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Alimentary System > Pathology of Colon > Flashcards

Pathology of Colon Flashcards

1
Q

What does the portal venous system transmit?

A

Deoxygenated blood from most of the GI tract and GI organs to the liver

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2
Q

Hepatocytes receive oxygenated blood from the

A

hepatic artery

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3
Q

The mixture of oxygenated and deoxygenated blood received by the liver filters through the

A

sinusoids

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4
Q

The portal vein is formed from

A

the superior mesenteric and splenic veins

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5
Q

Where does the portal vein lie in relation to the hepatic artery and bile duct?

A

Posterior

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6
Q

The portal vein penetrates the right border of the

A

lesser omentum

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7
Q

The porto-systemic/porto-caval anastamosis is the

A

collateral communication between the portal and systemic venous systems

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8
Q

What are the types of ano-rectal conditions?

A

Congenital/acquired
Local/systemic
Benign/malignant
Early/late

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9
Q

What are the most common presentations of ano-rectal conditions?

A

Pain
Haemorrhage
Dysfunction

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10
Q

Ano-rectal conditions can be caused by;

A

Inflammation
Infection
Malignancy
Trauma

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11
Q

Give an example of A congenital an-rectal condition

A

Imperforate anus
Uro-genital fistulae
Hirschprung’s Myenteric Plexus Deficiency

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12
Q

Give 5 examples of acquired ano-rectal conditions

A 
Haemorrhoids 
Fissure 
Abscess 
Fistula-in-ano 
Ulceration 
Cancer 
Incontinence
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13
Q

What is the typical presentation of haemorrhoids?

A

Itching/irritation/pain around the anus
Painful bowel movements
Bleeding from anus after defaecation

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14
Q

What is the typical surgical treatment for haemorrhoids?

A

Stapled anopexy

Ultrasound guided ligation of haemorrhoids

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15
Q

What are the stagings of anal fissures?

A

Acute or chronic

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16
Q

At what point is an anal fissure classed as chronic

A

If it has been [resent for more than 6 weeks

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17
Q

How is an anal fissure treated?

A

By relaxing internal anal sphincter;
medically - topical nitric oxide, glyceryl trinitrate paste or diltiazem calcium blocker
surgically - internal lateral sphincterotomy

18
Q

What is the treatment for a peri-anal abscess?

A

Incision and drainage

19
Q

At what locations can a peri-anal abscess occur?

A

Submucosal
Intersphincteric
Ischiorectal
Perianal

20
Q

What is the typical presentation of fistula-in-ano?

A

Pain and swelling around the anus and pain during bowel movements

21
Q

How is a superficial fistula-in-ano treated?

A

Fistulotomy

22
Q

How is a trans-sphincteric fistula-in-ano treated?

A

Seton suture, fistula plug or permacol paste

23
Q

What are the causes of anal ulceration?

A

Crohn’s disease
Malignancy
Syphilis chancre
Nicorandil

24
Q

What is the treatment for anal squamous cell carcinoma?

A

Radiotherapy and surgery

25
Q

What is the treatment for rectal adenocarcinoma?

A

Neo-adjuvant chemo and radiotherapy and laparoscopic resection

26
Q

Give 6 causes of constipation

A 
Lack of fibre in diet 
Change in eating habits 
Ignoring urge to defaecate 
Immobility/lack of exercise 
Low fluid intake 
Anxiety/depression 
Antacids 
Antidepressants 
Anti-epileptics 
Calcium supplements 
Opiate painkillers 
Diuretics 
Iron supplements
27
Q

What do the majority of colorectal cancers arise from?

A

Pre-existing polyps

28
Q

What fraction of colorectal cancers are colonic and what fraction are rectal?

A

Two thirds colonic, one third rectal

29
Q

The majority of polyps are

A

adenomas

30
Q

What are the main histological types of polyps?

A

Tubular (75%)
Villous (10%)
Tubulovillous (15%)

31
Q

What appearances can polyps have?

A

Pedunculated

Sessile

32
Q

What is the basic pathogenesis of colorectal cancer from polyps?

A

Normal epithelium

  • > small adenoma (polyp)
  • > large adenoma
  • > invasive adenocarcinoma
33
Q

What is the typical presentation of colorectal cancer?

A

Persistent rectal bleeding
Altered bowel opening (particularly diarrhoea)
Iron deficiency anaemia
Palpable rectal or lower right abdominal mass
Acute colon obstruction (if stenosing tumour)
Systemic symptoms

34
Q

What are the sites of colorectal cancers?

A 
Ascending  colon
Transverse colon 
Descending colon 
Rectum 
Anus
35
Q

What is the most common histological type of colorectal carcinoma?

A

Adenocarcinoma

36
Q

What are the risk factors for developing colorectal carcinoma?

A

Lifestyle factors
Family history
IBD
Genetics

37
Q

What is the typical presentation of right sided colorectal carcinoma?

A

Anaemia
Vague pain
Weakness
Obstruction

38
Q

What is the typical presentation of left sided colorectal carcinoma?

A

Bleeding
Altered bowel habit
Obstruction

39
Q

What investigations would be done to diagnose colorectal cancer?

A

Colonoscopy
Barium enema
CT colongraphy
CT abdomen/pelvis

40
Q

What is the benefit of a colonoscopy?

A

Any polyps found can be removed and biopsies can be taken

41
Q

What staging investigations would be doe after a diagnosis of colorectal cancer had been reached?

A

CT chest, abdomen and pelvis
MRI scan for rectal tumours
PET/rectal endoscopic ultrasound in selected cases

42
Q

What are the treatment options for colorectal cancer?

A

Surgery - endoscopic if caught early enough
Stoma formation may be required
Removal of lymph nodes for histological analysis
Partial hepatectomy
Chemotherapy
Radiotherapy

Alimentary System (29 decks)

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