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GI - Year 2 > Pathology of Colon > Flashcards

Pathology of Colon Flashcards

1
Q

What is peristalsis mediated by in both small and large bowels?

A

Intrinsic (myenteric plexus)

Extrinsic (autonomic innervation)

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2
Q

Where is Meissener’s plexus?

A

Base of the submucosa

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3
Q

Where is Auerbach plexus?

A

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

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4
Q

What is idiopathic inflammatory bowel disease?

A

Chronic inflammation from inappropriate + persistent activation of muscosal immune system by presence of normal intraluminal flora

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5
Q

What are the 2 main IBDs?

A

Crohn’s disease

Ulcerative colitis

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6
Q

What is the main difference between crohns and ulcerative colitis?

A

CD can affect any part of GIT

UC limited to colon

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7
Q

What is the cause of IBD?

A

Exaggerated immune response

15% have affected 1st degree relative

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8
Q

What gene mutation is associated with CD?

A

NOD2

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9
Q

What gene has associations in UC?

A

HLA

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10
Q

What is the role of intestinal flora in the cause of IBD?

A

Defects in mucosal barrier could allow microbes access to mucosal lymphoid tissue triggering immune response

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11
Q

What test is used in diagnosis of IBD?

A

pANCA
+ve in 75% of UC
+ve in 11% of CD

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12
Q

What is the effect of UC?

A

Inflammation
Rectum to proximal
Pseudopolyps and ulceration can occur
Serosal surface usually minimal or no inflammation

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13
Q

What is the main difference in histology between UC and CD?

A 
UC = no granulomas
CD = non-caseating granulomas
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14
Q

What are the complications of UC?

A

Flat epithelial atypia = adenomatous change = invasive cancer
Haemorrhage
Perforation
Toxic dilatation

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15
Q

What are the effects of CD?

A 
Wrapping mesenteric fat
Mesentery = thickened, oedematous, fibrotic
Wall thick
Narrow lumen
Ulceration
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16
Q

What are the long term features of CD?

A 
Malabsorption in the small intestine
Strictures
Fistulas/abscesses
Perforation
Increased risk of cancer
17
Q

What is ischaemic enteritis?

A

When blood flow to the intestines are restricted

18
Q

Acute occlusion of which vessels leads to infarction?

A

Coeliac artery
Inferior mesenteric artery
Superior mesenteric artery

19
Q

What are predisposing conditions for ischaemia?

A

Arterial thrombosis
Arterial embolism
Non-occlusive ischaemia

20
Q

What can be seen in histology of acute ischaemia?

A

Oedema
Interstitial haemorrhages
Sloughing necrosis
Vascular dilatation

21
Q

What happens in chronic ischaemia?

A 
Mucosal inflammation
Ulceration
Submucosal inflammation
Fibrosis
Stricture
22
Q

What is radiation colitis?

A

Radiation damages the small/large bowel
Damage depends on dose
Radiation targets fast dividing cells which are also blood vessels and crypt epithelium

23
Q

What are the symptoms of radiation colitis?

A 
Anorexia
Abdominal cramps
Diarrhoea
Malabsorption
Chronic - mimics IBD
24
Q

What are histological features in radiation colitis?

A 
Inflammation - crypt abscesses and eosinophils
Later-arterial stenosis
Ulceration
Necrosis
Haemorrhage
Perforation
25
Q

What is appendicitis?

A

Acute inflammation of the appendix due to obstruction

26
Q

What are the histological features of appendicitis?

A 
Fibrinopurulent exudate
Perforation
Abscess
Inflammation in wall
Pus in lumen
Acute gangrenous
27
Q

What are the types of adenoma?

A

Tubular (90% in colon)
Villous
Tubulovillous

28
Q

What are the risk factors of colorectal carcinoma?

A

Lifestyle
FH
IBD
Genetics (FAP, HNPCC, Peutz-Jeghers)

29
Q

What are the features of right sided colorectal adenocarcinoma?

A 
Exophytic/polypod
Anaemia
Vague pain
Weakness
Obstruction
30
Q

What are the features of left sided colorectal adenocarcinoma?

A

Annular
Bleeding
Altered bowel habit
Obstruction

GI - Year 2 (39 decks)

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