Colorectal pathology Flashcards by Stacey Hansen

This type of diarrhea is usually infectious (viral) and persists during fasting

Secretory

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This type of diarrhea can occur with GI preps and dissacharide deficiency

Osmotic

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This type of diarrhea occurs with IBD and infection

Exudative

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This describes watery diarrhea with normal endoscopic appearance

Microscopic colitis

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Chronic watery diarrhea in an older female with normal endoscopy may be this condition

Microscopic colitis

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What type of diarrhea occurs with Microscopic colitis?

Chronic watery diarrhea

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This age group and gender most commonly has Microscopic colitis

Older female (50-70)

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These are the two pathologic entities under Microscopic colitis

Lymphocytic colitis
Collagenous colitis

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Normal mucosa grossly, surface epithelial attenuation, and increased lymphocytes in surface epithelium occur in this condition

Lymphocytic colitis

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Normal mucosa grossly, surface epithelium attenuation, and increased collagen table thickness occurs in this condition

Collagenous colitis

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Changes in Microscopic colitis are most pronounced in this part of the GI tract

Right colon

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Inpatients receiving antibiotics have greater colonization with this organism, which can cause pseudomembranous colitis

C. diff

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C. diff secretes these two toxins which cause secretory diarrhea

Toxin A and toxin B

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Does C. diff cause sepsis?

No
(unless secondary infection from other organism)

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This is the most common cause of nosocomial (hospital-acquired) infectious diarrhea

Pseudomembranous colitis

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Is there bloody diarrhea in C. diff pseudomembranous colitis?

Minimal or none

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Secretory diarrhea with minimal or no blood, as well as toxic megacolon, occur in this condition

Pseudomembranous colitis

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Superficial mucosal erosion/ulceration - volcanic appearing exudate - is seen in this condition

Pseudomembranous colitis (C. diff)

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Fibrin rich membrane with numerous neutrophils is seen in this condition characterized by fever, crampy abdominal pain, and diarrhea

Pseudomembranous colitis

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This is the diagnostic test for Pseudomembranous colitis

EIA for toxin A/B or NAAT

only test symptomatic patients due to high carriage rate in normal population

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This is the largest cause of long-term morbidity in bone marrow transplant patients

Graft vs Host disease

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In graft vs host disease, these cells attack colonic epithelium, leading to apoptosis of enterocytes
Eventual crypt drop-out and mucosal fibrosis

T cells

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Apoptosis of enterocytes, with eventual crypt drop-out and mucosa fibrosis and watery sometimes bloody diarrhea, can be seen in this condition that often occurs after bone marrow transplant

Graft vs Host disease

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This condition occurs due to absence of ganglion cells in submucosa and muscularis propria

Hirschsprung disease

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Hirschsprung disease is due to an absence of this in submucosa and muscularis propria

Ganglion cells

This condition is also known as congenital aganglionic megacolon

Hirschsprung disease

Primary form of Hirschsprung disease is due to failure of this

Ganglion cell migration

Secondary form of Hirschsprung disease is due to either of these conditions

Chagas disease or CMV infection

Chagas disease or CMV infection can cause a secondary form of this condition, which is usually due to failure of cell migration

Hirschsprung disease

Is short- or -long segment Hirschsprung disease more common?

Short segment (limited to rectosigmoid colon in most) (some have disease proximal to sigmoid colon = long-segment HD)

Most cases of Hirschsprung disease are limited to this part of the GI tract

Rectosigmoid colon

Hirschsprung disease is associated with this syndrome

down syndrome

A neonate with failure to pass meconium, abdominal distention, and bilious emesis may have this condition which is most often limited to rectosigmoid colon

Hirschsprung disease

This condition is malformed mucosal/submucosal vessels in GI tract (dilated and thin walled)

Angiodysplasia

Does Angiodysplasia produce bloody stools?

Yes produce range of bleeding, can range from chronic intermittent or profuse and life threatening

This condition that causes major lower GI bleeding episodes is associated with aortic stenosis and end-stage renal disease

Angiodysplasia Lifetime of rhythmic contractions produces abnormal vessels

Angiodysplasia is more common in these locations of the GI tract

Cecum and right colon (less common in small intestine)

Ectatic (dilated) vascular channels present in superficial mucosa with minimal overlying tissue are seen morphologically in this condition

Angiodysplasia

Are vessels constricted or dilated in Angiodysplasia?

