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Pathology Flashcards

1
Q

What may be the causes of acute oesophagitis?

A
  • corrosive following chemical ingestion

- immunocompromised patients

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2
Q

What causes chronic oesophagitis?

A
  • reflux disease

- rare causes include Crohn’s disease

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3
Q

What is most common? Acute or chronic Oesophagitis?

A
  • Chronic oesophagitis is most common
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4
Q

What causes reflux oesophagitis? and what causes it

A
  • inflammation of oesophagus due to refluxed low pH gastric content
  • defective sphincter mechanisms
  • hatius hernia
  • increased intra-abdominal pressure
  • abnormal oesophageal motility
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5
Q

What is the definition of Barrett’s Oesophagus?

A
  • replacement of stratified squamous epithelium by columnar epithelium
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6
Q

What may cause Barrett’s oesophagus?

A
  • persistent reflux of acid/bile

- differentiation from oesophageal stem cells

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7
Q

Allergic oesophagitis is characterised by what cell type?

A
  • eosinophills
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8
Q

Treatment for allergic oesophagitis?

A
  • steroids
  • chromoglycate (mast cell stabiliser)
  • montelukast
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9
Q

What may cause malignant squamous cell carcinoma of the oesophagus?

A
  • smoking
  • alcohol
  • vitamin A/ zinc deficiency
  • HPV
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10
Q

What would oral squamous cell carcinoma appear like?

A
  • white, red, speckled, ulcer lump

- floor of mouth, lateral border, ventral tongue, soft palate

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11
Q

What may cause acute gastritis?

A
  • irritant chemical injury
  • severe burns
  • shock
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12
Q

What is a peptic ulcer?

A
  • breach in the gastrointestinal mucosa because of acid and pepsin attack
  • failure of barrier function and increased acid secretion
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13
Q

What is another name for benign gastric tumours?

A
  • polyps
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14
Q

Patients with anti-H.pylori antibodies have higher risk of ____

A
  • cancer
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15
Q

What is the major cause of chronic gastritis?

A
  • H.pylori (bacterial infection)

- autoimmune less common

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16
Q

What may cause ischaemia of the small bowel?

A
  • mesenteric arterial occlusion

- non-occlusive perfusion insufficiency

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17
Q

What does Meckel’s diverticulum result in?

A
  • incomplete regression of Vitelli-intestinal duct
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18
Q

Appendicitis is characterised by what cell type?

A
  • neutrophils (acute inflammation)
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19
Q

Will it be an exudate or transudate fluid in appendicitis?

A
  • serosal congestion

- exudate

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20
Q

What is the pathology of coeliac disease?

A
  • Strong association with HLA-B8
  • Flat mucosal
  • villous atrophy = decreased surface area
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21
Q

complications of coeliac disease/

A
  • t-cell lymphomas of GI tract
  • gall stones (reduced CCK released)
  • increased risk of small bowel carcinoma
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22
Q

What are polyps

A
  • protrusions above epithelial surface
  • tumours (swellings)
  • doesn’t indicate benign or malignant
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23
Q

Name some benign epithelial polyp

A
  • ademona inflammatory hamartomatous
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24
Q

Name a malignant epithelial polyp?

A
  • polypoid adenocarcinomas
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25
Q

Name a benign mesenchymal polyp

A
  • lipoma

- fibromass

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26
Q

Name a malignant mesenchymal polyp

A
  • sarcomas

- lymphomatous polyps

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27
Q

What may be the differential diagnosis of a polyp?

A
  • adenoma
  • serrated polyp
  • polypoid carcinoma
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28
Q

All adenomas are _______

A
  • dysplastic

- pre malignant so must be removed

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29
Q

Explain the sequence of events of adenoma-carcinoma formation

A
  • normal mucosa
  • adenoma
  • adenocarcinoma
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30
Q

What are precursors of colorectal carcinomas?

A
  • adenomas
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31
Q

What treatment should be done to colorectal adenomas?

A
  • removed (surgically or endoscopically)

- as they are precursors of carcinomas

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32
Q

What colorectal carcinoma scoring system is used?

A
  • Dukes Staging
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33
Q

Explain Dukes A

A
  • confined by muscularis propria
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34
Q

Explain Dukes C

A
  • Metastatic to lymph nodes
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35
Q

What may be the symptoms of left sided colorectal carcinoma?

A
  • blood PR
  • altered bowel habit
  • obstruction
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36
Q

What may be the symptoms of right sided colorectal carcinoma?

