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Gastrointestinal > Pathology > Flashcards

Pathology Flashcards

1
Q

What is the most common pathology of the biliary tract?

A

Cholelithiasis

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2
Q

What is cholelithiasis?

A

Gall stones

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3
Q

How do you remove gall stones?

A

Surgery is the number one choice

Can also use ursodeoxycholic acid

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4
Q

What is the main component of gall stones?

A

Cholesterol

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5
Q

Name the two inflammatory disorders of the oesophagus

A

Acute oesophagitis

Chronic oesophagitis

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6
Q

What is another name for chronic oesophagitis?

A

Reflux oesophagitis

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7
Q

What causes basal cell hyperplasia in the oesophagus?

A

reflux/chronic oesophagitis

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8
Q

Name 3 complications of reflux oesophagitis

A

Ulceration (bleeding)
Stricture
Barrett’s oeosophagus

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9
Q

What is Barrett’s Oesophagus?

A

Replacement of stratified squamous epithelium by columnar epithelium

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10
Q

If chronic oesophagitis causes hyperplasia, what does Barrett’s oesophagus cause?

A

Metaplasia

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11
Q

What is metaplasia?

A

Cell changes its identity/composition to deal with stress

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12
Q

How would you describe the mucosa of the oesophagus in a patient with Barrett’s oesophagus?

A

Red Velvet

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13
Q

What is the main risk for patients with Barrett’s Oesophagus?

A

Carcinoma

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14
Q

What is another name for allergic oesophagitis?

A

Eosinophillic oesophagitis

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15
Q

What are the risk factors for allergic oesophagitis?

A

Atopy
Asthma
Young
Male

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16
Q

What is the cardinal sign of eosinophillic oesophagitis?

A

Increased eosinophils in the blood

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17
Q

What does the oesophagus look like in allergic oesophagitis?

A

Corrugated (macroscopic) or spotty (microscopic)

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18
Q

Name the two main malignant oesophageal tumours

A

Squamous cell carcinoma

Adenocarcinoma

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19
Q

What are the risk factors for squamous cell carcinoma?

A 
Vit A/Zinc deficiency
Tannin
Smoking/Alcohol
HPV
Oesophagitis
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20
Q

Which cancer can develop following Barrett’s eosophagus

A

Adenocarcinoma

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21
Q

Where can oesophageal carcinoma metastasise to?

A

Lymph

Liver

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22
Q

How can oral squamous cell carcinoma present?

A

White, red, speckled, ulcer, lump

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23
Q

What are the risk factors for oral squamous cell carcinoma?

A 
Smoking
Alcohol
Chewing tobacco and Paan
HPV
Poor nutrition
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24
Q

What are the 2 main inflammatory disorders of the stomach?

A

Acute gastritis

Chronic gastritis

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25
Q

What can cause acute gastritis?

A 
Shock
Burns
Chemicals
Head injury
Trauma
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26
Q

What can cause chronic gastritis?

A

Autoimmune conditions
Bacteria (H.Pylori)
Chemicals (NSAID’s, Alcohol, Bile)

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27
Q

Name the 3 types of malignantgastric tumours

A

Carcinomas (adenocarcinomas)
Lymphomas (Maltoma)
Gastrointestinal stromal tumours

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28
Q

What is the pathogenesis for a gastric adenocarcinoma caused by a h.pylori infection?

A

H.Pylori Infection > Chronic gastritis> Metaplasia/Atrophy>

Dysplasia> Carcinoma

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29
Q

Where do gastric lymphomas orginate?

A

MALT

Mucosa associated lymphoid tissue

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30
Q

What can cause small bowel ischaemia?

A 
Mesenteric artery atherosclerosis
Thromboembolism from the heart
Shock
Strangulation (e.g hernia, adhesion)
Drugs (e.g cocaine)
Hyperviscosity)
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31
Q

What are the 3 kinds of ischaemic small bowel?

A

Mucosal infarct - can regenerate
Mural infarct - can repair and form fibrous stricture
Transmural infarct - Can cause gangrene and death. Bowel should be resected

32
Q

What is Meckel’s diverticulum?

A

Rule of 2s
2 inches long
2 foot above Ileocaecal valve 2% of people

33
Q

Tumours of the small bowel are rare, metastases from which areas are more common?

A

Ovary
Colon
Stomach

34
Q

Malignant tumours in the small bowel are associated with..?

A

Coeliac disease and crohn’s disease

35
Q

What is the most common site for small bowel carcinoid tumours?

A

Appendix

36
Q

If carcinoid tumours of the small bowel metastasise to the liver, what can occur?

A

Carcinoid syndrome

37
Q

What are the main symptoms of carcinoid syndrome?

A

Facial flushing and diarrhoea

38
Q

What kind of cells in the small bowel can be damaged and lost due to coeliac disease?

A

Enterocytes

Villi

39
Q

What kind of change in bowel habits can coeliac disease cause?

A

Diarrhoea

Steatorrhoea

40
Q

What are the main effects of coeliac disease?

