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GI > Pathology of the large intestine > Flashcards

Pathology of the large intestine Flashcards

1
Q

What is the longiduinal stripe on the large bowel?

A

Tenaie coli

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2
Q

What causes diverticular disease?

A

Low fibre diet and increased intralumenal pressure
Stool is solid so peristalsis has to work harder increasing intraluminal presure so that the mucosa of the colon herniates through the bowel wall

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3
Q

What are the 2 types of diverticular disease?

A

True (penetrates all of the walls of bowel such as meckel’s diverticulum)
False

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4
Q

What are the common complications of diverticular disease?

A 
Inflammation 
Rupture
Abscess
Fistula 
Massive bleeding
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5
Q

Who is likely to be affected by ischeamia of the large bowel?

A 
Elderly 
Left dises 
CVS disease 
Atherosclerosis of mesenteric vessels
Shock
A. Fib
Embolus
Vasculutis
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6
Q

What are the microscopic changes of ischaemia of the large bowel?

A

Withering of crypts and smudging of lamina propria

Eosinophilic change within the lamina propria

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7
Q

What are common complications of ischaemic colitis?

A

Massive bleeding
Rupture
Stricture

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8
Q

What causes pseudomembranous colitis?

A

Patients on broad spectrum antibiotics, C. diff selected out
Toxin A and B attack endothelium and epithelium

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9
Q

What are the symptoms of pseudomembranous colitis?

A

Massive diarrhoea

Bleeding

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10
Q

How is psedommebranous colitis treated?

A

Flagyl/vancomycin

Many need colectomy

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11
Q

What 4 antibiotics are known to cause C.diff?

A

Cephalosporins
Co-amoxiclav
Ciprofloxacin
Clindamycin

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12
Q

What are the different types of diarrhoea?

A

Blood
Mucus
Simply more watery version of normal stools

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13
Q

What is the histological finnsings of collagenous colitis?

A

Thick band of collagen in subepithelium due to an autoimmune reaction
Thickened basement membrane
Acssociated with intraepithelial inflammatory cells
No chronic architecular changes

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14
Q

What are the common signs of collagenous colitis?

A 
Water diarrhoea
Normal endoscopy 
Drug history (lansoprazole and NSAIDs have been associated with collaegnous colitis)
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15
Q

What are the histological changes in lymphocytic colitis?

A

No chronic architectural changes in cryps
Intraepithelial lymphocytes are raised
No thickening of BM

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16
Q

What should be looked for in the history when susepecting lymphocytic colitis?

A

Normal endoscopy

Raise possibility of coeliac disease

17
Q

What is the histological appearance of radiation colitis?

A

Disturbed colonic architecture, branches crypts, random distribution, not much inflammation, spaces in lamina propria

18
Q

What causes acute infective colitis?

A

Infection, rarely drugs, ischaemia, endoscopy prep

19
Q

What sort of bacteria can cause acute colitis?

A 
Salmonella
Shigella
Campylobacter
E. coli 
Cholera
20
Q

What does acute colitis look like?

A

Acute inflammation in the bowel wall without any chronci structural changes int the mucosa

21
Q

What is diverticular disease?

A

Mucosal herniation through muslce coat

22
Q

How is diverticulosis diagnosed?

A

Clinical
Barium enema
Sigmoidoscopy

23
Q

What are the clinical features of diverticulitis?

A

LIF pain/tenderness
Septic - high fever, tachycardia, tachypnoeic, hypotension
Altered bowel habit

24
Q

How is uncomplicated diverticulitis treated?

A

IV antibiotics - usually self-limiting

25
Q

How is complex diverticulitis treated?

A

Hartmann’s procedure
Primary resection / anastomosis
Percutaneous drainage
Laprascopic lavage and drainage

26
Q

What can cause acute and chronic colitis?

A

Infective colitis
Ulcerative colitis
Crohn’s colitis
Ischaemic colitis

27
Q

What are symptoms of colitis?

A 
Diarrhoea +/- blood
Abdominal cramps
Dehydration 
Sepsis
Weight loss
Anaemic
28
Q

How is colitis diagnosed?

A

Plain x-ray
Sigmoidoscpy and biopsy
Stool cultures
Barium enema

29
Q

How is UC/Crohn’s colitis treated?

A 
IV fluids
IV steroids 
GI rest 
Rescue medical therapy
Surgery
30
Q

What is colonic angiodysplasia?

A

Submucosal lakes of blood
Obscure cause of rectal bleeding
Usually right side of colon

31
Q

How is colonic angiodysplasia diagnosed?

A

Angiography

Colonoscopy

32
Q

How is colonic angiodysplasia treated?

A

Embolisation
Endoscopic ablation
Surgical resection

33
Q

What can cause large bowel obstruction?

A

Colorectal cancer
Benign stricture
Volvulus (common in sigmoid, transverse and caecum)

34
Q

How is large bowel obstruction treated?

A

Resuscitate
Operate
Stenting

35
Q

What can cause a sigmoid volvulus?

A

Bowel twists on mesentery

May become gangrenous

36
Q

How is sigmoid volvulus diagnosed?

A

Plain AXR

Rectal contrast

37
Q

What are examples of functional bowel disorders?

A

Chronic constipation

Faecal impaction

GI (42 decks)

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