intestinal pathology

Question 1

3 main categories of mechanical findings

Answer 1

1. disordered development/malformations
2. inflammation
3. growth (neoplastic)

Question 2

at the cellular levels, what kinds of changes are usually seen in pathology (6)

Answer 2

1. loss of ATP
2. Mt damage
3. influx of calcium and loss of Ca homeostasis
4. accumulation of oxygen-derived free radicals
5. defects in membrane permeability
6. damage to DNA proteins

Question 3

what is plurisy

Answer 3

lack of lubrication on pleura causing friction as fibre passes through

Question 4

what lines the small and large intestine to provide lubrication

Answer 4

mesothelium lining

Question 5

what is atresia

Answer 5

complete occlusion of the intestinal lumen secondary to intraluminal diaphragm or disconnected blind end (occur in foetuses with polyhydramnios)

Question 6

what are duplications (GI congenital condition)

Answer 6

tubular or cystic structures that may communicate with the intestinal lumen -> most common in ileum and may contain gastric mucosa, may cause peptic ulcer)

Question 7

what is meckel’s diverticulum

Answer 7

a common congenital abnormality of the small intestine caused by incomplete obliteration of the vitelline (omphalomesenteric) duct

Question 8

4 causes of intestinal obstruction

Answer 8

1. herniation
2. adhesions
3. volvulus
4. intussusception

Question 9

what derm condition is associated w coeliacs

Answer 9

dermatitis herpetiformis (big blisers, epithelium is detached, IgA deposition)

Question 10

what is seen endocopically in coeliacs

Answer 10

abnormally smooth gut mucosa

Question 11

why is Dermatitis H. associated with coeliac’s

Answer 11

anti-gliadin antibody is an IgA antibody which also arises in the skin -> deposits can occur in the skin which act as opsining agents -> destruction of the basement membrane and blister formation

Question 12

what does the mucosa look like in crohn’s disease

Answer 12

1. ulcers -> longitudinal, serpentine fissures and cobblestoning;
2. skip lesions
3. in late stage disease -> fistulas with the skin or loops of other bowel
4. oedamatous, rubbery wall which progresses to fibrosis
5. narrow lumen (string sign radiologically)
6. serosa becomes dusky and grey

Question 13

what is the most common site of involvement in crohn’s disease

Answer 13

the terminal ileum

Question 14

what are pseudopolyps and what condition are they seen in (GI)

Answer 14

polypoid protrusions into the lumen of a colon exhibiting the changes of severe IBD -> everything around it is damaged and they are an island of normal but now protrudes out from the rest of the mucosa
seen in UC

Question 15

examples of complications of crohns

Answer 15

1. aphthae in the mouth (ulcers)
2. fibrosis of bile ducts (sclerosis cholangitis)
3. perianal abscesses
4. anal fissures/fistulas

Question 16

what are the 2 types of fistulas that commonly form as a complication of recurrent diverticulitis

Answer 16

1. colovesical
2. colovaginal

Question 17

what is a Colovesical fistula and how does it present (3)

Answer 17

a fistula that forms between the bowel and the bladder;
Generally present with:
1. recurrent UTIs
2. pneumoturia (gas bubbles in the urine)
3. passing faecal matter in the urine

Question 18

what is a Colovaginal fistula and how does it present (2)

Answer 18

a fistula that forms between the bowel and the vagina

Generally present with:
1. copious vaginal discharge
2. recurrent vaginal infections