids can cause patients to have chronic pelvic pain, heavy periods and excessive urination due to pressure on the bladder
They can also be a cause of infertility
