Pathology of the Lower GI Flashcards

1
Q

Celiac, whipple disease giardia

A

small bowel diseases

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2
Q

colitis, IBS, IBD, diverticular disease, appendicitis

A

large bowel diseases

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3
Q

Host factors associated with celiac

A

Class II HLA-DQ2 or HLA DQ8

type 1 DM, thyroiditis, Sjogren

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4
Q

Bulky fatty diarrhea, flatulence, weight loss, anemia, nutritional deficiencies, growth failure in children

A

Classical presentation of celiac disease

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5
Q

Microscopic findings in celiac disease

A

villous blunting, intraepithelial lymphocytes

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6
Q

extra-intestinal complaints with celiac disease

A

fatigue, Fe deficiency, pubertal delay, short stature, canker sore

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7
Q

triad of diarrhea, weight loss, malabsorption

arthritis, lymphadenopathy, neurologic disease

middle-aged or elderly white males

A

Whipple disease

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8
Q

Whipple disease microscopic findings

A

swollen macrophages –> villi distension

macrophages filled with Whipple bacilli (PAS stain)

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9
Q

protozoan parasite –> chronic diarrhea, malabsorption flatulence, weight loss

A

giardia lamblia

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10
Q

Pathology: “schools of fish” in the duodenum

A

giardia lamblia

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11
Q

Pathogenesis of C diff colitis

A

disruption of normal colonic flora by antibiotic –> C diff overgrowth –> toxins released –> disruption of epithelial cytoskeleton, tight junction barrier loss, cytokine release, apoptosis

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12
Q

Histology: pseudomembranes (adherent layer of inflammatory cells and mucinous debris at sites of colonic mucosal injury), denuded surface epithelium, mucopurulent exudates

A

pseudomembranous colitis

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13
Q

most common cause of severe childhood diarrhea and diarrheal mortality worldwide

A

rotavirus

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14
Q

rotavirus pathophysiology

A

selectively infects and destroys mature enterocytes –> villus surface repopulated by immature secretory cells –> loss of absorptive function –> net secretion of water and electrolytes –> osmotic diarrhea –> dehydration

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15
Q

flask-shaped ulcers in cecum mucosa

severe dysentery-like, fulminant colitis

A

entamoeba histolytica parasitic enterocolitis

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16
Q

Stool exam –> ova and parasites

A

helminth infection enterocolitis

17
Q

Helminthic infections epidemiology

A

seen in nations with deficient sanitation systems, poor SES and hot, humid climates

18
Q

parasites in tropics, ingested from soil contaminated with feces

A

roundworm –> obstruction, perforation, growth retardation

19
Q

Histology: focal acute mucosal necrosis or full-thickness necrosis

A

ischemic colitis

20
Q

normal endoscopy, chronic non-bloody watery diarrhea without weight loss

A

microscopic colitis

21
Q

Histology: thickened subepithelial collagen layer

A

collagenous colitis

22
Q

Histology: increased intraepithelial lymphocytes

A

lymphocytic colitis

23
Q

Population with highest incidence of IBD

A

Female Ashkenazi Jews

24
Q

Th1 mediated IBD

25
Th2 mediated IBD
UC
26
Histology: crypt architectural distortion (chronic), cyptitis, crypt abscess
active chronic colitis (IBD)
27
outpouchings lined by mucosa, submucosa and variable amounts of muscularis propria
diverticulosis
28
diverticulitis histology
diverticulum becomes infiltrated with acute, then chronic inflammatory cells extension of infection --> mucosal ulceration, pericolonic abscesses, fistulas
29
appendicitis histology
mucosal ulceration, transmural acute and chronic inflammation, extension of inflammation into the mesoappendix