Pathology of GI Flashcards
Give 4 common symptoms of GI disease
Nausea and vomiting
Diarrhoea
Dyspepsia and heartburn
Abdominal pain and heartburn
What affected organs present as upper abdomen pain?
Stomach – Gastritis
Gall Bladder – Gall stone in common bile duct
Duodenum – Peptic ulcer
What affected organs present as lower abdomen?
Appendix – Appendicitis
Large intestine – Crohn’s disease, Ulcerative Colitis
*Bladder – Infection
What affected organs present as back pain?
Pancreas – Pancreatitis
Colon – Crohn’s disease, Ulcerative Colitis
*Kidney (upper back) – UTI, kidney stones
Name signs of upper GI disease
Weight loss
Dysphagia
Ulceration
Bleeding
What are the 4 types of GI bleeding
Melena, haematochezia, haematemesis, faecal occult bleeding
What is melena?
Black stool caused by haemoglobin being altered by enzymes
What is haematochezia?
bright red fresh blood through ANUS
What is haematemesis?
Vomiting blood
What is faecal occult bleeding?
Blood in faeces that is not visibly apparent
What are sign of Crohn’s in the face and hands?
Angular cheilitis, facial swelling, orofacial ganulomatosis, beefy tongue, oral ulcers and joint pain
What are sign of coeliac disease in the face and hands?
Pallor of face and hands blistering rash, bruising and swelling of hands.
Name 2 signs of ulcerative colitis in face and hands
Angular cheilitis and finger clubbing
What 6 investigations can be used for GI queries
- Stool analysis
- Urea Breath Test
❖ HELICOBACTER PYLORI converts urea → CO2 + Ammonia - Full Blood Count
- Endoscopy
❖ To assess a mass or ulcer - Biopsy
- Ultrasound
What is acute abdomen?
Sudden onset of severe abdominal pain developing over a short period of time
What are the surgical and medical causes of acute abdomen?
Surgical - ruptured aortic aneurysm, perforation of organ
Medical - addisons disease, diabetic ketoacidosis
What is the aetiology, pathogenesis, symptoms, investigations, complications and pathological appearance (macro and micro) of gastritis and peptic ulcers
❖ Aetiology ▪ HELICOBACTER PYLORI, NSAIDS, alcohol ❖ Pathogenesis ▪ INFLAMMATION of the INNER LINING of the stomach ❖ Symptoms ▪ Nausea and vomiting ▪ Abdominal bloating ▪ Abdominal pain ▪ Dyspepsia ❖ Investigation ▪ Endoscopy ▪ Urea breath test ❖ Complications ▪ Vomiting blood ▪ Perforation of stomach wall ❖ Pathological Appearance ▪ Macroscopic [ Oval shaped with slightly raised boarders ▪ Microscopic [ Necrosis, granulation tissue, fibrosis
What is the aetiology, pathogenesis, symptoms, investigations, complications and pathological appearance of coeliac disease?
❖ Aetiology ▪ AUTOIMMUNE DISEASE triggered by GLUTEN ❖ Pathogenesis ▪ Hereditary intolerance to GLUTEN ▪ Gluten stimulates ANTIBODIES that damage the INNER LINING of the small intestine, resulting in FLATTENING of the VILLI ❖ Symptoms ▪ Diarrhoea ▪ Weakness and fatigue ▪ Abdominal pain ▪ Weight loss ❖ Investigation ▪ IgA TTG ▪ Endoscopy ❖ Complications ▪ Malnutrition ▪ Bone loss ▪ Lactose intolerant ❖ Pathological Appearance ▪ Villous atrophy
What is the aetiology, pathogenesis, symptoms, investigations, complications and pathological appearance of Crohn’s disease?
Aetiology ▪ NO SPECIFIC CAUSE (unknown) ❖ Pathogenesis ▪ Various GENETIC ABNORMALITIES that lead to an OVERLY AGGRESSIVE T-CELL response to a subset of commensal enteric bacteria ❖ Symptoms ▪ Mucosal ulceration ▪ Mucosal swelling ▪ Angular cheilitis [ Consider CANDIDA infection FIRST ▪ Full width gingivitis ▪ Mucosal tags ▪ Abdominal pain ❖ Investigation ▪ Biopsy ❖ Complications ▪ Small bowel obstruction ▪ Fistula formation ▪ Nutrition deficiency ▪ Colon cancer
Macroscopic appearances of small intestine:
Thickened wall, narrowed lumen, cobblestoning
of mucosa
Microscopic appearances from biopsy:
Non-caseating granulomata (non-necrotizing),
transmural inflammation (affects whole
thickness of wall)
Histology of Crohn’s?
Stratified squamous epithelium of buccal
mucosa
Granuloma – Accumulation of epithelioid
macrophages/histiocytes
What is the aetiology, pathogenesis, symptoms, investigations, complications and pathological appearance of Ulcerative Colitis?
❖ Aetiology ▪ Unknown ❖ Pathogenesis ▪ Various GENETIC ABNORMALITIES that lead to an OVERLY AGGRESSIVE T-CELL response to a subset of commensal enteric bacteria ❖ Symptoms ▪ Diarrhoea with bleeding ▪ Mucosal ulcers ▪ Pyostomatitis vegetans – Definitive symptom ▪ Fever ▪ Weight loss ❖ Investigation ▪ Endoscopy with biopsy ❖ Complications ▪ Severe bleeding ▪ Perforated colon ▪ Colon cancer ▪ Nutrition deficiency
Name 4 conditions predisposing to malignancy
Intestinal metaplasia
Dysplasia
Adenomatous polyp
Polyposis syndromes
What is the aetiology pathophysiology an symptoms, complications and risk factors of intestinal metaplasia?
❖ Aetiology ▪ GASTROESOPHAGEAL REFLUX DISEASE (GERD) ▪ Usually driven by INFLAMMATORY processes ❖ Pathophysiology ▪ REPLACEMENT of normal SQUAMOUS epithelium with a normal GLANDULAR epithelium resembling those in the intestine in the WRONG PLACE ❖ Symptoms ▪ Heartburn ▪ Dysphagia ▪ Halitosis ▪ Vomiting ❖ Complications ▪ May lead to ADENOCARCINOMA ❖ Risk factors: ▪ Smoking ▪ Alcohol
What is the definition and significance of dysplasia of the GI
❖ Definition
▪ HISTOLOGICAL DISTURBANCE in the way the EPITHELIUM is ORGANISED
❖ Significance
▪ May or may not be cancer, may be next to cancer
▪ GRADE of DYSPLASIA signifies LIKELIHOOD of development of cancer
▪ Likelihood of low grade dysplasia transforming into high grade dysplasia is LOW
▪ High grade dysplasia indicates transformation into MALIGNANCY
