Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PAT > Patho 27 - > Flashcards

Patho 27 - Flashcards

1
Q

definition of the typhoid fever

A

Systemic infective disease of the small intestine & other organs,
caused by Salmonella typhi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Route of infection by the salmonella typhi

A

Ingestion of contaminated water or food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Incubation period of typhi

A

2 week. Disease: 5 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pathogenesis of typhoid fever

A
  • Organisms are resistant to gastric acid; they invade the small intestinal mucosa and are subsequently engulfed by macrophages which go to Peyer’s patches /solitary follicles.
  • The organism proliferate, reach the lymphatics then the blood causingbacteremia.
  • The organisms are finally taken by RECs in liver, spleen and bone marrow were they multiply inside it. The REC’s undergo necrosis and the released organisms disseminate widely causing septicemia.
  • Disease manifestation start in small intestine and then extra intestinal as spleen, bone marrow, gall bladder & other organs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pathological features of the typhoid fever

A
  1. Peyer’s patches in the terminal ileum are enlarged and swollen. The overlying mucosa is shed leaving oval ulcers oriented along the long axix of the ileum..
  2. The spleen is enlarge soft and red, and shows prominent hyperplasia of phagocytic cells.

Gross “ peyer patches enlarged, oval ulcers , spleen enlarged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Complications of the typhoid fever

A
  1. Intestinal hemorrhage
  2. Perforation leading to septic peritonitis.
  3. Toxemia leading to heart failure.
  4. Bronchopneumonia
  5. Cholecystitis and development of carrier state.
  6. Typhoid osteomyelitis, localized periostitis develops after months or years.
  7. Meningitis encephalitis, pyelonephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Definition of the Dysentry

A

Inflammation of large intestine characterized by
diarrhea, tenesmus, mucous & blood in the stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

the types of dysentry

A

1) bacillary dysentry caused by shigella colitis
2) amoebic dysentry caused by enatameba histolytica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

defintion of bacillary dysentry

A

Acute pseudomembranous inflammation of the colon due to infection by exotoxin producing Shigella organisms (a non-encapsulated Gram-negative bacillius).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

route in infection of shigella colitis

A

fecal-oral rout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

complications of Bacillary Dysentry

A
  • Local
    1- Hemorrhage
    2- Perforation:
    3- Rectal prolapse from frequent motions & straining.
    4- Intussusception due to frequent motions with abnormal peristalsis.
    5- Healing by fibrosis with stricture formation.
  • General toxic manifestation: Myocarditis, arthritis, peripheral neuritis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical Picture of bacillary dysentry

A

§ Dysentery; severe: diarrhea, tenesmus, blood & mucus..
§ Fever is high. & stool culture is +ve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pathological features of the bacillary dysentry

A

The large intestinal mucosa is diffusely inflamed, congested, edematous with patches of dirty greyish yellow pseudomembrane.
Shallow bleeding ulcers exist in between (areas where the pseudo-membrane has fallen off).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

gross of Amoebic Dysentery

A
  • Amebic colitis usually affects the cecum and ascending colon
    followed by the rectum then sigmoid colon.
  • Multiple, small flask shaped ulcers
    i.e. more destruction in submucosa than mucosa.
    The ulcers have deep edges, necrotic floor & a base formed of the muscle layer.
  • The mucosa in-between the ulcers is healthy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Defintion of Amoebic Dysentery

A

Infection of large intestine by Entameba histolytica parasite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

microscopic picture of amoebic dysentery

A
  • The edges and floor of the ulcers contains amoebae, which appear as rounded bodies surrounded by clear zones (due to lysis by the proteolytic enzymes of the amoeba).
  • Chronically inflamed granulation tissue & fibrosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications of amoebic dysentery

