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GIT Module > Pathology > Flashcards

Pathology Flashcards

1
Q

What are the major diseases causing malnutrition?

A 
Celiac disease
Tropical Sprue
Whippel's disease
Lymphangeactasia
Crohn's enteritis
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2
Q

Define malabsorption

A

A condition characterized by suboptimal absorption of fat, fat- soluble and other vitamins, proteins, carbohydrates, electrolytes and minerals, and water.

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3
Q

What functions, when affected, would lead to malabsorption?

A

Intraluminal digestion
Terminal digestion
Transepithelial transport

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4
Q

Describe the clinical presentation of Malabsorption

A

Abnormal greasy, yellow/gray stools
Weight loss
Anorexia
Abdominal distention

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5
Q

Why can a patient with celiac disease be misdiagnosed?

A

can present with extra GIT symptoms

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6
Q

What is another name for celiac disease?

A

Celiac Sprue

Gluten Sensitive Enteropathy

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7
Q

Epidemiology of Celiac disease

A

Caucasians

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8
Q

Pathophysiology of Celiac Disease

A

Cell mediated immunity against the gluten [alcohol soluble protein component [Gliadin]]

Gluten taken into small intestine → ↑ intraepithelial cytotoxic T cells and ­ ↑ large number of lamina propria T-helper cells that are sensitized to gliadin → cytokine release → damage to the intestinal enterocytes. HLA DQ XIB heterodiamer genetic trend → confer susceptibility through interaction with gliadin.

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9
Q

Hypothesis behind the immune reaction in Celiac Disease

A

Gliadin cross- react with a fragment protein
The E1b protein of type 12 adenovirusàraise possibility that this disease might be resulted from exposure to this virus earlier in life.

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10
Q

Gross morphology of Celiac Disease

A

Flat mucosa [Loss of normal villous architecture → atrophy of mucosa]

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11
Q

Microscopic features of Celiac Disease

A

Surface epithelial layer is packed by T- lymphocytes and lamina propria

Crypts are hyperplastic, ­ ↑ in number, tortuous with ­ ↑ mitotic figures → overall mucosal thickness remains the same

Loss of microvilli + brush borders

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12
Q

What are the symptoms of Celiac Disease

A 
Diarrhea
Unexplained weight loss
Abdominal pain 
Failure to thrive 
Skin Rash
Arthritis 
Unexplained malaise and fatigue
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13
Q

What does Celiac disease increase the risk of?

A

T-cell lymphoma
GI carcinoma
Breast carcinoma

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14
Q

What genetic factors are associated with Celiac Disease?

A

HLA B8

HLA DR3-DQw2

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15
Q

What is a diagnostic finding of Celiac disease?

A

Mucosal mosiac changes seen on endoscopy

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16
Q

Epidemiology of Tropical Sprue

A

Tropics [Carribean], Central Africa, India, Southern Asia, South and Central America

Occurs as endemic and epidemics

17
Q

Patholophysiology of Tropical Sprue

A

Same as celiac deficiency → folate and vitamin B12 deficiency → megaloblastic anemia

18
Q

Symptoms of Whipple’s disease

A 
Steatorrhea 
Lymphadenopathy 
Malabsorption 
Diarrhea
Arthritis [often]
Encephalopathy [occasionally]
19
Q

What stain is used in Whipple’s disease?

A

PAS stain

20
Q

What is bacterial organisms are implicated in Tropical Sprue?

A

enterotoxigenic organisms [E. coli and Haemophilus in. ]

21
Q

Microscopic features of Tropical Sprue

A

Bacteria-laden macrophages and lipid pools in mucosa

22
Q

What would a culture from a patient with Whipple’s disease show?

A

Tropherhyma whippli bacilli within macrophages

[PAS Stain]

23
Q

What is the treatment for IBD?

A

Immunosuppressive therapy

24
Q

What is the possible etiology of IBD?

A

alteration in usual steady state between immune system and host defenses that maintain integrity of mucosa and down-regulate inflammation.

25
Q

Epidemiology of IBD

A

Increased prevalence
Occurs at an early age
Low mortality
Family history is common

26
Q

Epidemiology of Ulcerative Colitis

A

Onset: 15-40 yrs,
Second peak: 50 - 80 yrs.
Men = women
Variable course and severity

27
Q

What are the local complications of Ulcerative Colitis?

A 
Perforation 
Toxic Megacolon
Hemorrhage
Inflammatory polyps [pseudopolyps]
Colonic carcinoma
28
Q

What are the symptoms of Ulcerative Colitis?

A

Relapsing blood mucoid diarrhea [stringy mucus]
Pain/Cramps [relieved bu defecation]
Disease course lasts days/month
Remission for months/years

29
Q

What are the systemic complications of Ulcerative colitis?

A 
Uveitis
Ankylosing Spondylitis 
Sclerosing cholangitis 
Erythema nods 
Malnutrition 
Arthritis 
Pyoderma gangrenosum
30
Q

What are the gross findings of Ulcerative colitis?

A

Diffuse mucosal inflammation confined to the colon [mucosa is hemorrhagic, granular, friable]

Rectum involvement in 95%; can extend proximally, in a continuous fashion, aCrypt s far as the cecum.

Back wash ileitis occur in continuity with active pancolitis

Extensive ulceration along bowel axis

Pseudopolyps and flat mucosa

Normal wall thickness and normal serosa

31
Q

What are the microscopic findings of Chronic Ulcerative colitis?

A 
Architectural distortion
Basal plasma cells 
Chronic inflammation in lamina propria 
Paneth cell metaplasia 
Pseudopolyps
32
Q

What are the microscopic findings of Acute Ulcerative colitis?

A

Crypt abscesses/Cryptitis

Ulceration

GIT Module (16 decks)

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