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MB1: Gastrointestinal > Pathology > Flashcards

Pathology Flashcards

1
Q

cause of acute oesophagitis

A

corrosion following chemical ingestion

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2
Q

causes of chronic oesophagitis

A

GORD

Chron’s disease

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3
Q

complications of chronic oesophagitis

A

ulceration
stricture
barrett’s oesophagus

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4
Q

what is barrett’s oesophagus

A

replacement of stratified squamous epithelium by columnar epithelium

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5
Q

consequence of barrett’s oesophagus

A

increased risk of dysplasia and carcinoma

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6
Q

who does allergic oesophagitis affect mostly and what is the treatment

A

young males/asthmatics

steriods, chromolycate, montelukast

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7
Q

how common are benign oesophageal tumours

A

rare

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8
Q

name a benign oesophageal tumour

A

squamous papilloma

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9
Q

causes of squamous cell carcinoma

A

genes
oesophagitis
HPV
Smoking/alcohol/Vitamin A and zinc deficiency

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10
Q

in who is adenocarcinoma more common in

A

white, obese men

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11
Q

presentation of malignant oesophageal tumours

A

dysphagia
anaemia
weight loss
fatigue

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12
Q

what percentage of oral cancers are squamous cell

A

90%

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13
Q

where in the mouth may oral cancer present

A

floor of mouth, lateral border/ventral tongue, tonsillar pillars

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14
Q

causes of oral squamous cell carcinoma

A 
tobacco
alcohol
betel quid 
viral?
nutritional deficiency 
genes
post-transplant 
previous oral SCC
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15
Q

prognosis of oral SCC

A

40-50% in 5 years

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16
Q

What antibodies are the cause of chronic autoimmune gastritis

A

anti-parietal and anti-intrinsic factor antibodies

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17
Q

what is the most common cause of chronic gastritis

A

H.pylori

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18
Q

what chemical agents may cause chronic gastritis

A

NSAIDs, alcohol, bile reflux

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19
Q

what causes a peptic ulcer

A

breach of GI mucosa due to acid and pepsin attack

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20
Q

where are peptic ulcers most common

A

stomach and duodenum

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21
Q

a peptic ulcer has a layered appearance. what are the three layers

A

necrotic fibrinopurulent debris
granulation tissue
fibrotic scar tissue

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22
Q

complications of peptic ulcer

A

perforation
haemorrhage
stenosis
intractable

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23
Q

true/false - h.pylori has no effect on formation of adenocarcinoma

A

false - it increases the risk

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24
Q

describe gastric adenocarcinoma formation

A

chronic gastritis leads to atrophy and metaplasia

dysplasia and carcinoma are formed

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25
Q

where would a gastric lymphoma be found

A

mucosa associated lymphoid tissue

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26
Q

describe gastric lymphoma formation

A

continous chronic inflammation causes B cell proliferation

if continuous error may occur and mutated cell may replicte to cause low grade lymphoma

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27
Q

causes of mesenteric arterial occlusion

A

thromboembolism from heart

atherosclerosis

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28
Q

cause of non occlusive perfusion insufficiency

A

shock
venous return obstruction
drugs, cocaine
hyperviscosity

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29
Q

complications of small bowel ischaemia

A 
fibrosis 
stricture 
chronic ischaemia 
obstruction 
perforation 
peritonitis 
sepsis 
death
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30
Q

what is meckel’s diverticulum

A

incomplete regression of vitello-intestinal duct

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31
Q

where would you find meckel’s diverticulum, how long is it and what is the incidence

A

2 inches long
2 foot above IC valve
2% population

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32
Q

small bowel lymphomas are __ cell derived

A

B

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33
Q

where are carcinoid tumours most common

A

appendix

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34
Q

what diseases make small bowel carcinoma more common

A

chron’s and coeliac

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35
Q

in secondary bowel tumours, where are the primary sites most common

A

ovary, colon, stomach

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36
Q

in who is appendicitis most common

A

children

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37
Q

causes of appendicitis

A

foecolith
parasite
tumour
lymphoid hyperplasia

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38
Q

complications of appendicitis

A 
peritonitis 
rupture
abscess
fistula 
sepsis and liver abscess
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39
Q