A

1- Hemorrhage.
2- Perforation.
3- Rectal prolapse from frequent motions & straining.
4- Intussusception due to frequent motions with abnormal peristalsis.
5- Healing by fibrosis with stricture formation.
6- Chronic carrier.
7- Amoeboma:
© amoebic granuloma forming a mass in the wall which may be mistaken for a malignant tumor.
8- Spread of infection
- Direct: perianal fistula or ulcer.
- Blood: liver amoebic abscess.
Lung amoebic abscess.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

cause of Antibiotic associated colitis

A

due to suppression of normal flora and
overgrowth of Clostridium difficile which causes a widespread toxic mucosal injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pathological feature of Antibiotic associated colitis

A

The colon shows pseudomembranous colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

definition of ulcerative colitis

A

Chronic disorder with repeated acute attacks of abdominal pain, diarrhea,& bleeding followed by periods of remission.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Gross of ulcerative colitits

A

It involves the rectum and extends proximally in a retrograde fashion to involve the entire colon.
1) Rectosigmoid most commonly affected by multiple superficial, small irregular ulcers.
2) Pseudopolyps which are small elevations formed of regenerating mucosa and granulation tissue.
3) Fibrosis in prolonged disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

clinical picture of ulcerative colitis

A

pain, diarrhea,& bleeding followed by periods of remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

other name of ulcerative colitis

A

ulcerative procto colitis (procto=rectum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

small elevations formed of regenerating mucosa and granulation tissue and related to?

A

Pseudopolyps related to ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

microcopic picture of ulcerative colitis

A
  • Active phase:
    1- Mucosal ulcers. Inflammation is limited to mucosa and submucosa.
    2- Diffuse infiltration by acute and chronic inflammatory cells with crypt abscess formation (aggregates of polymorphs in the lumen of distended crypts).
    3- Degenerative changes in the surface epithelium with depletion of their mucin content and loss of goblet cells
    4- Severe mucosal edema, congestion & focal hemorrhages.
    5- No granuloma
  • Chronic phase:
    1- Mucosal crypt distortion
    (important in diagnosis when the inflammatory features have subsided)
    2- Mucosal atrophy with submucosal fibrosis
    3- Epithelial dysplasia in long standing conditions (premalignant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

microcopic picture of active phase of ulcerative colitis

A

Active phase:
1- Mucosal ulcers. Inflammation is limited to mucosa and submucosa.
2- Diffuse infiltration by acute and chronic inflammatory cells with crypt abscess formation (aggregates of polymorphs in the lumen of distended crypts).
3- Degenerative changes in the surface epithelium with depletion of their mucin content and loss of goblet cells
4- Severe mucosal edema, congestion & focal hemorrhages.
5- No granuloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

microcopic picture of chronic phase of ulcerative colitis

A

Chronic phase:
1- Mucosal crypt distortion
(important in diagnosis when the inflammatory features have subsided)
2- Mucosal atrophy with submucosal fibrosis
3- Epithelial dysplasia in long standing conditions (premalignant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

complications of ulcerative colitis

A

1- Hemorrhage.
2- Perforation &septic peritonitis.
3- Dysplasia & adenocarcinoma.
4- Amyloidosis.
5- Liver damage in the form of fatty change or biliary cirrhosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

definition of chron’s disease

A

Idiopathic chronic inflammation of terminal ileum and other areas of the gastrointestinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

other name of chron’s disease

A

REGIONAL ILEITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

gross of chron’s disease

A

§ Skip lesions (separate) with inflamed serosa and adherent creeping mesenteric fat; the bowel wall is thick and often strictured.

§ Early aphthous ulcers which may progress and coalesce into elongated ulcers along the axis of the bowel (serpentine ulcers).

§ Cobblestone appearance of the mucosa (diseased tissue appears depressed below the level of normal mucosa).

