pathology of large bowel + colorectal cancer Flashcards

1
Q

what is diverticular disease

A

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

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2
Q

which area is most likely to be affected by diverticular disease

A

sigmoid colon

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3
Q

what factors can contribute to DD

A

low fibre, high fatty duet

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4
Q

what is true DD compared to false

A

all layers of bowel affected, false only serosa and mucosal

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5
Q

what is diverticulitis

A

inflammation of diverticulum

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6
Q

what are the symptoms of diverticulitis

A

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

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7
Q

what are the symptoms of diverticular disease

A

asymptomatic until complications

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8
Q

how is diverticular disease discovered

A

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

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9
Q

what are some complications of diverticular disease

A

perforation, fistula, intestinal obstruction, bleeding, mucosal inflammation

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10
Q

for uncomplicated diverticular disease what would the treatment be

A

IV fluids and antibiotics

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11
Q

for complicated diverticular disease what would the treatment be

A

hartmann’s procedure, percutaneous drain

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12
Q

name some symptoms of colitis

A

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

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13
Q

what are investigations for colitis

A

AXR, sigmoidoscopy, stool

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14
Q

what is the treatment for colitis

A

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

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15
Q

what arteries are normally occluded for ischaemic colitis

A

superior or inferior mesenteric arteries. left sided disease

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16
Q

what is the aiteology for ischaemic bowel disease

A

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

17
Q

what bacteria can cause antibiotic induced pseudomembranous colitis

18
Q

how does C diff cause colitis

A

produce toxins A and B which attack epithelium

19
Q

what is the treatment for C diff colitis

A

flagyl and vancomycin

20
Q

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

A

watery diarrhoea, increases thickness of basement membrane

21
Q

what causes lymphocytic colitis and what are the symptoms

A

intraepithelial lymphocytes are raised, watery diarrhoea

22
Q

what is radiation colitis

A

telangiectasia, from cancer causes vessel damage

23
Q

what is the main cause of acute colitis

24
Q

what is colonic angiodysplasia

A

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

25
what is the investigations and treatment for colonic angiodysplasia
CT angiography, colonoscopy, injection or surgery
26
what can cause large bowel obstruction
cancer, faecal impaction, pseudo-obstruction, volvulus (twist)
27
how do you diagnose large bowel obstruction and treat it
X ray, resuscitate and operate