what is coeliac disease

A

abnormal reaction to gluten, reducing absorption capacity

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40
Q

what is coeliac disease associated with

A

childhood diabetes, dermatitis, HLA-B8

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41
Q

describe the pathology of coeliac disease

A

gliadin (gluten) enters cells and causes immune response

IELS damage enterocytes so impaired illous structures, and loss of absorption

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42
Q

what type of biopsy is a sensitive way of diagnosing coeliac

A

duodenal biopsy

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43
Q

what serology can be done to check for coeliac disease

A

Anti-TTG
anti-gliadin
anti-endomesial

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44
Q

complications of coeliac

A

T cell lymphomas
small bowel carcinoma
gallstones
ulcerative-jejenoilleitis

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45
Q

what is the aetiology of IBD

A

it is unknown

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46
Q

what it chron’s disease and where does it affect

A

inflammation and ulceration of entire GI tract, mouth to anus

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47
Q

who is chron’s more common in

A

younger patients and men

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48
Q

true/false - all patients with chrons have lifelong exacerbation and remission

A

false - some go into lasting remission within 3 years

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49
Q

how would chron’s disease look histologically

A

increased infammatory cells and in 50% patients non caeseating granuloma

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50
Q

true/false - chrons has skip lesions and is segmental

A

true

51
Q

true/false - ulcerative colitis has skip lesions and is segmental

A

false

52
Q

complications of chrons

A 
malabsorption 
fistulas 
anal disease 
intractable disease 
obstruction 
perforation 
malignancy 
amyloid 
toxic megacolon
53
Q

what increases trigger risk for chrons

A

smoking and viral and mycobacterial agents

54
Q

what is ulcerative colitis and who is more likely to have it

A

inflammation and ulceration confined only to rectum and colon
younger patients and males

55
Q

complications of ulcerative colitis

A 
intractable disease 
toxic megacolon 
colorectal carcinoma 
blood loss 
electrolyte disturbance
56
Q

what are the extra-GI manifestations of ulcerative colitis

A 
uveitis 
pyoderma gangrenosum 
erythema nodosum 
arthritis 
primary sclerosing cholangitis
57
Q

true/false - chrons is more likely to cause colorectal carcinoma

A

false- ulcerative colitis is

58
Q

what is a polyp?

A

protrusion above epithelial surface- unspecified aetiology

59
Q

why must adenoma polyps be removed?

A

they may become adenocarcinoma

60
Q

primary treatment of adenocarcinoma

A

surgery

61
Q

3 stages of differentiation of adenocarcinoma

A

moderately differentiated
necrosis
invasive through muscularis propria

62
Q

what would a dukes A colorectal carcinoma look like?

A

confined by muscularis propria

63
Q

what would a dukes B colorectal carcinoma look like?

A

throught muscularis propria

64
Q

what would a dukes C colorectal carcinoma look like?

A

metastatic to lymph nodes

65
Q

most colorectal carcinoma is right/left sided

A

left

66
Q

symptoms of left sided colorectal carcinoma

A

blood PR, altered bowel habit obstruction

67
Q

symptoms of right sided colorectal carcinoma

A

anaemia, weight loss

68
Q

in what 3 ways may colorectal carcinoma appear

A

polypoid
stricturing
ulcerating

69
Q

where may colorectal carcinoma spread to locally, and most likely organ to spread to

A

mesorectum
peritoneum
liver

70
Q

what lymph nodes may colorectal carcinoma spread to

A

mesenteric

71
Q

features of HNPCC

A 
<100 polyps 
right sided
mucinous 
chrons like inflammation 
association with gasric/endometrial carcinoma
72
Q

features of FAP

A

> 100 polyps
throughout colon
no specific inflammatory response
associated with desmoid tumours and thyroid carcinoma

73
Q

what factors relate to diverticular disease

A

increased intralumenal pressure

Low fibre diet

74
Q

complications of diverticular disease

A 
inflammation
rupture 
abscess
fistula 
massive bleed
75
Q

to who and where does ischaemic colitis affect

A

elderly

left side of bowel

76
Q

cause of ischaemic colitis

A 
AF
emboli
shock 
vasculitis 
atherosclerosis of mesenteric vessels
77
Q

complications of ischaemic colitis

A

massive bleed
rupture
stricture

78
Q

withering of crypts, pink smudgy lamina propria and fewer chronic inflammatory cells are signs of