§ Deep fissures, fistula tracts and fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

serpentine ulcers related to serpentine ulcers related to

A

CROHN’S DISEASE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

cobblestone appearance of the mucosa related to

A

CROHN’S DISEASE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

complication of chrons disease

A

1- Hemorrhage.
2- Malabsorption.
3- Fistulae & healing by fibrosis with strictures
4- 2ry amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Microscopic of chron’s disease

A
  • Segmental Inflammation and ulceration rich in
    neutrophils affecting the whole thickness of
    the wall (transmural inflammation).
  • Non caseating granulomas of epitheloid cells &
    giant cells , is a hallmark of Crohn’s disease in 35% of cases.
  • Fibrosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

definition of DIVERTICULAR DISEASE OF THE COLON

A

Diverticulae are acquired herniations of mucosa and submucosa into the wall of the intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

predisposing factors of DIVERTICULAR DISEASE OF THE COLON

A
  • are weakness in the intestinal wall due to senility & increased intracolonoic pressure from chronic constipation and deficiency of fiber in the diet.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

pathological features of DIVERTICULAR DISEASE OF THE COLON

A
  • They are most common in the sigmoid colon.
  • They are usually multiple.
  • The pouches are formed of mucosa & submucosa only.
  • They protrude outwards through weak spots in the muscle layer on the mesenteric border (where the mesentery is penetrated by arteris, between the taenia coli).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

complication of DIVERTICULAR DISEASE OF THE COLON

A

1- Stasis leading to 2ry infection causing diverticulitis or abscess.
2- Diverticulitis may
- Heal by fibrosis with stricture formation.
- Perforate leading to septic peritonitis.
- Lead to a fistula between 2 loops.
3- Hemorrhage & bleeding per rectum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

definition of appendix

A

Acute inflammation of the appendix, which may be catarrhal or suppurative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

causative oragnism of appendix

A

Staphylococci, E. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

route on infection that cause appendix

A

from intestinal lumen

40
Q

predisposing factors that cause appendix

A

Obstruction with:
© Fecolith (hard stool pellets)
© Food residues (seeds)
© Lymphoid hyperplasia (viral infections, children)
© Presence of a carcinoid tumor.

41
Q

pathogenesis of appendix

A
  • Acute inflammation starts in the mucosa following a breach in the epithelium which permits infection from the gut flora.
    First, there is mucosal ulceration and exudation of polymorphs and fibrin in the lumen. The inflammation spreads to involve all the layers of the appendix, resulting in congestion, edema and diffuse infiltration by polymorphs.
  • The build up of fluid exudate within the wall increases tissue pressure, together with toxic damage to blood vessels and thrombosis cause ischemia and the appendix can become gangrenous and perforate.

obstruction»catarrhal inflammation»mucosal ulceration»all layers of Appendix affected» gangrene

42
Q

complication of appendix

A
  1. Perforation or rupture with septic peritonitis may progress to fatal septicemia.
  2. Gangrene.
  3. Appendicular mass (omentum tries to wall off local spread into the peritoneum
    leading to abscess formation).
  4. Portal pyemia from septic thrombophlebitis of appendicular vein.
  5. Chronicity: Chronic appendicitis
  6. Mucocele of appendix: Complete obstruction of appendix lumen at one point
    following healing result in distention of appendix with mucus forming a
    mucocele.
  7. Pus formation with complete obstruction forms empyema (Bag full of pus)
43
Q

what are the neoplastic polyps of the colon?

A

Adenomas:
- Tubular adenoma (adenomatous polyp).
- Villous adenoma (papillary adenoma).
- Tubulo-villous adenoma.

44
Q

what are the non-neoplastic polyps of the colon?

A

1- Bilharzial polyps
2- Hyperplastic Polyps
3- Pseudopolyps
4- Hamartomatous Polyps
* Juvenile polyps
* Peutz-Jeghers Syndrome

45
Q

gross of tubular adenoma?

A

precancerous, small and pedunculated

46
Q

other name of tubular adenoma?

A

adenomatous polyp

47
Q

Gross of villous adenoma

A

highly precancerous. Large and sessile.
Covered by villi

48
Q

other name of villous adenoma

A

papillary adenoma

49
Q

pseudopolyps are related to?

A

ulcerative colitis

50
Q

gross of hyperplastic polyps of colon?