A 
Weight loss
Anaemia (Fe, Vit B12, Folate)
Abdominal bloating
Failure to thrive
Vit deficiencies
41
Q

What are patients with coeliac disease at risk of?

A

T-cell lymphomas of the GI tract
Small bowel carcinoma
Gall stones
Ulcerative jejunoilleitis

42
Q

How is Crohn’s disease characterised?

A

Patchy, segmental with skip lesions anywhere on the GI tract
Cobblestone appearance
Transmural
Granulomatous

43
Q

What are the main complications of chrohn’s disease?

A 
Fistulas
Anal disease
Non-curative disease
Bowel obstruction
Perforation
Malignancy
Amyloidosis
Toxic megacolon (rare)
44
Q

Which population is most likely to get Crohn’s?

A

Jewish people

45
Q

Which part of the GI tract is UC confined to ?

A

Colon and rectum

46
Q

How deep is the inflammation in UC?

A

Mucosal and submucosal

47
Q

How do patients with UC present?

A

Diarrhoea, mucus, PR blood

48
Q

What are patients with UC at risk of?

A

Toxic megacolon

49
Q

What are the extra GI complications of UC?

A

Eyes- Uveitis
Liver- Primary sclerosing cholangitis
Joints - Arthritis, ankylosing spondylitis
Skin - Eyrthema nodosum

50
Q

What is the pathogenesis of liver disease?

A

Insult to hepatocytes > Inflammation > Fibrosis > Cirrhosis

51
Q

What are the causes of pre-hepatic jaundice?

A

Haemolysis
Haemolytic anaemia
Unconjugated bilirubin

52
Q

What are the causes of hepatic jaundice?

A 
Acute liver failure
Alcoholic hepatitids
Decompensated cirrhosis
Bile duct loss 
Pregnancy
53
Q

What are the causes of post-hepatic jaundice?

A

Congenital

54
Q

What causes the formation of gallstones?

A

An imbalance between the ratio of cholesterol to bile salts disrupting micelle formation

55
Q

What are the risk factors for gallstones?

A

Female
Obesity
Diabetes
Genetics

56
Q

What can gallstones cause?

A 
Acute cholecystitis
Chronic cholecystitis
Mucocoele
Empyema
Carcinoma
Ascending cholangitis
Obstructive jaundice
Gallstone ileus
Acute pancreatitis
Chronic pancreatitis
57
Q

What is cholecystitis?

A

Inflammation of the gallbladder

58
Q

What is the gold standard test for acute pancreatitis?

A

Elevated serum amylase

59
Q

What can cause acute pancreatitis?

A 
Alcohol
Cholelithiasis
Shock
Mumps
Hyperparathyroidism
Hypothermia
Trauma
Iatrogenic (e.g ERCP)
60
Q

What kind of complications can arise from pancreatitis?

A 
Death
Shock
Pseudocyst formation
Abscess formation
Hypocalcaemia
Hypergylcaemia
61
Q

What can cause chronic pancreatitis?

A 
Alcohol
Cholelithiasis
Cystic fibrosis
Hyperparathyroidism
Familial
62
Q

What is the type of cancer that occurs in the pancreas?

A

Adenocarcinoma

63
Q

Where can adenocarcinoma of the pancreas spread to?

A

Direct spread to Duodenum, Biliary tree, stomach and spleen
Spread to local lymph nodes
Metastases to liver

64
Q

What is a colonic polyp?

A

A portrusion from the epithelial wall. Either benign or malignant

65
Q

What is the main differential diagnosis of a colonic polyp?

A

Adenoma
Serrated polyp
Polypoid carcinoma
Other

66
Q

Is adenoma of the colon, benign or malignant?

A

Benign

67
Q

What kind of cancer is colonic adenoma a precursor of?

A

Colonic adenocarcinoma

68
Q

What is the first step in the treatment of colonic adenocarcinoma?

A

Section of bowel is removed and sent to be staged

69
Q

Explain Dukes staging of colorectal cancer

A

Dukes A - Confined to muscle wall
Dukes B - Spread through bowel wall
Dukes C - Metastasised to lymph nodes

70
Q

What are the complications of diverticular disease?

A 
Inflammation
Rupture
Abscess
Fistula
Bleeding
71
Q

What is cirrhosis on a microscopic level?

A

Bands of irreversibly damaged tissue that is now fibrotic that seperated regenenerative nodules of hepatocytes

72
Q

What is the pathogenesis for developing alcohol related cirrhosis?

A

Days - Fatty Liver - reversible
Weeks - Hepatitis - reversible
Months - Fibrosis - irreversible
Years - Cirrhosis - irreversible

73
Q

What is haemochromatosis?

A

Excess iron stored in the liver

74
Q

What is Wilson’s disease?

A

The accumulation of excess copper in the liver and brain

75
Q

What does alpha-1-antitrypsin deficiency cause?

A

Emphysema and cirrhosis

Gastrointestinal (26 decks)

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