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Phoebe's GI > Pathology > Flashcards

Pathology Flashcards

1
Q

Acute oesophagitis

A

Rare
Corrosive following chemical ingestion
Infective in immunocompromised (candidas, herpes)

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2
Q

Chronic oesophagitis

A

Common

Reflux disease

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3
Q

Reflux oesophagitis

A

Inflammation of oesophagus due to refluxed low pH gastric content
May be due to defective sphincter, hiatus hernia, increased intra-abdominal pressure (pregnancy)

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4
Q

Microscopic appearance of reflux oesophagitis

A

Basal zone epithelial expansion

Intraepithelial neutrophils, lymphocytes and eosinophils

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5
Q

Barret’s Oesophagus

A

Replacement of stratified squamous epithelium by columnar epithelium
Unstable mucosa
Increased risk of developing dysplasia and carcinoma

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6
Q

Allergic oesophagitis

A

Eosinophilic oesophagitis
Family history of allergy
Asthma, young, males more

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7
Q

Benign Oesophageal Tumours

A 
Squamous Papilloma
Rare
Papilliary 
Asymptomatic 
HPV related
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8
Q

Malignant Oesophageal Tumours

A

Squamous Cell Carcinoma

Adenocarcinoma

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9
Q

Adenocarcinoma of Oesophagus Pathogenesis

A
  1. Genetic factors, reflux disease
  2. Chronic reflux oesophagitis
  3. Barret’s oesophagus
  4. Low grade dysplasia
  5. High grade dysplasia
  6. Adenocarcinoma
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10
Q

Mechanism of metastases

A

Direct invasion
Lymphatic permeation
Vascular invasion

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11
Q

Acute gastritis

A

Irritant chemical injury

Severe trauma

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12
Q

Chronic gastritis

A

Autoimmune
Bacterial (H. pylori)
Chemical

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13
Q

Autoimmune chronic gastritis

A

Anti-parietal and anti-intrinsic factor antibodies
Atrophy and intestinal metaplasia in stomach
Increased risk of malignancy

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14
Q

H. Pylori gastritis

A

Bacteria inhabits a niche between epithelial cell surface and mucous barrier
Gram -ve rod
Early inflammatory response
Lamina propria cells produce anti H. Pylori antibodies

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15
Q

Chemical gastritis

A

Due to NSAIDS, alcohol, bile reflux
Direct injury to mucous layer by fat solvents
Marked epithelial regeneration, hyperplasia, congestion and little inflammation

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16
Q

Peptic Ulceration

A

Breach into GI mucosa as a result of acid and pepsin attack

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17
Q

Chronic peptic ulcer sites

A

Duodenum (first part)
Stomach (junction of body and antrum)
Oesophago-gastric junction
Stomal ulcers

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18
Q

Peptic ulcers microscopically

A

Layered appearance
Floor of necrotic fibrinopurulent debris
Base of inflamed granulomation tissue
Deepest layer is fibrotic scar tissue

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19
Q

Complications of peptic ulcers

A 
Perforation
Penetration
Haemorrhage 
Stenosis
Intractable pain
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20
Q

Benign gastric tumours

A

Polyps
Hyperplastic polyps
Cystic fundic gland polyps

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21
Q

Malignant gastric tumours

A

Carcinomas
Lymphomas
GI stromal tumours

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22
Q

Gastric adenocarcinoma pathogenesis

A
  1. H. Pylori infection
  2. Chronic gastritis
  3. Inestinal metaplasia
  4. Dysplasia
  5. Carcinoma
23
Q

2 types of gastric adenocarcinoma

A

Intestinal type

Diffuse type

24
Q

Intestinal Gastric adenocarcinoma

A

Exophytic/polypoid mass

25
Diffuse gastric adenocarcinoma
Expands/infiltrates stomach wall
26
Ischaemia of small bowel
Mesenteric arterial occlusion | Non-occlusive perfusion insufficiency
27
Mesenteric arterial occlusion
1. Mesenteric artery atherosclerosis | 2. Thromboembolism from heart
28
Non occlusive perfusion insufficiency
1. Shock 2. Strangulation obstructing venous return 3. Drugs eg.cocaine 4. Hyperviscosity
29
Complications of ischaemia of the small bowel
Resolution Fibrosis, stricture, chronic ischaemia, mesenteric angina and obstruction Gangrene, perforation, peritonitis, sepsis and death
30
Meckel's Diverticulum
Result of incomplete regression of vitello-intestinal duct | Tubular structure, 2 inches long, 2 foot above IC valve
31
Carcinoid tumours of small bowel
``` Common in appendix Small, yellow growing tumours Locally invasive Produce hormone like substances Flushing and diarrhoea ```
32
Appendicitis pathology
Acute inflammation Mucosal ulceration Serosal congestion, exudate Pus in lumen
33
Complications of appendicitis
``` Peritonitis Rupture Abscess Fistula Sepsis ```
34
Polyp
Protrusion above an epithelial surface | Tumour (swelling)
35
Why must all adenomas be removed?
They are all pre-malignant
36
Primary treatment for adenocarcinoma
Surgery
37
Dukes A
Confined by muscularis propria
38
Dukes B
Through muscularis propria
39
Dukes C
Metastatic to lymph nodes
40
Colorectal carcinoma
75% left sided (rectum, sigmoid, descending) | 25% right sided (caecum, ascending)
41
Adenoma of colon
Benign tumour | Not invasive, do not metastasise
42
HNPCC
Hereditary Nonpolyposis Colorectal Cancer
43
Hereditary Nonpolyposis Colorectal Cancer
``` Defect in DNA mismatch repair Right sided tumour <100 polyps Mucinous tumours Inflammatory response Associated with gastric and endometrial carcinoma ```
44
FAP
Familial Adenomatous Polyposis
45
Familial Adenomatous Polyposis
``` Defect in tumour suppression Throughout colon >100 polyps Adenocarcinoma NOS Associated with desmoid tumours and thyroid carcinoma ```
46
Liver injury
1. Insult to hepatocytes (viral, drug, toxin, antibody) 2. Grading (degree of inflammation) 3. Staging (degree of fibrosis) 4. Cirrhosis
47
Pre-hepatic jaundice
Too much haem to breakdown Haemolysis of all causes Haemolytic anaemias Unconjugated bilirubin
48
Post-hepatic jaundice
``` Bile cannot escape into bowel Congenital biliary atresia Gallstones block CBDuct Strictures of CBDuct Tumours at head of pancreas ```
49
Non-alcoholic Steatohepatits
Non-drinkers Identical to alcoholic liver disease Occurs in pts with diabetes, obesity, hyperlipidaemia
50
HALO
Haemorrhoidal artery ligation
51
Haemorrhoid
Enlarged vascular cushions in lower rectum and anal canal
52
Rectal prolapse
``` Partial = anterior mucosal prolapse Complete = full thickness ```
53
Anal fissure
Tear in anal margin due to passage of constipated stool

Phoebe's GI (24 decks)

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