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Gastrointestinal > Large bowel pathology > Flashcards

Large bowel pathology Flashcards

0
Q

What do most polyps in the colon or rectum turn out to be?

A

Adenoma

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1
Q

What are the differential diagnoses of a polyp?

A

Adenoma
Serrated polyp
Polyploid carcinoma
Other

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2
Q

What are adenomas precursors to?

A

Adenocarcinoma

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3
Q

Why must all adenomas be removed?

A

They are all premalignant

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4
Q

What is the primary treatment for most adenocarcinoma?

A

Surgery

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5
Q

What is Dukes stage A?

A

Tumour is confined to submucosa or muscle layer

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6
Q

What is Dukes stage B?

A

Tumour has spread through muscle layer but does not involve lymph nodes

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7
Q

What is Dukes stage C?

A

Tumour has spread to lymph nodes

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8
Q

Where does colorectal carcinoma mist commonly occur?

A

Left-sided

Descending colon, sigmoid, rectum

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9
Q

How might a right sided colorectal carcinoma present?

A

Anaemia

Weight loss

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11
Q

How might a left sided colorectal carcinoma present?

A

Blood PR
Altered bowel habit
Obstruction

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12
Q

What is diverticular disease?

A

Mucosal herniation through muscle coat of the bowel

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13
Q

Where is diverticular disease most common?

A

Sigmoid colon

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14
Q

What are some of the clinical presentations of diverticulitis?

A

LIF pain/tenderness
Sepsis
altered bowel habit

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15
Q

How is the diagnosis of diverticulitis made?

A

History/examination
Barium enema
Sigmoidoscopy

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16
Q

What is the treatment of diverticulitis?

A

IV fluids
Bowel rest
IV antibiotics

17
Q

What are some of the complications of diverticulitis?

A 
Pericolic abscess
Perforation
Haemorrhage
Fistula
Stricture
18
Q

When would surgery be indicated in diverticulitis?

A

No improvement with standard treatment

Complications

19
Q

What are some of the causes of colitis?

A

Infective colitis
Ulcerative colitis
Crohn’s colitis
Ischaemic colitis

20
Q

What are some of the symptoms of colitis?

A 
Diarrhoea + blood
Abdominal cramps
Dehydration
Sepsis
Weight loss, anaemia
21
Q

How is a diagnosis of colitis made?

A

Plain X-ray
Sigmoidoscopy + biopsy
Stool cultures
Barium enema

22
Q

What is colonic angiodysplasia?

A

Submucosal lakes of blood

An obscure cause of rectal bleeding

23
Q

Which side of the colon does colonic angiodysplasia tend to affect?

A

Right side

24
Q

What are some of the causes of large bowel obstruction?

A

Colorectal cancer
Sigmoid or caecal volvulus
Pseudobstruction
Faecal impaction

25
Q

How is the diagnosis of sigmoid volvulus made?

A

Plain AXR

Rectal contrast

26
Q

What is the treatment for sigmoid volvulus?

A

Flatus tube

Surgical resection

Gastrointestinal (17 decks)

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