A

Small sessile polyps, have no malignant potential

51
Q

Small sessile polyps of colon, have no malignant potential

A

Hyperplastic Polyps

52
Q

polyps of colon common in children

A

Hamartomatous Juvenile polyps

53
Q

gross of pseudopolyps?

A

small elevations of regenerating epithelium and
granulation tissue

54
Q

polyps of colon related to extraintestinal manifestation

A

Peutz-Jeghers Syndrome (hamartomatous polyps)

54
Q

types of hamartomatous polyps

A

Juvenile polyps
Peutz-Jeghers Syndrome

55
Q

what polyps

The polyps consist of cystically dilated hyperplastic
mucous glands filled with retained secretion

A

juvenile polyps

55
Q

gross of juvenile polyps

A

The polyps consist of cystically dilated hyperplastic mucous glands filled with retained secretion

56
Q

enumerate colonic polyps?

A

1- Bilharzial polyps.
2- Hyperplastic Polyps:
3- Pseudopolyps :
4- Hamartomatous Polyps: these include
* Juvenile polyps :
* Peutz-Jeghers Syndrome:
Adenomas:
- Tubular adenoma (adenomatous polyp).
- Villous adenoma (papillary adenoma).
- Tubulo-villous adenoma

57
Q

what is Peutz-Jeghers Syndrome

A

mucocutaneous hyperpigmentation and increased risk
of several malignancies as cancer colon, breaşrt, lung,
ovaries and others.

58
Q

mucocutaneous hyperpigmentation and increased risk
of several malignancies as cancer colon, breaşrt, lung,
ovaries and others.

A

Peutz-Jeghers Syndrome

59
Q

tumors of small and large intestine

A

benign epithelial tumors: adenomas
benign mesenchymal: leiomyoma, schwannoma, lipoma, fibroma, angioma
malignant epithelial: carinoid and adenocarcinoma
malignant mesenchymal: lymphoma

60
Q

malignant mesenchymal tumors of small and large intestine

A
  • Lymphoma
  • Leiomyosarcoma
61
Q

benign epithelial tumors of colon

A

adenomas

62
Q

the hereditary tumors of the colon

A

Familial Adenomatous Polyposis
hereditary non-polyposis colerectal cancer

63
Q

diagnosis of FAP (familial adenomatous polyposis)

A

A count of at least 100 polyps is necessary for diagnosis of classic FAP

64
Q

malignant epithelial tumors of colon

A

carcinoid and adenocarcinoma

65
Q

gene mutation cause FAP

A

adenomatous polyposis coli gene (APC gene), a
tumor suppressor gene.

66
Q

complication of FAP

A

Colorectal carcinoma

67
Q

gene mutation cause Hereditary non polyposis colorectal cancer

A

DNA mismatch repair gene

68
Q

treatment of FAP

A

Prophylactic colectomy

69
Q

complication of HNPCC syndrome

A

colorectal cancer
exocolonic cancer

69
Q

common location of the HNPCC

A

right proximal colon

70
Q

other name of HNPCC syndrome

A

Lynch syndrome

71
Q
A
72
Q

common location of adenocarcinoma of colon

A

rectosigmoid

73
Q

most common gastrointestinal malignancy

A

adenocarcinoma

74
Q

predisposing factors of adenocarcinoma of colon

A

1- Adenomas: All adenomas.
2- Diet: high fat & low fiber
3- Ulcerative colitis with dysplasia
4- Familial adenomatous polyposis

75
Q

Gross of adenocarcinoma of colon in proximal and distal

A
  • Polypoid fungating mass (more in proximal colon).
  • Malignant ulcer.
  • Annular stricture (more in distal colon).
76
Q

microsopic picture adenocarcinoma of colon

A
  • Adenocarcinoma formed of infiltrating malignant glands
  • Mucoid carcinoma (minority).
  • Poorly differentiated carcinoma without gland formation (rare and poor prognosis).
  • Signet ring carcinoma (rare and poor prognosis)
  • Invasive tumors
77
Q

complication of adenocarcinoma

A

1- Intestinal obstruction: Mechanical obstruction of lumen by tumor.
2- Intussuception (tumor induces abnormal peristalsis).
3- Hemorrhage from ulceration or tumor necrosis.
4- Perforation leads to septic peritonitis .
5- Spread:
-transcoelomic spread : kurkenberg syndrome
-direct: malignant fistula formation.
- Lymphatic
- Blood spread mainly to the liver.

