Lower GI tract pathology Flashcards
Where types of abnormalities occur in the GI tract?
What are the general effects of pathology in large bowel?
What are the congenital disorders?
What is this?
Congenital defect: atresia
Define Hirschprung’s disease. Who gets it? How does it present? What is it associated with? What oncogenes and genomic markers related to it?
What modality is this? What is it showing?
Barium scan, Hirschprung’s disease
How do you diagnose Hirschprung’s disease?
What are the mechanical disorders?
Define volvulus. What does it cause? Where does it commonly occur?
Where does diverticular disease occur? What happens?
Can be a difficult disease to treat.
What is this? What scan is this?
Diverticular disease - barium enema
What is this
Ballooning out of the wall - diverticular disease
What are the complications of diverticular disease?
What are the inflammatory disorders of the large bowel?
What causes infectious colitis?
What are the effects of infections?
Define pseudomembranous colitis. What is it caused by?
Describe the picture.
Very erythematous. Wet cornflakes - pseudomembrane
How do you diagnose and treat pseudomembranous colitis?
What is this?
Pseudomembranous colitis
Describe ischaemic colitis/infarction?
Describe the aetiology of ischaemic colitis?
What is this?
Ischaemic bowel
What is this?
Ischaemic bowel
What are the idiopathic IBDs?
Crohns and UC - Diagnosis of exclusion
Describe the aetiology of IBD?
Unsure.
What are the clinical features of CIBD?
Who gets Crohn’s?
What is affected in Crohn’s disease?
What other features would you expect to see in Crohns Disease?
What are the extra-intestinal effects of Crohn’s disease?
What is this’
Skip lesion in crohn’s
Granuloma in Crohn’s
Who does UC affect?
Where in the intestine does UC affect?
Does not affect small bowel
What are the complications of UC?
Extra inessential uc signs?
What is this?
UC - no skip lesions
Not transmural - UC
Crypt abscesses
What are the tumours of the colon and rectum?
What is the difference between neoplastic and non-neoplastic tumours?
Hyperplastic polyp - not linked to cancer
Hyperplastic polyp.
Define adenocarcinomas.
Tubular adenoma
Villous adenoma
Villous adenoma - carpet
What are the risk factors for cancer from polyps?
Are adenoma precursors of cancer?
What are the symptoms of adenomas?
Usually none
Maybe bleeding or anaemia
What familial causes adenomas?
FAH and HNOCC
What is the inheritance pattern of APC? What part is most affected? How many polyps are seen? What chromosomes are involved? How often do these patients develop cancer?
- Autosomal dominant - average onset is 25 years old
- Adenomatous polyps, mostly colorectal
- Minimum 100 polyps, average ~1,000 polyps
- chromosome 5q21, APC tumour suppressor gene
- virtually 100% will develop cancer within 10 to 15 years; 5% periampullary Ca
FAP
Gardners Syndrome
- Same clinical, pathological, and etiologic features as FAP, with high Ca risk
- Distinctive extra-intestinal manifestations:
–multiple osteomas of skull & mandible
–epidermoid cysts
–desmoid tumors
–dental caries, unerrupted supernumery teeth
–post-surgical mesenteric fibromatoses
Describe the genetics of HNPCC.
What it the onset and distributions of HNPCC?
–Onset of colorectal cancer at an early age
–High frequency of carcinomas proximal to splenic flexure
–Poorly differentiated and mucinous carcinoma more frequent
–Multiple synchronous cancers
–Presence of extracolonic cancers (endometrium, prostate, breast, stomach)
Who gets colorectal carcinoma?
What is the aetiology of colorectal carcinoma?
Polyp - cancerous
Pink - good
Purple - bad
INVASIVE CANCER
What are the symptoms of cancer?
How do we grade and stage carcinomas?
Moving away from Duke’s
Why is grading and staging important?
Tailor treatment and tell prognosis
What is the role of pathology in cancers?
Tailor therapy
