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GI > Pathology- Large Intestine > Flashcards

Pathology- Large Intestine Flashcards

1
Q

what is psuedomembranous colitis

A

antibiotic induced colitis

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2
Q

what can a blocked and inflamed diverticulae cause

A

abscesses, fibrosis, strictures, adhesions

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3
Q

what are the symptoms of diverticular disease

A

often symptomatic, symptoms only if complicated

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4
Q

what is the difference between a true and a false diverticulum

A

True diverticula involve all layers of the structure, including muscularis propria and adventitia, such as Meckel’s diverticulum.

False diverticula (also known as “pseudodiverticula”) do not involve muscular layers or adventitia. False diverticula, in the GI tract for instance, involve only the submucosa and mucosa.

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5
Q

what is diverticular disease of the large bowel associated with

A

low fibre diet and increased intralumenal pressure (compacts stools)

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6
Q

what are the complications of diverticular disease of the large bowel

A

inflammation, rupture, abscess (can erode into artery), fistula, massive bleeding

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7
Q

is merkels diverticulum true or false

A

true

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8
Q

what does ischaemia of the large bowel look like microscopically

A

destruction of colonic mucosae- withering of crypts and smudging of lamina propria

pink smudgy lamina propria

fewer chronic inflammatory cells

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9
Q

what can cause ischaemia of the large bowel

A

CVS disease- atherosclerosis of mesenteric vessels

A Fib- shock, as blood supply prioritised

Embolus- Vasculitis

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10
Q

what does the SMA supply in the gut

A

small bowel and proximal colon

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11
Q

what does the IMA supply in the gut

A

the large intestine

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12
Q

what is the most metabolically active part of the bowel

A

the mucosa

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13
Q

what is the usual clinical context of ischaemic colitis

A

elderly people, left sided, segmental on endoscopy

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14
Q

what are the complications of ischaemic colitis

A

massive bleeding, rupture, stricture

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15
Q

where is a speckeled colonic lining seen

A

antibiotic induced ‘pseudomembranous’ colitis

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16
Q

what does pseudomembranous colitis look like endoscopically

A

patchy yellow membranous exudate on mucosal surface

17
Q

what does antibiotic induce colitis look like microscopically

A

explosive fibrinopurulent exudate on surface, explosive lesions of mucosa- volcano, crypts dead, everything inside crytps and blood make plaques on top of damaged epithelium

18
Q

who gets pseudomembranous colitis

A

patients on broad spectrum antibiotics

19
Q

what causes antibiotic induced colitis

A

C diff overgrowthm toxins A and B attack endothelium and epithelium

20
Q

what are the symptoms of antibiotic induced colitis

A

massive diarrhoea and bleeding- could be fatal

21
Q

how is antibiotic induced colitis treated

A

flagyl/vancomycin , may need colectomy

22
Q

what causes watery diarrhoea, a patchy thickened basement membrane, normal endoscopy, no chronic architectural changes,

A

collagenous colitis

23
Q

what is collagenous colitis

A

autoimmune disease of the colon of unknown aetiology

24
Q

what causes the diarrhoea in collagenous colitis

A

thick band of collagen beneath epithelial cells- increase in sub epithelial collagen

25
Q

what inflammatory cells are associated with collagenous colitis

A

intraepithelial inflammatory cells

26
Q

what causes watery diarrhoea, normal mucosa and crypt architecture, a massive increase in intra-epithelial lymphocytes

A

lymphocytic colitis

27
Q

what causes the diarrhoea in lymphocytic colitis

A

the presence of lymphocytes creates defects in epithelial barrier

28
Q

what is telangectasia

A

a condition in which widened venules (tiny blood vessels) cause threadlike red lines or patterns on the skin

29
Q

what is seen microscopically in radiation colitis

A

Bizarre stromal cells, bizzarre vessels, pinpoint haemorrhages in rectum, Random distribution
Vascular spaces- expanded capillaries

30
Q

how does radiotherapy kill cancer

A

one way is to kill blood vessels supplying the tumour

31
Q

what can cause general inflammation of the colon, a busy epithelium with crypt regularity, B cells moving into lumen in florid diffuce acute cryptitis, focal acute cryptitis as neutrophils try to get into colonic crypts to get to bacteria

A

acute infective colitis

32
Q

what usually causes acute colitis

A

infection- rarely drugs, ischaemia, endoscopy prep

GI (64 decks)

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