A

ischaemic colitis

79
Q

what is the cause of antibiotic induced colitis

A

broad spectrum antibiotics causing c diff overgrowth

80
Q

treatment of antibiotic related colitis

A

vancomycin/metronidazole

colectomy if severe

81
Q

what is raised in lymphocytic and collagenous colitis

A

IELs

82
Q

unique feature of radiation colitis

A

telangectasia

83
Q

describe the pathogenesis of liver disease

A

insult to hepatocytes causes inflammation leading to fibrosis and cirrhosis

84
Q

causes of acute liver failure q

A

alcohol
drugs
viral infection
bile duct obstruction

85
Q

outcomes of acute liver failure

A

death from liver failure
complete recovery
chronic liver disease

86
Q

what is pre hepatic jaundice and causes

A

too much haem broken down
haemolytic anaemia
haemolysis

87
Q

what is hepatic jaundice and causes

A 
dead/injured liver cells
alcoholic hepatitis 
acute liver failure 
cirrhosis 
bile duct loss
pregnancy
88
Q

what is post hepatic jaundice and causes

A 
bile cannot escape into bowel 
congenital biliary atresia 
gallstones block CBD
Stricture of CBD
tumour at head of pancreas
89
Q

causes of liver cirrhosis

A 
alcohol
hep B/C
iron overload 
autoimmune disease
gallstones
90
Q

complications of cirrhosis

A

portal hypertension
ascites
liver failure

91
Q

is an alcoholic fatty liver reversible?

what can it lead to?

A

yes, leads to hepatitis, reversible

leads to irreversible fibrosis and cirrhosis

92
Q

complications of alcoholic liver disease

A

cirrhosis
hepatocellular carcinoma
portal hypertension
malnutrition

93
Q

causes of NASH and who does it affect

A

non drinkers
hyperlipidaemia
diabetes
obesity

94
Q

outine Hep A

A

faecal-oral, short incubation
sporadic/endemic
mild illness, usually full recovery

95
Q

how is liver damage caused by hep B and describe its spread

A

antiviral immune response

blood/transfusion/sexually/vertically

96
Q

hep c is usually acute/chronic and its spread is ____

A

chronic

blood/transfusion/sexually

97
Q

rare causes viral hepatitis

A 
delta agent 
EBV
Yellow fever
HSV
CMV
98
Q

causes of chronic hepatitis

A

viral - Hep B/C
drugs
autoimmune disease

99
Q

autoimmune chronic hepatitis is more common in?

A

females

other autoimmune disease

100
Q

who is affected by primary biliary cirrhosis and how does biopsy appear

A

90% women

granulomas/bile duct loss

101
Q

who gets primary sclerosing cholangitis and what does it lead to

A 
men, UC 
malignancy possible 
periductal fibrosis 
duct destruction
jaundice
102
Q

what is haemochromatosis

A

excess iron in liver

103
Q

secondary haemochromotosis

A

iron overload from diet/transfusion/iron therapy

104
Q

primary haemocromotosis?

A

autosomal recessive
worse men
excess absorption from metabolism
fibrosis and cirrhosis

105
Q

complications of primary haemochromotosis

A

diabetes
heart failure
impotence

106
Q

what is alpha-1-antitrypsin deficiency

A

autosomal recessive disorder of enzyme inhibitor

causes emphysema and cirrhosis

107
Q

what is wilsons disease

A

recessive disorder of copper metabolism

108
Q

what does wilsons disease lead to

A

chronic hepatitis

neurological deterioration

109
Q

hepatocellular adenoma is benign/malignant, more common in men/women

A

benign

women

110
Q

complication of hepatocellular adenoma

A

bleed/rupture

111
Q

hepatocellular carcinoma is associated with?

prognosis?

A

HBV, HCV, cirrhosis

poor

112
Q

where are secondary mets to liver common from?

A 
colon
pancreas
stomach
breast
lung
113
Q

risk factors for cholesterol stones

A

female
obesity
genes
smoking

114
Q

risk factor for pigment stones

A

haemolytic anaemia

115
Q

complications of acute cholecystitis

A

infected bile forms empyema, rupture and peritonitis

116
Q

how does a chronically inflamed gallbladder look

A

thickened wall, no distention

117
Q

what type of cancer is gallbladder carcinoma

A

adenocarcinoma

118
Q

what type of carcinoma is cholangiocarcinoma and associations?

A

adenocarcinoma

primary sclerosing cholangitis and UC

119
Q

cause of acute pancreatitis

A 
alcohol
gallstones 
shock 
mumps 
hyperparathyroidism 
hypothermia 
trauma
iatrogenic
120
Q

what do lipases digest in autodigestion

A

intra/peripancreatic fat

121
Q

what do proteases digest in pancreatic autodigestion

A

tissue, causes haemorrhage

122
Q

complications of acute pancreatitis

A 
death 
shock 
pseudocyst
abscess
hypocalcaemia 
hyperglycaemia
123
Q

cause of chronic pancreatitis

A 
alcohol 
gallstones 
CF
hyperparathyroidism 
FHx
124
Q

where does pancreatic carcinoma spread to

A 
duodenum
stomach
spleen
lymph nodes 
liver

MB1: Gastrointestinal (19 decks)

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