A
  • anaemia

- weight loss

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37
Q

Where are the sites of local invasion of a colorectal carcinoma?

A
  • mesorectum

- peritoneum

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38
Q

Explain hereditary non-polyposis coli

A
  • <100 polyps
  • late onset
  • autosomal dominant
  • right sided tumours
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39
Q

Explain familial adenomatous polyposis

A
  • > 100 polyps
  • autosomal dominant
  • thought colon
  • early onset
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40
Q

What are common diseases of the large bowel?

A
  • polyps
  • adenomas
  • adenocarcinomas
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41
Q

Define Cholelithiasis?

A
  • gallstones

- hard stone like material formed within the biliary system most commonly the gallbladder

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42
Q

What procedure is conducted to remove cholelithiasis (gallstones)?

A
  • cholecystectomies
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43
Q

Explain the composition of normal bile?

A
  • micelles of cholesterol, phospholipids, bile salts and bilirubin
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44
Q

Where is bile stored and concentrated?

A
  • gallbladder
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45
Q

Why are gallstones formed?

A
  • imbalance between the ratio of cholesterol to the ratio of bile salts
  • disrupts micelle formation
46
Q

What are the 2 types of gallstones?

A
  • pigment stones

- cholesterol stones

47
Q

How are cholesterol stones formed?

A
  • excess cholesterol in bile
48
Q

How are pigment stones formed?

A
  • excess bilirubin
49
Q

Define cholecystitis?

A
  • inflammation of the gallbladder

- usually associated with gallstones

50
Q

Explain acute cholecystitis?

A
  • gallstones obstructing outflow of bile

- indicated by neutrophils

51
Q

Explain chronic cholecystis

A
  • gallbladder wall thickened due to fibrosis
52
Q

What causes obstructive jaundice?

A
  • stone (blockage) of common bile duct
53
Q

Cholangiocarcinoma?

A
  • carcinoma of the bile ducts
54
Q

What is cholangiocarcinoma associated with?

A
  • ulcerative colitis

- primary sclerosing cholangitis

55
Q

Define pancreatitis?

A
  • inflammation of the pancrease
56
Q

Explain acute pancreatitis?

A
  • adults
  • sudden onset of abdo pain
  • elevated serum amylase
57
Q

lipases in acute pancreatitis released by what?

A
  • intra and peri- pancreatic fat necrosis
58
Q

Proteases in acute pancreatitis released by what?

A
  • tissue destructing and haemorrhage
59
Q

Explain chronic pancreatitis?

A
  • relapsing disorder may develop insidiously of following bouts of acute pancreatitis
60
Q

What are the symptoms of gallstones?

A
  • Stone impacts in cystic duct
  • Gradual build-up pain in RUQ
  • Radiates to back/shoulders
  • Associated with indigestion/nausea
61
Q

What is the differential diagnoisis of acute epigastric pain?

A
  • Biliary colic (gallstones)
  • peptic ulcer disease
  • oesophageal spasm
  • myocardial infarction
  • acute pancreatitis
62
Q

How might gallstones be diagnosed?

A
  • ultrasound

- CT scan

63
Q

What is ascending cholangitis?

A
  • inflammation of the bile ducts
  • by ascending bacteria from the gut
  • tends to be if bile flow is bloked, by a gallstone in the common bile duct
64
Q

Functions of the pancreas?

A
  • Exocrine - Acinar cells secrete pancreatic enzymes

- Endocrine- Islets of Langerhans secrete hormones into blood

65
Q

Define pancreatitis?

A
  • An acute inflammatory process in the pancreas
66
Q

Clinical presentation of pancreatitis?

A
  • Acute onset epigastric pain
  • Radiating through to back
  • Very serve
  • Nausea and vomiting
  • Jaundice
67
Q

Name some pancreatic tumours

A
  • Adenocarcinoma (exocrine)

- Gastrinoma (endocrine)

68
Q

Symptoms of pancreatic tumours?

A

o Jaundice
o Weight loss
o Back pain

69
Q

Name some complications of reflux

A
  • ulceration
  • stricture
  • Barrett’s oesophagus
70
Q

What is the Z line?

A
  • where the squamous mucosa of the oesophagus meets the columnar mucosa of the stomach
71
Q

What would be seen down a microscope for reflux oesophagitis?

A
  • intraepithelial neutrophils, lymphocytes and eosinophils

- basal zone hyperplasia

72
Q

Name a benign tumour of the oseophagus?

