pathology of the colon Flashcards

1
Q

Describe the length of the small intestine

A

Duodenum - 25 cm
Jejunum - 2.5m
ileum - 3.5m

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2
Q

What innervates the peristalsis of the small and large intestine

A

Intrinsic - myenteric plexus
Extrinsic - autonomic control

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3
Q

Describe the myenteric plexus

A

Meissener’s plexus - base of the submucosa

Auerbach plexus - between the inner circular and outer longitudinal layers of the muscularis propria

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4
Q

What are the 2 main inflammatory bowel disease

A

Crohn’s disease
Ulcerative colitis

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5
Q

What parts of the body does crohns disease affect

A

Anywhere in the GI tract from the mouth to the anus

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6
Q

What parts of the body does ulcerative colitis affect

A

Colon

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7
Q

What gene is associated with Crohns disease and ulcerative colitis

A

NOD2 - Crohns
HLA - ulcerative colitis

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8
Q

What does a 1st degree relative do to the chances of getting inflammatory bowel disease

A

Increase - 15% of cases have a 1st degree relative affected

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9
Q

What is used to diagnose Inflammatory bowel disease

A

History
radiography
positive pANCA can help but not eliminate if negative

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10
Q

Who is most at risk of ulcerative colitis

A

M>F
20-30 and 70-80

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11
Q

Where in the colon does ulcerative colitis affect usually

A

Distal end of colon and spread proximally

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12
Q

What is backwash ileitis in ulcerative colitis

A

inflammation moves to the ileum from the caecum - only exception with ulcerative colitis not affecting the colon as well as appendix

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13
Q

Describe pathology of Ulcerative colitis

A

Continuous inflammation
Pseudopolyps
Ulceration
no granulomas
crypt abscesses
Doesn’t go through every layer of the tissue

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14
Q

Who is most at risk of Crohns disease

A

F>M
peaks 20-30 and 60-70 but any age
Caucasions and jewish population most common

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15
Q

Describe pathology of Crohns disease

A

Sharp demarcation between the skip lesions of affected tissue
Oedamatous
Cobblestone appearance with ulceration
Non caseating granulomas
Fibromas
Transmural inflammation - occurs throughout the entire wall

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16
Q

What is ischaemic colitis

A

Blood supply to the bowel is impinged - insufficient blood supply to the bowel which leads to cell death

17
Q

What is enteritis

A

Inflammation of the small intestine

18
Q

What does pain at McBurney’s point and pain that started at umbilicus and goes to right inguinal region suggest

A

Appendicitis

19
Q

What increases the risk of colorectal adenocarcinoma

A

IBD

genetics;
FAP
HNPCC
peutz-jeghers

20
Q

How does right sided colorectal adenocarcinoma present

A

Exophytic/Polypoid
Anaemia
Altered blood PR
Vague pain
Weakness
Obstruction

21
Q

how does left sided colorectal adenocarcinoma present

A

Annular
Napkin ring lesion
Bleeding
Fresh/altered blood PR
Altered bowel habit
Obstruction

22
Q

Why can left sided colorectal adenocarcinoma obstruct more than the right

A

The faeces have all the water absorbed by the time they get to the left side of the colon