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Pathology Flashcards

1
Q

What are the common diseases of the large bowel? (5)

A 
Diverticular disease
Ischaemia
Antibiotic reduced colitis
Microscopic colitis
Radiation colitis
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2
Q

what is diverticular disease?

A

a condition in which muscle spasm in the colon (lower intestine) in the presence of diverticula causes abdominal pain and disturbance of bowel function without inflammation

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3
Q

What are the causes of diverticular disease?

A

It is related to a low fibre diet and increased interlumenal pressure

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4
Q

What are the complications of Diverticular disease? (5)

A 
inflammation
rupture
abscess
fistula
massive bleeding
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5
Q

What can cause ischaemia of the large bowel? (6)

A 
CVS disease
Atrial fibrillation
Embolus
Atherosclerosis of the mesenteric vessels
Shock 
Vasculitis
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6
Q

Histopathological signs of ischaemic colitis

A

withering of crypts
pink smudgy lamina propria
fewer chronic inflammatory cells

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7
Q

Complications of ischaemic colitis?

A

massive bleeding
rupture
stricture

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8
Q

What is colitis?

A

Inflammation of the lining of the colon

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9
Q

Who gets antibiotic induced colitis?

A

Patients on broad spectrum antibiotics and is caused by C. Diff

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10
Q

What does the bacteria in antibiotic colitis produce?

A

Produces toxins which attack the endothelium and epithelium causing mini-infarcts

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11
Q

What are the symptoms of antibiotic induced colitis?

A

massive diarrhoea and bleeding

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12
Q

what is the treatment for antibiotic induced colitis?

A

flagyl or vancomycin

May need colectomy if complications arise

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13
Q

How does collagenous colitis present?

A

watery diarrhoea

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14
Q

What histopathological changes are present in collagenous colitis?

A

thickened basement membrane i.e. between 2-3 microns

It is associated with intraepithelial inflammatory cells

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15
Q

How is collagenous colitis diagnosed?

A

A biopsy must be taken and clinical history will include watery diarrhoea and a normal endoscopy

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16
Q

what is the histopathology of lymphocytic colitis?

A

there are no cjronic changes in the crypts but have raised intraepithelial lymphocytes

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17
Q

How does lymphocytic colitis present?

A

Watery diarrhoea with no blood and normal mucosa on endoscopy

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18
Q

What is telangiectasia?

A

a condition characterized by dilatation of the capillaries causing them to appear as small red or purple clusters, often spidery in appearance, on the skin or the surface of an organ.

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19
Q

What would be seen in radiation colitis?

A

bizarre stroma cells and bizarre vessels

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20
Q

What is a polyp?

A

A protrusion above an epithelial surface (tumour)

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21
Q

what are the differential diagnoses of a colonic polyp? (4)

A

adenoma
serrated polyp
polypoid carcinoma
other

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22
Q

Are adenomas benign or malignant?

A

benign - they don’t invade or metastasise

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23
Q

What is the sequence of events which leads to an adenoma becoming a carcinoma?

A

Normal mucosa
Dysplastic adenoma
Invasive adenomacarcinoma

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24
Q

Which gene must acquire mutations in the most common pathway for the development of a colorectal carcinoma?

A

APC

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25
What is the treatment for adenomas?
removal endoscopically or surgically as they are all premalignant
26
Do all colorectal carcinomas have the same genetic origins?
No - there are separate pathways for inherited tumours and serrated adenomas
27
What is the treatment for an adenocarcinoma?
Surgery - the colon or rectum is removed and sent to pathology for staging
28
What is the criteria for Dukes staging A?
Confined by muscularis propria
29
What is the criteria for Dukes staging B?
Through muscularis propria
30
What is the criteria for Dukes staging C?
Metastatic to lymph nodes
31
which parts of the colon would be affected in left sided colorectal cancer?
rectum sigmoid descending colon
32
which parts of the colon would be affected in right sided colorectal cancer?
caecum | ascending colon
33
what are the common presenting complaints in patients with left sided colorectal cancer?
post rectal blood altered bowel habits obstruction
34
what are the common presenting complaints in patients with right sided colorectal cancer?
anaemia | weight loss
35
Describe the gross appearance of colorectal cancer
It can be varied - may be polyploid, stricturing and ulcerating
36
where does colorectal carcinomas spread during local invasion?
mesorectum peritoneum other organs
37
How does colorectal cancer spread through the lymphatics
mesenteric nodes - lie between the layers of the mesentery
38
where does colorectal cancer spread when it metastasises haematogeniously?
liver | distant sites
39
Is HNPCC late or early onset
late - usually around 60s
40
Is FAP late or early onset?
early - usually around 20s
41
Wha is the inherited mutation in HNPCC?
Mutation in MLH-1, MSH-2, PMS-1 or MSH-6
42
what is the inherited mutation in FAP?
mutation in the FAP gene
43
Name two types of inherited colorectal carcinomas
HNPCC and FAP
44
where do the tumors present in HNPCC?
right side of the colon
45
where do tumours present in FAP?
throughout the colon
46
which other carcinomas is HNPCC related to
gastric | endometrial
47
which other carcinoma is associated with FAP
desmoid tumours | thyroid tumours
48
what are the three zones of the liver?
Zone 1: Periportal Zone 2: Mid acing Zone 3: Pericentral
49
what kind of necrosis can liver insult produce and is this reversible?
Parenchymal necrosis - heals by resolution
50
what occurs after insult to hepatocytes?
Inflammation - fibrosis - cirrhosis
51
What causes acute liver failure?
Viruses Alcohol Drugs Bile duct obstruction
52
what are the three classifications of jaundice?
Pre-hepatic Hepatic Post-hepatic
53
What are the pre-hepatic causes of jaundice?
Haemolysis Haemolytic anaemia unconjugated bilirubin
54
what are the hepatic causes of jaundice?
``` Acute liver failure Alcoholic hepatitis Cirrhosis Bile duct loss Pregnancy ```
55
what are the post-hepatic causes of jaundice?
congenital biliary atresia galstone blocked common bile duct Strictures of the common bile duct Tumours
56
what is cirrhosis pathologically defined by?
Bands of fibrosis separating regenerative nodules of hepatocytes
57
what are the causes of cirrhosis?
``` Alcohol Hepatitis B Iron overload Gallstones Autoimmune liver disease ```
58
What are the complications of cirrhosis?
Portal hypertension Ascites Liver failure
59
what are the clinical presentations of portal hypertension?
Caput medusa Oesophageal varices Haemorrhoids
60
what is the outcome of alcoholic liver disease?
``` Cirrhosis Portal hypertension Malnutrition Hepatocellular carcinoma Social disintegration ```
61
what is the difference between NASH and NAFLD?
NASH is a more serious progression of NAFLD
62
In what patients does NASH occur?
Diabetics Obese patients Hyperlipidaemic patients

Gastroenterology (Own) (18 decks)

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