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Path - Histo > Lower GI > Flashcards

Lower GI Flashcards

1
Q

how does volvulus affect different age groups

A

Children: small bowel
Elderly: sigmoid colon

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2
Q

explain how diverticular disease occurs

A

high intraluminal pressure > herniation of bowel mucosa through weak points in the bowel wall

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3
Q

what can cause acute colitis

A

infection
drug/toxin
chemo/radiotherapy

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4
Q

What bacterium causes pseudomembranous colitis

A

C diff

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5
Q

explain the aetiology behind pseudomembranous colitis

A

C diff is commensal in the gut, kept under control by other bacteria
Course of ANTIBIOTICS kills off other bacteria
C diff is unopposed > produces toxin > colitis

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6
Q

What antibiotics trigger pseudomembranous colitis

A

3Cs
ciprofloxacin
clindamycin
cephalosporin

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7
Q

hgow do you detect C diff toxin

A

toxin stool assay

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8
Q

what are symptoms of pseudomembranous colitis

A

explosive watery diarrhoe

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9
Q

How do you treat pseudomembranous colitis

A

STOP causative antibiotic

Metronidazole / vancomycin > fidaxomicin > daecal transplant

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10
Q

What are causes of ischaemic collitis

A

occlusion (arterial/venous)
small vessel disease (DM, hypercholesteraemia, vasculitis)
low flow states (CCf, hhaemorrhage, shock)

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11
Q

Explain Chron’s disease effect on GI tract

A
  • entire GI tract, mouth to anus
  • mainly around large bowel, terminal ileum
  • skip lesions
  • transmural inflammation
  • non-caseating granulomas
  • THICK WALL, narrow lumen
  • COBBLESTONE mucosa
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12
Q

Explain UC effect on GI tract

A
  • ONLY affects rectum and colon (+ backwash ileitis)
  • continuous lesions
  • superficial ulcers, confined to mucosa
  • bowel thickness in normal
  • shallow ulcer
  • regenerating mucosa forms pseudopolyps
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13
Q

what is a polyp

A

protrusion from bowel wall

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14
Q

what are three types of neoplastic polyps (i.e. can develiop into tumour)

A

Tubular adenoma

Vollpis adenoma

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15
Q

What is mode of inheritance of FAP

A

AD

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16
Q

Explain FAP

A

large numbers of adenomatous polyps by age of 25

will very likeluy develop cancer

17
Q

what is the gene responsible for FAP

A

APC tumour suppressor gene on 5q21

18
Q

How do you manage FAP

A

preventative panproctocolectomy

19
Q

WHat is Gardner’s syndrome

A

Same as FAP, with extraintestinal manifestations (oseoma, epidermoid cyst, desmoid tumour, dental caries)

20
Q

What is mode of inhritance of HNPCC

A

AD

21
Q

explain HNPCC

A

No polyps

but very high risk of developing calcer regardless

22
Q

what is the most common type of colorectal cancer

A

ADENOCARCINOMA

23
Q

what staging is used for colorectal adenocarc

A

Dukes /TNM

24
Q

what are symptoms of chron’s

A

intermittent diarrhoea, pain, fever

25
Q

what are symptoms of UC

A

bloody diarrhoea with mucous

crampy abdo pain relieved by defecation

26
Q

what other disease is UC associated wiht

A

PSC

27
Q

what is carcinoid syndrome

A

tumour of enterochromaffin cell origin produced 5-HT (serotonin)

28
Q

where is carcinoid syndrome tumours found

A

bowel

also lung, ovaries, testes

29
Q

what are symptoms of carcinoid

A

bronchoconstriction
flushing
diarrhoea

30
Q

what are symptoms of carcinoid crisis

A 
life threatening vasodilation 
hypotension 
tachycardia 
bronchoconstriction 
hyperglucaemia
31
Q

what IX for carcinoid

A

24h urine 5-HIAA

32
Q

what MX for carcinoid

A

octreotide (somatostatin analogue)

33
Q

WHo do hamartomatous polyps occur in

A

children under 5

34
Q

what are sx of hamartomatous polyps

A

bleeding (in rectum)

35
Q

what syndrome are hamartomatous polyps seen in

A

Peutz-Jeghers syndrome

36
Q

Explain Peutz-Jeghers syndrome

A

multiple polyps
mucocutaneous hyperpigmentation
freckles around the mouth, palms, soles

increased risk of intusseption and malignancy

37
Q

what antigen marker can be used to monitor colorectal cancer

A

CEA

38
Q

what staging can you use for colon cancer

A

Dukes

Path - Histo (19 decks)

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