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Pathology > Lecture 13 Lower GI tract disease > Flashcards

Lecture 13 Lower GI tract disease Flashcards

1
Q

Name the parts of the large intestine

A

Ileum, Cecum, ascending colon, transverse colon and descending colon, rectum.

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2
Q

Large intestine membranes

A

Mucosa -> submucosa -> taeniae coli

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3
Q

Define appendicitis

A

Acute bacterial infection of the appendix caused by lumen obstruction

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4
Q

What are clinical symptoms of appendicitis?

A

Pain, rebound tenderness, systemic symptoms

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5
Q

Define pseudomembranous colitis

A

Acute inflammation of the colon presenting with the formation of plaque like fibrinous exudate (pseudomembranes) covering parts of mucosa

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6
Q

What causes pseudomembranous colitis?

A

Toxin produced by overgrowth of C.diff, replacing normal intestinal flora

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7
Q

Who is more likely to develop pseudomembranous colitis

A

patients treated with broad spectrum antibiotics

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8
Q

What are symptoms of pseudomembranous colitis?

A

Fever and lower abdo tenderness

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9
Q

How is pseudomembranous colitis treated?

A

Stopping antibiotics, hydration, specifical antibacteria therapy

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10
Q

Define inflammatory bowel disease

A

Chronic inflammatory conditions of unknown aetiology affecting the gastrointestinal tract

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11
Q

What is the pathogenesis of IBD?

A

Genetics, environment, constitutional susceptibility

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12
Q

What are the two types of IBD?

A

Crohn’s disease and ulcerative colitis

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13
Q

What is crohn’s disease?

A

Idiopathic IBD, affects any part of GIT from mouth to anus. Has skip lesions

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14
Q

What are the percentages of the areas affected by crohns disease?

A

50% ileum and colon, 30% terminal ileum and 20% colon alone. Perianal skin involvement (75%)

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15
Q

Pathology of Crohns disease?

A

Mucosal ulceration, fissures, Oedema of adjacent epithelium (cobblestone), pseudopolyp formation regen. Transmural inflam, non-caseating

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16
Q

Complications of Crohns disease?

A

Anaemia, malabsorption, fistulas, extra-intestinal. ^risk of bowel carcinoma.

17
Q

Define colitis?

A

Disease affecting only colon, starts in rectum spreading proximally, continuous mucosal disease.

18
Q

Microscopy findings for ulcerative colitis?

A

Affects mucosa only above muscularis mucosae, cryptitis, crypt abscess, goblet cell depletion, pseudopolp formation regeneration

19
Q

What is pseudopolyp formation regeneration found in?

A

Crohn’s and ulcerative colitis

20
Q

Complications of ulcerative colitis

A

Anaemia, electrolyte loss, extra-interstinal disease, ^ carcinoma risk.

21
Q

What mimic IBD?

A

Ischaemic colitis, radiation colitis, Behcet’s disease, pouchitis, diversion colitis,

22
Q

What genetic factors can lead to colorectal carcinoma?

A

Familial adenomatous polyposis & lynch syndrome

23
Q

What dietary factors can lead to colorectal carcinoma?

A

Low, fibre, bile aerobes, red meat, lack of vits and antioxidants

24
Q

What is involved in the National Bowel Cancer Screening Programme?

A

60-75 years old, faecal occult blood test (FOBT) -> colonoscopy looking for polyps

25
Q

What is a polyp?

A

Projection above an epithelial surface

26
Q

Define adenoma

A

benign tumour of glandular epithelium

27
Q

What does the quantity and size of the polyps mean?

A

The more polyps -> ^ the risk. The larger the polyp -> ^ likely to be malignant

28
Q

Notes on familial adenomatous polyposis (FAP)

A

Autosomal dominant, chromosome 5, polyps from mid-teens onwards, Carcinoma inevitable (15 years). Needs genetic counselling.

29
Q

Which condition needs genetic counselling?

A

Familial adeonmatous polyposis

30
Q

What are the variants of familial adenomatous polyposis?

A

Gardner’s and Turcot syndromes

31
Q

Define lynch syndrome

A

hereditary non-polyposis colorectal carcinoma

32
Q

Notes on lynch syndrome?

A

autosomal dominant, associated with CRCa (70-85%)

33
Q

What disease is microsatellite instability is linked to?

A

Lynch syndrome

34
Q

Define TEMS

A

transanal endoscopic microsurgery

35
Q

What is the staging of colorecatal carcinoma?

A

Dukes stage A (above muscle 95%survival) B into serosal fat (66%) C LN involved (33%)

36
Q

Define desmoplasic response

A

Growth of fibres or connective tissue.

Pathology (25 decks)

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