Dilated and thin walled

Outpouchings of mucosa into muscularis propria

Diverticulosis

Diverticulosis occurs at weak points, specifically these sites

Sites of vascular penetration of muscle layer

Low fiber diets, constipation, straining with defecation can result in this condition in which high intraluminal pressure push mucosa/submucosa through

Diverticulosis

This may result in Diverticulosis, and involves abscess formation, sinus tract, fistula tract, sigmoid stenosis

Diverticulitis

Abdominal pain, fever, leukocytosis (high WBCs) may occur in this condition in which obstructions and fistula drainage can occur if complicated

Diverticulitis

IBD with deep inflammation which occurs anywhere in GI tract, but favors ileum

Crohn’s disease

Inflammation in this IBD extends below muscularis mucosa

Crohn’s disease

Is inflammation in Crohn’s disease contiguous?

No; often multifocal, skip lesions

This IBD is often multifocal, non-contiguous

Crohn’s disease

This IBD produces serosal changes Serositis - fat wrapping

Crohn’s disease

This IBD commonly forms adhesions with adjacent structures (bowel, bladder, abdominal wall), adhesions may form fistulas

Crohn’s disease

In Crohn’s disease, deep inflammation may heal with these

Strictures

This age is the usual presentation of IBD

Teens/20s

This is the earliest lesion seen in Crohn’s disease

Aphthous ulcer

In Crohn’s disease, these extend into mucosa to form deep, "knife-like" linear ulcers

Aphthous ulcer

In this IBD, aphthous ulcers extend into mucosa to form deep, "knife-like" linear ulcers

Crohn’s disease

Crohn’s disease favors this location of the GI tract

Ileum/cecum less common in rectum but may involve anywhere in GI tract

Crohn’s disease usually spares this part of the GI tract

Rectum

Deep ulcers and islands of preserved mucosa form cobblestone appearance in this IBD

Crohn’s disease

What forms cobblestone appearance in Crohn’s disease?

Deep ulcers and islands of preserved mucosa

Segmental stenosis/strictures occur in this IBD

Crohn’s disease

Transmural inflammation, lymphoid aggregates along muscle-serosa junction with underlying serositis are seen morphologically in this condition

Crohn’s disease

Granulomas form in this IBD

Crohn’s disease

Uveitis, oral aphthous ulcers, polyarthritis, ankylosing spondylitis, and erythema nodosum are extraintestinal findings of this condition

IBD (Crohn’s disease and ulcerative colitis)

Serositis can produce fat wrapping in this condition

Crohn’s disease

Is diarrhea with blood more common in Crohn’s disease or Ulcerative colitis?

Ulcerative colitis

This IBD has obstructive symptoms more often

Crohn’s disease (strictures, fistulas, adhesions)

Anti-Saccharomyces cerevisiae antibodies are seen in this condition

Crohn’s disease (can also occur in UC)

IBD with mucosal inflammation limited to rectum and colon

Ulcerative colitis

Does inflammation extend below the mucosa in Ulcerative colitis?

Does Ulcerative colitis have skip lesions?

No - continuous involvement Extends proximally from rectum a variable distance

Does Ulcerative colitis form granulomas?

No - Crohn's does

Neutrophils in crypt epithelium and crypt lumens, forming cryptitis and crypt abscesses occur in this condition

IBD (Crohn's and UC)

Toxic megacolon often occurs in this IBD

Ulcerative colitis

This form of Ulcerative colitis is limited to rectum

Ulcerative proctitis

This form of Ulcerative colitis involves the entire colon

Pancolitis

Can inflammation of the ileum occur in Ulcerative colitis?

Yes - "Backwash ileitis" seen in Pancolitis

These are islands of normal or regenerating tissue seen in Ulcerative colitis

Pseudopolyps

In Ulcerative colitis, the ulceration (due to mucosal inflammation) is contiguous but these may fuse with one another to form mucosal bridges

Psuedopolyps

Surgical cure is possible with this form of IBD

Ulcerative colitis

Transmural inflammation occurs in this IBD

Crohn's disease this is what produces strictures and fistulas

Colorectal pathology Flashcards

(80 cards)