HRP - Gastro Flashcards
Barium enema in a Crohn’s patient, what does it show?
Deep ulceration of colon
If there is a tumour/polyp in the caecum there will be obstructive symptoms, true or false?
Not necessarily true. NB may be anaemia if there is bleeding.
‘Apple core’ stricture is typical of what?
Colonic carcinoma
What is ‘thumbprinting’?
Thumbprinting is a radiographic sign of large bowel wall thickening, usually caused by oedema, related to an infective or inflammatory process (colitis). The normal haustra become thickened at regular intervals appearing like thumbprints projecting into the aerated lumen.
What makes up the mucosa?
Epithelium, lamina propria and muscularis mucosae
What are the layers of the gut?
Mucosa, submucosa, muscularis externa, serosa/adventitia
What’s the difference between serosa and adventitia?
Both connective tissue ‘coatings’ but serosa found in peritoneal cavity, adventitia found outside peritoneal cavity
Are there villi in the colon?
No
What are there lots of in the colon?
Glands and goblet cells
What epithelium lines the colon?
Simple columnar epithelium?
What are the two major cell types in the colon?
Enterocytes (absorptive cells) and goblet cells
What happens to the number of goblet cells as you move distally through the colon?
Goblet cells increase in number as move distally through colon
How does the histology of the colon differ from the oesophagus?
Oesophagus has stratified squamous epithelium
How does the histology of the colon differ from the stomach?
No goblet cells in stomach
How does the histology of the colon differ from the small intestine?
Villi in small intestine
How does the histology of the colon differ from the anal canal?
Distal third of anal canal is keratinised stratified squamous epithelium
How does the histology of the colon differ from the appendix?
Appendix has glandular epithelium and lymphoid tissue
Which parts of GIT have serosa and which have adventitia?
Above diaphragm - adventitia; below diaphragm - serosa.
Anastomosis between portal system and drainage of abdominal wall is between which veins? what is the clinical sign called?
Portocaval anastomosis between paraumbilical veins and superior and inferior epigastric veins. Caput medusae
What does colonic adenoma look like histologically?
Lots of crypts, increased number of cells, size of nuclei and mitotic activity. still forms glandular stuctures, low grade dysplasia (so looks reasonably normal)
What does pseudomembranous colitis look like histologically and what can cause it?
Errupting volcano appearance, lots of neutrophils, dead tissue, pus - forms a ‘pseudomembrane’
Antibiotic use - kills ‘good’ gut flora, leaves c.diff, c.diff takes over and damages epithelium
What cells attack the epithelium in collagenous colitis?
Lymphocytes (not neutrophils)
Are non-caseating granulomas present in Crohns and UC?
Just in Crohns, not in UC
What criteria is used to stage the invasion of the cancer and to determine the prognosis and treatment?
Duke’s Staging
