Lower GI tract pathology Flashcards

1
Q

Where types of abnormalities occur in the GI tract?

A
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2
Q

What are the general effects of pathology in large bowel?

A
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3
Q

What are the congenital disorders?

A
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4
Q

What is this?

A

Congenital defect: atresia

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5
Q

Define Hirschprung’s disease. Who gets it? How does it present? What is it associated with? What oncogenes and genomic markers related to it?

A
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6
Q

What modality is this? What is it showing?

A

Barium scan, Hirschprung’s disease

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7
Q

How do you diagnose Hirschprung’s disease?

A
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8
Q

What are the mechanical disorders?

A
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9
Q

Define volvulus. What does it cause? Where does it commonly occur?

A
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10
Q

Where does diverticular disease occur? What happens?

A

Can be a difficult disease to treat.

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11
Q

What is this? What scan is this?

A

Diverticular disease - barium enema

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12
Q

What is this

A

Ballooning out of the wall - diverticular disease

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13
Q

What are the complications of diverticular disease?

A
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14
Q

What are the inflammatory disorders of the large bowel?

A
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15
Q

What causes infectious colitis?

A
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16
Q

What are the effects of infections?

A
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17
Q

Define pseudomembranous colitis. What is it caused by?

A
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18
Q

Describe the picture.

A

Very erythematous. Wet cornflakes - pseudomembrane

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19
Q

How do you diagnose and treat pseudomembranous colitis?

A
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20
Q

What is this?

A

Pseudomembranous colitis

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21
Q

Describe ischaemic colitis/infarction?

A
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22
Q

Describe the aetiology of ischaemic colitis?

A
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23
Q

What is this?

A

Ischaemic bowel

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24
Q

What is this?

A

Ischaemic bowel

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25
Q

What are the idiopathic IBDs?

A

Crohns and UC - Diagnosis of exclusion

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26
Q

Describe the aetiology of IBD?

A

Unsure.

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27
Q

What are the clinical features of CIBD?

A
28
Q

Who gets Crohn’s?

A
29
Q

What is affected in Crohn’s disease?

A
30
Q

What other features would you expect to see in Crohns Disease?

A
31
Q

What are the extra-intestinal effects of Crohn’s disease?

A
32
Q

What is this’

A

Skip lesion in crohn’s

33
Q
A

Granuloma in Crohn’s

34
Q

Who does UC affect?

A
35
Q

Where in the intestine does UC affect?

A

Does not affect small bowel

36
Q

What are the complications of UC?

A
37
Q

Extra inessential uc signs?

A
38
Q

What is this?

A

UC - no skip lesions

39
Q
A

Not transmural - UC

40
Q
A

Crypt abscesses

41
Q

What are the tumours of the colon and rectum?

A
42
Q

What is the difference between neoplastic and non-neoplastic tumours?

A
43
Q
A

Hyperplastic polyp - not linked to cancer

44
Q
A

Hyperplastic polyp.

45
Q

Define adenocarcinomas.

A
46
Q
A

Tubular adenoma

47
Q
A

Villous adenoma

48
Q
A

Villous adenoma - carpet

49
Q

What are the risk factors for cancer from polyps?

A
50
Q

Are adenoma precursors of cancer?

A
51
Q

What are the symptoms of adenomas?

A

Usually none

Maybe bleeding or anaemia

52
Q

What familial causes adenomas?

A

FAH and HNOCC

53
Q

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?

A
  • 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
54
Q
A

FAP

55
Q

Gardners Syndrome

A
  • 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

56
Q

Describe the genetics of HNPCC.

A
57
Q

What it the onset and distributions of HNPCC?

A

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)

58
Q

Who gets colorectal carcinoma?

A
59
Q

What is the aetiology of colorectal carcinoma?

A
60
Q
A

Polyp - cancerous

61
Q
A

Pink - good

Purple - bad

INVASIVE CANCER

62
Q

What are the symptoms of cancer?

A
63
Q

How do we grade and stage carcinomas?

A

Moving away from Duke’s

64
Q

Why is grading and staging important?

A

Tailor treatment and tell prognosis

65
Q

What is the role of pathology in cancers?

A

Tailor therapy