78
Q

carcinoid tumor of Colon arise from?

A

neuroendocrine (argentaffine’) cells

78
Q

Modified Dukes’ staging related to

A

adenocarcinoma of colon

79
Q

what is Modified Dukes’ staging:

A

staging according to invasion of muscularis propria, and presence or absence of lymph node metastases

79
Q

staging of Modified Dukes’

A

Stage A: tumor which is confined to submucosa or muscle layer
Stage B: tumor has spread through the muscle layer but without lymph node metastases
B1 extendining into muscularis propria
B2 penetrating through muscularis propria
Stage C: Any tumor involving lymph nodes.
C1 extendining into muscularis propria, with lymph node metastases.
C2 penetrating through muscularis propria, with lymph node metastases.

80
Q

commonest site of carcinoid tumor

A

appendix

81
Q

gross of carcinoid tumor of colon

A

Yellow firm nodule

82
Q

microscopic of carcinoid tumor of the colon

A
  • groups of monotonous cuboidal cell.
  • The cytoplasm is rich in argyrophilc granules, observed by EM or by silver stains
83
Q

tumor cells that cytoplasm is rich in argyrophilc granules

A

carcinoid tumor

84
Q

manifestations of carcinoid syndrome

A

1- Fibrous stenosis of tricuspid and pulmonary valve.
2- Bronchoconstriction producing bronchospasm.
3- Skin flushing, oedma and diarrhea.
CARC
cutaneous flushing, asthmatic bronchoconstriction, right sided stenosis, cramps (diarrhea)

85
Q

behavior of carcinoid tumor

A

typical
atypical (high incidence of distant metastasis as liver metastasis which release serotonin and other substances leading to carcinoid syndrome

85
Q

liver metastasis of carcinoid release

A

serotonin

86
Q

commnest malignant tumor in small intestine

A

lymphoma

86
Q

definition of bleeding per rectum

A

Passage of fresh red blood in stools

87
Q

causes of bleeding per rectum

A

A- Local causes: Intestinal (anywhere below the stomach & duodenum).
1- Polyps
2- Malignant tumors
3- Piles (hemorrhoids)
4- Bilharziasis
5- Typhoid ulcers
6- Tuberculous ulcers
7- Amebic dysentery
8- Bacillary dysentery
9- Ankylostomiasis.
B-General causes of bleeding:
Ø Hemophilia, purpura, leukemia, and vit. C and vit. K deficiency

MATBP //// HBL 2 def

87
Q

Passage of dark altered blood in the stools

A

melena

88
Q

causes of hematemesis

A

A- Local causes: Bleeding from lesions high in the GIT above duodenum (mostly gastric & esophageal). The causes are similar to causes of hematemesis.
B- General causes of bleeding.

88
Q

definition of melena

A

Passage of dark altered blood in the stools

89
Q

Definition of hemorides

A

varicosity’s of hemorrhoidal veins in lower rectum

90
Q

Types of hemorrides

A
  • Internal: in superior hemorrhoidal veins.
  • External: in Inferior hemorrhoidal veins
91
Q

Etiology of hemorrides

A

1- Portal hypertension.
2- Congenital weakness of vessel walls.
3- Obstruction of lumen by tumor in rectum.
4- Chronic right sided heart failure with systemic venous congestion

92
Q

Complications of hemorrides

A

1- Hemorrhage fatal or microcytic hypochromic iron deficiency anemia
2- Thrombosis, septic thrombophlebitis & pyemia.
3- Strangulation of piles & their prolapse.

PAT (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions