Lower GI histology Flashcards

1
Q

hirschprungs disease

A

absence of ganglion cells in the myenteric plexus- distal colon fails to dilate, 80% male, constipation, abdominal distension, vomiting, overflow diarrhoea, associated with downs syndrome

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2
Q

what does a biopsy show in hiirschprungs disease

A

hypertrophied nerve fibres but not ganglia

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3
Q

what is a volvulus

A

complete twisting of a loop of bowel at mesenteric base around vascular pedical, occurs in small bowel in inhants and sigmoid colon in elderly

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4
Q

diverticular disease

A

low fiber diet, weak points in wall of bowel, 90% in left colon, barium enema, endoscopy , complications, diverticulitis, gross perforation, fistula

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5
Q

Acute colitis causes

A

infection, drug, toxins, chemo, radiation

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6
Q

chronic colitis

A

crohns, UC, TB

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7
Q

Effects of infection

A

secretory dirrhoea (toxin), exudative diarrhoea (invasion and mucosal damage)< severe tissue damage, peforatin, systemic illness

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8
Q

pseudomebranous colitis

A

antibiotic associated colitis with pseudomembrane formation caused by c diff exotoxins

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9
Q

diagnosis of pseudomembranous colitis

A

gross histology cornflake appearance, cdiff toxin stool assay, metronidazole

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10
Q

microscope appearance of pseudomembranous colitis

A

Mucopurulent exudate erupts out of crypts to form a mushroom-like cloud with a linear configuration of karyorrhectic debris and neutrophils that adheres to surface
Superficial crypts show patchy necrosis and dilation
Later in disease, entire crypt becomes necrotic and disease resembles ischemic colitis
Adjacent mucosa is normal, but may be covered by pseudomembrane
Superficial lamina propria contains dense neutrophils and some capillary fibrin thromb

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11
Q

where does infarction occur in the gut

A

watershed zones e.g. splenic flexure (SMA and IMA), and rectosigmoid (IMA and internal iliac)

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12
Q

ischaemic colitis aetiology

A

arterial occlusion, venous occlusion, small vessal disease, low flow states, obstruction

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13
Q

crohns disease epidemiology

A

peak onset, teens twenties, western populations, white, jewish, smoking

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14
Q

crohns disease presentation

A

whole GI tract can be affected, mouth to anus, skip lesions, transmural inflammation, non caseating granulomas, sinus fistula formation

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15
Q

crohns disease histology

A

fat wrapping, thick rubber hose like wall, narrow lumen, cobblestone mucosa, linear ulcers, fissures, anbscesses

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16
Q

crohns disease extra intestinal

A

arthritis, uveitis, stomatitis, skin lesions, pyoderma gangrenosum (neutrophil dysfunction), erythema multiforme, erythema nodosum

17
Q

UC epidemiology

A

white, peak at 20-25,

18
Q

UC histology

A

rectumand colon in contiguous fashion, may see backwash ileitis and appendiceal involvement, inflammation confined to mucosa, bowel wall normal thickness, shallow ulcers

19
Q

complications of UC

A

Severe haemorrhage, toxic megacolon, adenocarcinoma

20
Q

how much is risk increased of adenocarcinoma in UC

A

20-30x

21
Q

UC Extraintestinal manifestations

A

arthritis, myositis, uveitis, erythema nodosum, pyoderma gangrenosym, primary sclerosing cholangitis,

22
Q

non neoplastic polyps of colon and rectum

A

non neoplastic (hyperplastic, inflammatory pseudo polyps, hamartomatous e.g. peutz jeghers

23
Q

neoplastic polyps of colon and rectum

A

tubular adenoma, tubulovillous adenoma, villous adenoma

24
Q

how does gardenrs syndrome present

A

100s of polyps, multiple osteomas, epidermoid cysts, desmoid tumours, detal cauries

25
Q

how does HNPCC present

A

high frequency of carcinomas proximal to the splenic flexure, frequent poorly differentiated and mucinous carcinoma more frequent, multiple synchronous cancers, presence of extracolonic cancers