pathology of large bowel + colorectal cancer

Question 1

what is diverticular disease

Answer 1

divertoculosis, the presence of diverticulum which is an outpouching/ herniation of epithelial lining in bowel

Question 2

which area is most likely to be affected by diverticular disease

Answer 2

sigmoid colon

Question 3

what factors can contribute to DD

Answer 3

low fibre, high fatty duet

Question 4

what is true DD compared to false

Answer 4

all layers of bowel affected, false only serosa and mucosal

Question 5

what is diverticulitis

Answer 5

inflammation of diverticulum

Question 6

what are the symptoms of diverticulitis

Answer 6

common in elderly, left illiac fossa pain/ tenderness, altered bowel habits

Question 7

what are the symptoms of diverticular disease

Answer 7

asymptomatic until complications

Question 8

how is diverticular disease discovered

Answer 8

often accidentally by colonoscopy or barium, gold is USS or sigmoidoscopy

Question 9

what are some complications of diverticular disease

Answer 9

perforation, fistula, intestinal obstruction, bleeding, mucosal inflammation

Question 10

for uncomplicated diverticular disease what would the treatment be

Answer 10

IV fluids and antibiotics

Question 11

for complicated diverticular disease what would the treatment be

Answer 11

hartmann’s procedure, percutaneous drain

Question 12

name some symptoms of colitis

Answer 12

diarrhoea and blood, abdominal cramps, dehydration, weight loss/ anaemia

Question 13

what are investigations for colitis

Answer 13

AXR, sigmoidoscopy, stool

Question 14

what is the treatment for colitis

Answer 14

IV fluids, IV steroids (if not ischaemic or infective), GI rest. Surgery last resort

Question 15

what arteries are normally occluded for ischaemic colitis

Answer 15

superior or inferior mesenteric arteries. left sided disease

Question 16

what is the aiteology for ischaemic bowel disease

Answer 16

AF, CVD, old, atherosclerosis, withering of crypts and smudged lamina propria

Question 17

what bacteria can cause antibiotic induced pseudomembranous colitis

Answer 17

C diff

Question 18

how does C diff cause colitis

Answer 18

produce toxins A and B which attack epithelium

Question 19

what is the treatment for C diff colitis

Answer 19

flagyl and vancomycin

Question 20

what is the main symptom for collagenous colitis and what causes it

Answer 20

watery diarrhoea, increases thickness of basement membrane

Question 21

what causes lymphocytic colitis and what are the symptoms

Answer 21

intraepithelial lymphocytes are raised, watery diarrhoea

Question 22

what is radiation colitis

Answer 22

telangiectasia, from cancer causes vessel damage

Question 23

what is the main cause of acute colitis

Answer 23

infection

Question 24

what is colonic angiodysplasia

Answer 24

submucosal lakes of blood, is an obscure cause of rectal bleeding and is normally right sided

Question 25

what is the investigations and treatment for colonic angiodysplasia

Answer 25

CT angiography, colonoscopy, injection or surgery

Question 26

what can cause large bowel obstruction

Answer 26

cancer, faecal impaction, pseudo-obstruction, volvulus (twist)

Question 27

how do you diagnose large bowel obstruction and treat it

Answer 27

X ray, resuscitate and operate