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Gastrointestinal > Pathology of Small Bowel > Flashcards

Pathology of Small Bowel Flashcards

1
Q

types of ischaemia of the small bowel

A

mesenteric arterial occlusion
non occlusive perfusion insufficiency

usually acute but can be chronic

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2
Q

aetiology of ishcaemia of the small bowel - mesenteric arterial occlusion

A

mesenteric artery atherosclerosis

thromboembolism from heart (AF)

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3
Q

aetiology of ishcaemia of the small bowel - non occlusive perfusion insufficiency

A

shock
strangulation obstructing venous return (hernia, adhesion)
drugs (cocaine)
hyper viscosity

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4
Q

describe mucosa of the small bowel

A

most metabolically active part of bowel wall - most sensitive to effects of hypoxia

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5
Q

pathogenesis of ischaemia if small bowel - mesenteric arterial occlusion

A

longer the hypoxia the greater the depth of damage to the bowel wall and greater the likelihood of complications

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6
Q

pathogenies of ischaemia of small bowel - non occlusive ischaemia

A

tissue damage occurs after reperfusion

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7
Q

types of small bowel infarction

A

mucosal
mural
transmural

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8
Q

complications of ischaemia the small bowel

A

resolution
fibrosis, stricture, chronic ishcaemia, mesenteric angina and obstruction
gangrene, perforation, peritonitis, sepsis and death

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9
Q

what is Meckel’s Diverticulum

A

result of incomplete regression of Vitelli-intestinal duct

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10
Q

pathogenesis of Meckel’s Diverticulum

A

tubular structure, above IC valve

may contain heterotypic gastric mucosa

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11
Q

signs of Meckel’s Diverticulum

A

asymptomatic;
bleeding
perforation
diverticulitis mimicking appendicitis

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12
Q

tumours of the small bowel

A

primary - rare

secondary - common (ovary, colon and stomach)

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13
Q

primary tumours of the small bowel

A

lymphomas
carcinoid tumours
carcinomas

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14
Q

lymphomas of small bowel

A

rare all non Hodkins in type

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15
Q

pathology of lymphomas of small bowel

A

maltomas (B cell) derived

enteropathy associated T-cell lymphomas (associated with Coeliac disease)

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16
Q

treatment for lymphomas of small bowel

A

surgery and chemotherapy

17
Q

carcinoid tumours of small bowel

A

most commonly found in appendix
small, yellow, slow growing tumours
locally invasive

18
Q

pathology of carcinoid tumours of small bowel

A

can cause intussusception, obstruction

produces hormone like substances if metastases to liver producing flushing and diarrhoea

19
Q

describe carcinoma of small bowel

A

associated with Crohn’s disease and Coeliac disease

presents late

20
Q

pathology of carcinoma of small bowel

A

identical to colorectal carcinoma in appearance

metastases to lymph nodes and liver occurs

21
Q

describe appendicitis

A

common cause of acute abdomen

commoner in children but occurs in adults

22
Q

symptoms of appendicitis

A

vomiting
abdominal pain
right iliac fossa tenderness
increased white cell count

23
Q

aetiology of acute appendicitis

A 
unknown 
faecoliths (dehydration)
lymphoid hyperplasia 
parasites
tumours (rare)
24
Q

pathology of appendicitis

A

acute inflammation (neutrophils) involving muscles coat (mural)
mucosal ulceration
serosal congestion, exudate
pus in lumen

25
Q

complications of appenditics

A 
peritonitis 
rupture
abscess
fistula 
sepsis and liver abscess
26
Q

what is coeliac disease

A

abnormal reaction to constituent of wheat flour, gluten

27
Q

pathology of coeliac disease

A

effects small intestine;
damaging enterocytes - reducing absorptive capacity, loss of villous structure, loss of surface area, flat duodenal mucosa

28
Q

aetiology of coeliac disease

A

gliadin (component of gluten);
tissue injury as bystander effect
IEL and CD8 T cell mediated

29
Q

metabolic effects of coeliac disease

A

malabsorption

reduced intestine hormone production

30
Q

what substances does malabsorption affect

A 
fats
sugars
amino acids
water
electrolytes
31
Q

what does malabsorption of fats lead to

A

steatorrhea

32
Q

what does reduced intestinal hormone production lead to

A

reduced pancreatic secretion and bile flow (CCK) - leading to gallstones

33
Q

complications of malabsorption

A 
weight loss
anaemia 
abdominal bleeding 
failure to thrive
vitamin deficiencies 
T-cell lymphomas of GI tract
increased risk of small bowel carcinoma 
gallstones 
ulcerative-jejenoilleitis

Gastrointestinal (71 decks)

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