Lec 29 Flashcards

1
Q

What happens to crypts in IBD?

A

have distortion of crypts; neutrophils within crypt epithelium

can form crypt abscess

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2
Q

Which IBD disease associated with creeping fat?

A

crohns

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3
Q

Which IBD disease associated with penetrating fissures and peritonitis?

A

crohns

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4
Q

What is major complication of toxic megacolon?

A

perforation

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5
Q

Is patient with crohns colitis or ulcerative colitis at more risk for colon cancer?

A

same risk

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6
Q

What do you see histologically in pseudomembranous colitis?

A

surface necrosis with dilated crypts; volcano-like acute inflammatory exudate

dilated glands filled with mucous

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7
Q

What is morphology of clostridium difficile?

A

gram positive spore forming rod
endemic in health care settings

toxins A and B –> necrosis of colonic epithelial cells

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8
Q

What are 3 treatments for CDiff colitis?

A

metronidazole
vancomycin
fecal transplant

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9
Q

What is string sign in barium xray?

A

sign of stenosis in crohns

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10
Q

What do you see on endoscopy with colonic ischemia?

A
  • dusky red discoloration with ulceration
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11
Q

What are features of colon that make it at risk for ischemia?

A
  • low blood flow relative to tissue mass
  • poor collateral flow
  • sensitivity to vasoconstrictors
  • watershed regions
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12
Q

What are the two watershed areas of colon?

A

splenic flexure = SMA + IMA

sigmoid colon = IMA + hypogastric artery

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13
Q

Can superficial ischemia of colon heal completely? What about injury deep to mucosa?

A

superficial can heal; deep may cause stricture when it heals

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14
Q

Who is at risk for colonic ischemia?

A

elderly
pts in shock
oral contraceptives; vasoconstrictive drugs

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15
Q

What are complications of diverticular disease?

A

painless bleeding from small artery at base of diverticulum

inflammation –> diverticulitis

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16
Q

What are signs of diverticulitis?

A

fever, LLQ tender, rope-like mass

can get abscess, fistula, perforation

17
Q

What do you see on endoscopy with collagenous colitis?

A

nothing

18
Q

What are symptoms of mild colonic ischemia?

A

ab cramps
rectal bleeding
diarrhea

19
Q

What do you see histologically with colonic ischemia?

A

eosinophilic staining, near absence of goblet cells, shrunken crypts
coagulative necrosis
few inflammatory cells

20
Q

Where are most diverticula located?

A

sigmoid colon

21
Q

What is triad of signs seen in collagenous and lymphocytic colitis

A
  • long standing watery non-bloody diarrhea
  • mucosa looks normal grossly
  • chronic mucosal inflammation by histology
22
Q

What do you see histologically in collagenous colitits?

A

abnormal band of collagen beneath surface epithelium

may have intraepithelium lymphocytes

23
Q

Who gets collagenous colitits?

A

mostly women; middle aged or older

24
Q

What do you see histologically in lymphocytic colitis?

A

intraepithelial lymphocytes

no collagen band

25
Q

Who gets lymphocytic colitits?

A

equally affects men/women