CH10 - Gastrointestinal Pathology Flashcards Preview

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Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
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241

What is involved in inflammation with ulcerative colitis?

Crypt abscesses with neutrophils

242

What is the gross appearance of ulcerative colitis?

Pseudopolyps, loss of haustra ? lead pipe sign on imaging

243

What are the complications for ulcerative colitis?

Toxic megacolon and carcinoma

244

For ulcerative colitis what is the risk based on?

Its based on extent of colonic involvement and duration of disease (generally not a concern until >10 years of disease)

245

What are the associations for ulcerative colitis?

Primary sclerosing cholangitis and p-ANCA positivity

246

What is the effect of smoking on ulcerative colitis?

Smoking protects against it

247

What is the wall involvement for crohns disease?

Full thickness inflammation with knife like fissures

248

What is the location for Chrons disease?

Anywhere from mouth to anus with skip lesions

249

What is the most common and least common site for chrons disease?

Most common is the terminal ileum and the least common is the rectum

250

What are the symptoms for chron?s disease?

Right lower quadrant pain (ileum) with non bloody diarrhea

251

What is involved with the inflammation in Crohn?s disease?

Lymphoid aggregates with granulomas (40% of cases)

252

What is the gross appearance of Crohn Disease?

Cobblestone mucosa, creeping fat, and strictures (string sign on imaging)

253

What are the complications for Crohns Disease?

Malabsorption with nutritional deficiency, calcium oxalate nephrolithiasis, fistula formation, and carcinoma if colonic disease is present

254

What are the associations for Crohns disease?

Ankylosing spondylitis, sacroiliitis, migratory polyarthritis, erythema nodosum and uveitis

255

What effect does smoking have on Crohns disease?

It increases the risk for developing Crohns disease

256

What is hirschsprung disease?

Defective relaxation and peristalsis of rectum and distal sigmoid colon

257

What is hirschsprung disease associated with?

Down syndrome

258

What is hirschsprung disease due to?

congenital failure of ganglion cells which are neural crest-derived, to descend into myenteric and submucosal plexus

259

Where is the myenteric (Auerbach) plexus located?

between the inner circular and outer longitudinal muscle layers of the muscularis propria and regulates motility

260

Where is the submucosal (Meissner) plexus located?

in the submucosa and regulates blood flow, secretions, and absorption.

261

What are the clinical features for hirschsprung disease based on?

Obstruction

262

What are the clinical features for hirschsprung disease?

1. Failure to pass meconium 2. Empty rectal vault on digital rectal exam 3. Massive dilatation (megacolon) of bowel proximal to obstruction with risk for rupture

263

In hirschsprung disease what does rectal suction biopsy reveal?

lack of ganglion cells.

264

What is the treatment for hirschsprung disease?

involves resection of the involved bowel; ganglion cells are present in the bowel proximal to the diseased segment.

265

What is colonic diverticula?

Outpouchings of mucosa and submucosa through the muscularis propria (false diverticulum)

266

What is colonic diverticula related to?

wall stress

267

What is colonic diverticula associated with?

constipation, straining, and low-fiber diet; commonly seen in older adults (risk increases with age)

268

From where does the colonic diverticula arise?

where the vasa recta traverse the muscularis propria (weak point in colonic wall)

269

What is the most common location for colonic diverticula?

sigmoid colon

270

What are usually the symptoms for colonic diverticula?

Its usually asymptomatic