GI Pathology 2

Question 1

Bling ended out pouchings of bowel

Answer 1

Diverticular disease

Question 2

give an example of aquired diverticular disease

Answer 2

Meckle’s

Question 3

Where are diverticula commonly found?

Answer 3

Sigmoid colon, between mesenteric and anti-mesenteric taenia coli

Question 4

What is the cause of diverticular disease

Answer 4

Uncoordinated peristalsis- increase in intraluminal pressure

Points of relative weakness in the bowel wall

Question 5

Where in the bowel wall do penetrations occur?

Answer 5

At the arteries, where they enter the mucosa of the wall

Question 6

Clinical presentation of diverticula disease

Answer 6

Cramping abdominal pain

Alternating diarrhoea and constipation

Question 7

3 acute complications of diverticular disease

Answer 7

Diverticulitis/peridiverticular abscess
Perforation
Haemorrhage

Question 8

4 chronic complicatioons of diverticular disease

Answer 8

Intestinal obstruction
Fistula
Diverticular colitis
Polypoind prolapsing mucosal fold

Question 9

Which part of the bowel wall is colitis usually confined to?

Answer 9

Mucosa

Question 10

Give 3 causes of acute colitis

Answer 10

Acute infection (camplylocbacter, salmonella, CMV)
Antibiotics
Drugs

Question 11

Give a cause of chronic colitis

Answer 11

Chronic idiopathic inflammatory bowel disease

Question 12

What 2 diseases come under idiopathic inflammatory bowel disease

Answer 12

Crohns and UC

Question 13

Smoking is a) a risk factor, b)protective of which diseases

Answer 13

a) Crohns b)UC

Question 14

Which part of the colon do you find UC

Answer 14

Starts in the rectum, spreads to a variable extent along colon

Question 15

Crypt abscesses in crohn’s or UC?

Answer 15

UC

Question 16

Complications of UC

Answer 16

Toxic megacolon and perforation
Haemorrhage
Stricture
Carcinoma

Question 17

What part of the GI tract does Crohn’s affect?

Answer 17

Mouth to anus (most common form is ileocolic)

Question 18

Skip lesions- discontinuous cobblestoning, and granulomas in UC or Crohn’s

Answer 18

Crohn’s

Question 19

Mainly mucosal inflammation

Answer 19

UC

Question 20

transmural inflammation

Answer 20

Crohn’s

Question 21

Anal lesions more common

Answer 21

Crohn’s

Question 22

Fistulae more common

Answer 22

Crohn’s

Question 23

Strictures more common

Answer 23

Crohn’s

Question 24

Serositis

Answer 24

Crohn’s

Question 25

Inflammatory polyps more common

Answer 25

UC

Question 26

The name of the chronic liver disease, often in UC patients, which is a big risk factor for colorectal cancer

Answer 26

Primary sclerosing cholangitis

Question 27

Types of colorectoal polyps

Answer 27

Pedunculated Sessile Flat

Question 28

2 main types of non-neoplastic polyps

Answer 28

Hyperplastic | Hamartomatous

Question 29

Describe hyperplastic polyps

Answer 29

1-5mm in size, often multiple. Only when large (>10mm) and on the right side are they capable of becoming malignant.

Question 30

2 types of hamatomatous polyps

Answer 30

Peutz-jegher's | Juveline

Question 31

Juveline polyps are common in what age group, what do they look like, where are they found and what tpe of cancers are they associated with?

Answer 31

Teenagers and children Spherical and pedunculated Found in the rectum and distal colon Associated with colorectal cancer and gastric cancer

Question 32

AD condition- polyps

Answer 32

Peutz-Jeghers syndrome

Question 33

Multiple GI tract polyps and muco-cutaneous pigmentation (lips, buccal mucosa, fingers and toes)

Answer 33

Peutz Jeghers

Question 34

Peutz jeghers polyps are found where?

Answer 34

Small bowel

Question 35

Peutz jeghers syndrome predisposes you to what types of cancer?

Answer 35

colon, pancreas, stomach

Question 36

What type of benigh neoplastic polyp may be a precursor to colorectal cancer?

Answer 36

Adenoma

Question 37

What types of adenoma are most at risk of malignant change?

Answer 37

'flat' >10mm Vilous and tubulo villous HNPCC associated adenomas

Question 38

Risk factors for colorectal cancer

Answer 38

``` Diet Obesity Alcohol NSAIDs HRT and oral contraceptives Schistosomiasis Pelvic radiation UC, Crohns ```

Question 39

What staging is used for colorectal cancer

Answer 39

Duke's staging

Question 40

Dukes stage A

Answer 40

Confined to wall no lymph node metastasis

Question 41

Dukes stage B

Answer 41

Invades through wall, no lymph node metastasis

Question 42

Dukes stage C

Answer 42

Regional lymph node metastasis

Question 43

Dukes stage D

Answer 43

Distant metastasis present

Question 44

familial cancer syndrome with a 100% lifetime risk of large bowel cancer

Answer 44

FAP

Question 45

Familial cancer syndrome with a mutation in the APC tumour suppressor gene

Answer 45

FAP

Question 46

familial cancer syndrome with a 50-70% lifetime risk of large bowel cancer and other cancers

Answer 46

HNPCC

Question 47

familial cancer syndrome with a mutation in the DNA mismatch repair gene

Answer 47

HNPCC

Question 48

Most common colorectal cancer

Answer 48

Adenocarcinoma (>95%)