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GI System > Pathology of Colon > Flashcards

Pathology of Colon Flashcards

1
Q

What is the small and large bowel peristalsis mediated by?

A

Intrinsically - Myenteric plexus

Extrinsic neural control - Autonomic innervation

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2
Q

Where is the Meissner’s plexus (Part of the myenteric plexus) found?

A

Base of the submucosa

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3
Q

Where is Auerbach’s plexus found?

A

Between the inner circular and out longitudinal layers of the muscularis propria

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4
Q

Is the duodenum intraperitoneal or retroperitoneal?

A

Retroperitoneal

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5
Q

Histologically, in the small intestine, what are the three cell types present and what are the three levels of the bowel wall?

A

Goblet, Columnar absorptive & Endocrine

Lamina propria, Muscularis mucosa & Submucosa

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6
Q

How long is the rectum and how much of it is extraperitoneal?

A

15cm

Distal 7cm

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7
Q

Histologically, what is the large bowel like?

A

No villi present

Flat with tubular crypts and the surface is made of columnar absorptive cells

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8
Q

What three types of cell may the crypts in the large bowel contain?

A

Goblet
Endocrine
Stem

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9
Q

What IBD of the lower GI Tract are there? (5)

A 
UC
CD
Appendicitis
Ischaemic colitis
Radiation colitis
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10
Q

What drives the mucosal immune system to be activated?

A

The presence of normal intraluminal flora e.g. H. pylori

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11
Q

When diagnosing a patient what is it best to do?

A

Have a conversation - It could be? What it might be? No definitive answers

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12
Q

Where must UC originate from and where is it limited to?

A

Rectum

Colon

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13
Q

Where can UC never just present?

A

Caecum

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14
Q

What organ can be involved with UC and its systemic manifestations?

A

Appendix

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15
Q

In UC, what does the ulceration erode and what might the UC have?

A

Mucosa

Pseudopolyps

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16
Q

In UC, does the serosal surface have any inflammation?

A

Minimal or none at all

17
Q

What kind of fibrosis occurs in UC?

A

Submucosal fibrosis

18
Q

How is dysplasia categorised in UC?

A

High or Low grade

19
Q

What complications of UC are there?

A

Haemorrhage
Perforation
Toxic dilatation

20
Q

How does the mesentery thicken and fibrose in CD?

A

Granular serosa/dull grey wraps around the mesenteric fat

21
Q

Histologically, how does CD appear? (4)

A

Cryptitis and crypt abscesses with atrophy leading to crypt destruction
Deep ulceration
Fibrosis is present
Contains non-caseating granulomas

22
Q

What are the long term features of CD? (5)

A 
Small Intestine has malabsorption
Strictures
Fistulas & Abscesses
Perforation
Increased risk of cancer
23
Q

Where does Ischaemic Enteritis affect?

A 
Small Intestine
or
Large Intestine
or
Both at the same time
24
Q

What happens if one of the Coeliac, Inferior and Superior mesenteric arteries become occluded?

A

Infarction

Gradual occlusion will have little effect

25
Q

What type of occlusion is less common?

A

Mesenteric venous

26
Q

Histologically, how does acute ischaemia appear?

A

Oedema with interstitial haemorrhages
Initial absence of inflammation
Within 1-4 days bacteria gangrene and perforation has occured

27
Q

Why is splenic flexure vulnerable?

A

It has an arterial sharp demarcation as the venous fades gradually

28
Q

What is indicative of chronic ischaemia?

A 
Mucosal inflammation
Ulceration
Submucosal inflammation
Fibrosis
Stricture
29
Q

Radiation colitis - What does abdominal irradiation impair?

A

The normal proliferative activity of the small and large bowel’s epithelium

30
Q

What are the symptoms of radiation colitis?

A

Anorexia
Abdominal cramps
Diarrhoea
Malabsorption

31
Q

Histologically, how does radiation colitis appear?

A 
Inflammation of crypt abscesses and eosinophils
Necrosis
Ulceration
Haemorrhage
Perforation
32
Q

What is appendicitis?

A

Inflammation of the appendix causing tissue to regress with age and it has fibrous obliteration

33
Q

Histologically, how does appendicitis appear?

A

Exudate
Perforation
Abscess
Acute gangrene leads to full thickness necrosis

34
Q

In dysplasia, how does the adenoma present?

A 
Tubular
or 
Villous 
or 
Tubulovillous
*90% of tubular occur in the colon*
35
Q

What is the main type of tumour in colorectal carcinoma?

A

Adenocarcinoma (98%)

36
Q

What are the risk factors for colorectal carcinoma?

A

Lifestyle
Family history
IBD
Genetics e.g. FAP & HNPCC

37
Q

What are the two most common sites of metastases for colorectal carcinoma?

A

Liver

Lung

38
Q

What are the signs of right sided (Ascending colon) adenocarcinoma?

A 
Exophytic/polypoid
Anaemia
Vague pain
Weakness
Obstruction
39
Q

What are the signs of left sided (Descending colon) adenocarcinoma?

A

Annular - Napkin ring lesion
Bleeding - Fresh/altered blood PR
Altered bowel habit
Obstruction

GI System (38 decks)

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