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Gastro > Pathology of the Small Bowel > Flashcards

Pathology of the Small Bowel Flashcards

1
Q

What are the 2 main causes of ischaemia of the small bowel

A

Mesenteric arterial occlusion

Non occlusive perfusion insufficiency

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2
Q

Is bowel ischamia acute or chronic

A

Usually acute but can be chronic

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3
Q

What can cause mesenteric arterial occlusion

A

Mesenteric artery atherosclerosis

THromboembolism from heart

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4
Q

What can cause non occlusive perfusion insufficiency

A

Shock
Strangulation obstructing venous return
Drugs (cocaine)
Hyperviscosity

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5
Q

What is the most metabolically active part of the bowel wall

A

The mucosa- most sensitive to the effects of hypoxia

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6
Q

What happens to the cyrpts in muscosal infarction

A

They die

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7
Q

What are 3 complications of ischaemia of the small bowel

A

Resolution
Fibrosis, stricture, chronic ischaemia
mesenteric angina and bstruction
Gangrene, perforation, peritonitis, sepsis and death

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8
Q

What is Meckel’s Diverticulum

A

A congenital abnormality which is a result of incomplete regression of vitello-intestinal duct

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9
Q

What might Meckel’s diverticulum mimic

A

Appendicitis

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10
Q

Are primary or secondary tumours more common

A

Secondary (metastases)

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11
Q

Tumours of the small bowel are metastases from which 3 places

A

Ovary
Colon
Stomach

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12
Q

What are 3 types of primary tumours of the small bowel

A

Lymphomas
Carcinoid tumours
Carcinomas (Adenocarcinomas)

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13
Q

What are all lymphomas of the small bowel

A

Non Hodkins in type

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14
Q

How can we treat lymphomas of the small bowel

A

Treated by surgery and chemotherapy

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15
Q

Where is the commonest site of carcinoid tumours of the small bowel

A

Appendix

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16
Q

Describe the typical appearance of carcinoid tumours of the small bowel

A

Small, yellow, slow growing tumours

17
Q

Describe the typical appearance of carcinoid tumours of the small bowel

A

Small, yellow, slow growing tumours

18
Q

What are carcinomas of the small bowel commonly associated with

A

Crohn’s disease and Coeliac disease

19
Q

Where do carcinomas of the small bowel metastasise to?

A

Lymph nodes and liver

20
Q

What are 4 common presentations of appendicitis

A

Vomiting
Abdo pain
RIF tenderness
Increased WCC

21
Q

What causes acute appendicitis

A 
Unknown 
Faecoliths (dehydration)
Lymphoid hyperplasia 
Parasites
Tumours (rare)
22
Q

What must acute inflammation involve in appendicitis

A

Muscle coat

23
Q

What are 5 complications of appendicitis

A 
Peritonitis
Rupture
Abscess
Fistula 
Sepsis and liver abscess
24
Q

What is coeliac diseased

A

Caused by an abnormal reaction to a constituent of what flour, gluten, which damages enterocytes and reduces absorptive capacity
It is a lifelong condition

25
Q

What 2 things is coeliac disease associated with

A

dematitis herpetiformis

childhood diabetes

26
Q

When can coeliac disease present

A

Childhood, middle age or adulthood

27
Q

When can coeliac disease present

A

Childhood, middle age or adulthood

28
Q

What is the suspected toxic agent

A

Gliadin (a protein component of gluten)

29
Q

What are the 2 clinical features of coeliac disease

A

Mucosa may be endoscopically normal or appear attenuated

Lesion worse in proximal bowel so duodenal biopsy is very sensitive (not an ileal biopsy)

30
Q

What is tested in serology

A

Antibodies: anti-TTG, anti-endomesial, anti-gliadin

31
Q

What are 2 metabolic effects of coeliac disease

A

Malabsorbtion of sugars, fats, amino acids, water and electroyltes
Malabsorption of fats leads to steatorrhowa

32
Q

What can reduce pancreatic secretion and bile flow leading to gallstones

A

Reduced intestinal hormone production

33
Q

What are 5 presentations of coeliac disease

A 
Loss of weight 
Anaemia (Fe, Vit B12, Folate)
Abdominal bloating
Failure to thrive
Vitamin deficiencies
34
Q

What are 4 complications of coleiac disease

A

T cell lymphomas of GI tract
Increased risk of small bowel carcinoma
Gall stones
Ulcerative- jejenoilleitis

Gastro (67 decks)

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