5: Pathology of the large intestine Flashcards Preview

Gastrointestinal Week 4 2016/17 > 5: Pathology of the large intestine > Flashcards

Flashcards in 5: Pathology of the large intestine Deck (36):
1

Out-pouching found in the large bowel via endoscopy indicate ____ disease.

diverticular

2

What is a diverticulum?

Herniation of the mucosa through the muscle coat

3

What can happen to diverticula to produce disease?

Inflammation

Perforation

Bleeding

Blockage

4

What collects in diverticula?

Faeces

Bacteria

5

Why do diverticulae become inflamed?

What does the initial diverticulosis progress to?

Blockage (e.g with seeds, food products)

Diverticulitis

6

What dietary factor is associated with diverticular disease?

Low fibre diet

7

Symptoms only occur if the diverticular disease is ___.

complicated

8

What name is given to inflammation of diverticulae?

Diverticulitis

9

If inflammation weakens the walls of diverticulae, what can happen?

Rupture

10

If pus/faeces/bacteria leak from a ruptured diverticulum into the abdominal cavity, what can develop?

Peritonitis

11

What can develop on the walls of the colon following diverticular rupture?

Abscesses

pain, fever

12

What can develop between viscera following diverticular disease?

Fistula

13

What organ, close to the large bowel, can develop a fistula following diverticular disease?

Bladder

14

Why can diverticular disease cause blood in the stool?

Massive bleeding

15

Why does low fibre intake cause diverticular disease?

Stool is more liquidy, harder to move along colon than solid

Greater pressure contractions, produces diverticular disease

16

How are most cases of diverticular disease treated?

Surgery

17

Who commonly develops ischaemia of the large bowel?

Elderly people

Those at risk of atherosclerosis

18

What side of the large bowel tends to become ischaemic?

Left side

around the splenic flexure

19

What disease process and which vessels are affected to produce large bowel ischaemia?

Atherosclerosis

S / I mesenteric arteries

20

"withering of crypts"

"pink smudgy lamina propria"

"few chronic inflam. cells"

indicators of large bowel ischaemia

21

What are some complications of ischaemic colitis?

Haemorrhage

Rupture

Stricture --> obstruction due to fibrosis following ischaemia

22

What does a patient have if you find patchy membranes stuck to mucosa throughout the colonic wall?

Anti-biotic induced colitis

"Pseudomembranous" colitis

23

"volcano like fibrinopurulent exudate lesions"

"flamethrower like"

antibiotic-induced pseudomembranous colitis

24

What drugs cause the patchy membranous colitis seen all over the colonic wall?

Broad spectrum antibiotics

25

Which bacteria produces toxins to kill the epithelium of the colon following broad spectrum antbiotic treatment?

C. difficile

26

What drug can be used to treat infection following antibiotic-induced colitis?

Oral vancomycin

27

What is wrong with a patient's large bowel if they have watery diarrhoea?

Collagenous colitis

One of the microscopic colitis diseases - nothing can be seen grossly

28

What becomes thicker and more prominent in the epithelial cells of patients with collagenous colitis (with watery diarrhoea)?

Thickened basal lamina

29

What drugs can cause microscopic collagenous colitis?

NSAIDs

30

Another patient has watery diarrhoea. Under the microscope they have increased numbers of IELs reminiscent of Coeliac disease. What disease do they actually have?

Lymphocytic colitis

increased numbers of IELs

31

What disease may someone have if they show microscopic lymphocytic colitis?

Coeliac disease

32

What are the two types of microscopic colitis?

Collagenous

Lymphocytic

33

thick walled blood vessels

inflammation

disturbed crypts

indicators of radiation induced coltis

34

What is radiation induced colitis caused by?

Cancer treatment

e.g chemo/radiotherapy

35

What should be asked about in the history of someone with suspected radiation-induced colitis?

Past medical history

(previous history of cancer?)

36

Acute colitis is commonly caused by ___.

infection