A
  • squamous papilloma
73
Q

Name 2 malignant tumours of the oesophagus

A
  • squamous cell carcinoma

- adenocarcinoma

74
Q

What are the 3 mechanisms of metastases?

A
  • direct invasion
  • lymohatic permeation
  • vascular invasion
75
Q

Explain adjuvant therapy

A
  • therapy given in addition to primary or inital therapy, to mazimise its effectiveness
76
Q

3 factors which may lead to chronic gastritis?

A
  • autoimmume
  • bacteria
  • chemical
77
Q

H.pylori is a gram_________

A

gram negative curvilinear rod

78
Q

What causes chronic peptic ulcers?

A
  • increased acid production

- failure of mucosal defence

79
Q

What is maltoma?

A
  • gastric lymphoma
80
Q

Explain Zolinger Ellison Syndrome

A
  • gastrin secreting tumour
  • damages the mucosa
  • can cause recurrent peptic ulcers
81
Q

Where might carcinoid tumours originate?

A
  • appendix
82
Q

What are the 3 zones of the liver called?

A

Zone 1 = periportal
Zone 2 = mid acinar
Zone 3 = pericentral

83
Q

What are the potential consequences of acute liver failure?

A
  • complete recovery
  • chronic liver disease
  • death from liver failure
84
Q

Explain pre-hepatic jaundice?

A
  • too much haem breakdown
85
Q

Explain hepatic jaundice?

A
  • liver cells injured
86
Q

Explain post-hepatic jaundice?

A
  • blockage of bile to the bowel
87
Q

What are the complications of ccirrhosis?

A
  • portal hypertension
  • ascites
  • liver failure
88
Q

What are the complication of portal hypertension?

A
  • oesophageal varcies
  • captu medusa
  • haemorrhoids
89
Q

NASH stands for?

A
  • Non-Alcoholic SteatoHepatitis
90
Q

What patients get NASH?

A
  • diabetic
  • obese
  • hyperlipideamia
91
Q

Explain hep A

A
  • faecal-oral spread
  • no carriers exist
  • poor hygiene
  • hepatitis A IgM test
92
Q

Explain hep B

A
  • sex, blood, mother to child
  • carriers exist
  • HBsAg test
93
Q

What is hep D associated with?

A
  • only in co-existance with Hep B
94
Q

Explain hep C

A
  • similar to spread of hep B, less sex route
  • often asymptomatic
  • PCR test for RNA
95
Q

What are some causes of chronic hepatitis?

A
  • autoimmune hepatitis
  • hep B and C
  • primary biliary cirrhosis
  • primary sclerosis cholangitis
96
Q

Explain primary biliary cirrhosis

A
  • autoimmune
  • female
  • granulomas and bile duct loss seen
  • leads to cholestasis –> cirrhosis
97
Q

Explain autoimmune hepatitis

A
  • seen in pts. with additional allergies

- may have triggers

98
Q

Explain primary sclerosis cholengitis

A
  • associated with UC and Males

- increased risk of malignancy

99
Q

Define haemochromatosis?

A
  • excess iron within the liver
100
Q

Explain primary haemochromatosis?

A
  • autosomal recessive

- genetic condition

101
Q

What is Wilson’s disease?

A
  • autosomal recessive

- copper accumulates in the liver and brain

102
Q

What are common diseases of the large bowel?

A
  • diverticular disease
  • ischaemia
  • antibiotic induced colitis
103
Q

Explain diverticular disease

A
  • common
  • asymptomatic
  • related to low fibre diet and increased intralumenal pressure
104
Q

What are possible complications of diverticular disease?

A
  • diverticulitis
  • rupture
  • abscess
  • fistula
  • bleed
105
Q

Explain ischaemia of the bowel causes

A
  • left sided
  • CVS
  • AF
  • Embolus
  • shock
  • atherosclerosis
106
Q

Withering of crypts and pink smudy lamina propria, are signs of______

A
  • large bowel ischaemia
107
Q

Antibiotic induced colitis aetiology

A
  • patients on broad spectrum antibiotics
  • c.difficle toxin a and b
  • massive diarrhoea and bleeding
108
Q

Explosive lesions on mucosa are signs of

A
  • antibiotic induced colitis
109
Q

Explain collagenous colitis

A
  • thickened basement membrane
  • patchy disease
  • no chronic architectural changes
  • water diarrhoea
110
Q

Explain the main sign of lymphocytic colitis

A
  • intraepithelial lymphocytes raised

GI (36 decks)

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