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JL Gastrointestinal > Pathology of the Small Bowel > Flashcards

Pathology of the Small Bowel Flashcards

1
Q

What can mesenteric artery atherosclerosis and thromboembolism from the heart (AF) cause?

A

Mesenteric arterial occlusion leading to small bowel ischaemia

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2
Q

What drugs can lead to non occlusive perfusion insufficiency?

A

Cocaine

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3
Q

What is the most metabolically active part of the bowel wall?

A

Mucosa, so most sensitive to hypoxia

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4
Q

In non occlusive ischaemia, what does much of the tissue damage occur after?

A

Reperfusion

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5
Q

What are gangrene, perforation, peritonitis, sepsis and death all complications of?

A

Ischaemia of the small bowel

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6
Q

What is a result of incomplete regression of vitello-intestinal duct?

A

Meckel’s Diverticulum

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7
Q

What is the rule of twos in Meckel’s Diverticulum?

A

2 inches long, 2 foot above ileocaecal valve in 2% of people

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8
Q

What kind of structure are Meckel’s Diverticulum?

A

Tubular

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9
Q

What might Meckel’s diverticulum contain?

A

Heterotopic gastric mucosa

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10
Q

What does Meckel’s diverticulum mimick, with bleeding, perforation, or diverticulitis?

A

Appendicitis

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11
Q

What three organs can give secondary tumours to the small bowel?

A

Ovary, colon, stomach

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12
Q

What are three primary tumours of the small bowel?

A
  1. Lymphomas
  2. Carcinoid tumours
  3. Carcinomas
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13
Q

What are lymphomas of the small bowel like in relation to type?

A

Non Hodkins

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14
Q

What are lymphomas of the small bowel derived from?

A

Maltomas (B-cell) derived

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15
Q

What does enteropathy associated T cell lymphomas (associated with coeliac disease), occur in?

A

Lymphomas of small bowel

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16
Q

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

A

Appendix

17
Q

What are small, yellow, slow growing tumours?

A

Carcinoid tumours of small bowel

18
Q

What can carcinoid tumours of small bowel cause?

A

Intussusception and obstruction

19
Q

What happens when carcinoid tumour of small bowel metastases to the liver?

A

A carcinoid syndrome occurs producing flushing and diarrhoea

20
Q

What two conditions is carcinoma of the small bowel associated with?

A

Crohn’s disease and coeliac disease

21
Q

What happens to WWC in appendicitis?

A

Increases

22
Q

What are 4 pathological features of acute appendicitis?

A
  1. Acute inflammation (neutrophils)
  2. Mucosal ulceration
  3. Serosal congestion, exudate
  4. Pus in lumen
23
Q

What type of exudate is seen in acute appendicitis?

A

Yellow surface exudate

24
Q

What is caused by an abnormal reaction to a constituent of wheat, flour, gluten which damages enterocytes and reduces absorptive capacity?

A

Coeliac disease

25
Q

What condition has a strong associated with HLA-B8 and dermatitis herpetiformis?

A

Coeliac disease

26
Q

What is the suspected component of gluten that is the toxic agent in coeliac disease?

A

Gliadin

27
Q

What is coeliac disease mediated by?

A

T lymphocytes which exist within the small intestine epithelium

28
Q

What is the normal lifespan of an enterocyte?

A

72 hours

29
Q

In coeliac disease, what is there an increasing loss of enterocytes due to?

A

IEL mediated damage

30
Q

What 4 things occur as a result of increasing loss of enterocytes due to IEL mediated damage?

A
  1. Loss of villous structure
  2. Loss of surface area
  3. Reduction in absorption
  4. Flat duodenal mucosa
31
Q

What is coeliac morphology like?

A

Flat mucosal biopsy with total villous atrophy

32
Q

In coeliac disease, where is the lesion worse?

A

Proximal bowel so duodenal biopsy is very sensitive

33
Q

What 3 antibodies can be found in serology for coeliac disease?

A
  1. Anti-TTG
  2. Anti-endomesial
  3. Anti-gliadin
34
Q

What happens to sugars, fats, amino acids, water and electrolytes in coeliac disease?

A

Malabsorption

35
Q

What does malabsorption of fats lead to?

A

Steatorrhoea

36
Q

What can reduced intestinal hormone production lead to? (Coeliac disease)

A

Reduced pancreatic secretion and bile flow leading to gallstones

JL Gastrointestinal (33 decks)

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