Flashcards in GI Pathology 2 Deck (48):
1
Bling ended out pouchings of bowel
Diverticular disease
2
give an example of aquired diverticular disease
Meckle's
3
Where are diverticula commonly found?
Sigmoid colon, between mesenteric and anti-mesenteric taenia coli
4
What is the cause of diverticular disease
Uncoordinated peristalsis- increase in intraluminal pressure
Points of relative weakness in the bowel wall
5
Where in the bowel wall do penetrations occur?
At the arteries, where they enter the mucosa of the wall
6
Clinical presentation of diverticula disease
Cramping abdominal pain
Alternating diarrhoea and constipation
7
3 acute complications of diverticular disease
Diverticulitis/peridiverticular abscess
Perforation
Haemorrhage
8
4 chronic complicatioons of diverticular disease
Intestinal obstruction
Fistula
Diverticular colitis
Polypoind prolapsing mucosal fold
9
Which part of the bowel wall is colitis usually confined to?
Mucosa
10
Give 3 causes of acute colitis
Acute infection (camplylocbacter, salmonella, CMV)
Antibiotics
Drugs
11
Give a cause of chronic colitis
Chronic idiopathic inflammatory bowel disease
12
What 2 diseases come under idiopathic inflammatory bowel disease
Crohns and UC
13
Smoking is a) a risk factor, b)protective of which diseases
a) Crohns b)UC
14
Which part of the colon do you find UC
Starts in the rectum, spreads to a variable extent along colon
15
Crypt abscesses in crohn's or UC?
UC
16
Complications of UC
Toxic megacolon and perforation
Haemorrhage
Stricture
Carcinoma
17
What part of the GI tract does Crohn's affect?
Mouth to anus (most common form is ileocolic)
18
Skip lesions- discontinuous cobblestoning, and granulomas in UC or Crohn's
Crohn's
19
Mainly mucosal inflammation
UC
20
transmural inflammation
Crohn's
21
Anal lesions more common
Crohn's
22
Fistulae more common
Crohn's
23
Strictures more common
Crohn's
24
Serositis
Crohn's
25
Inflammatory polyps more common
UC
26
The name of the chronic liver disease, often in UC patients, which is a big risk factor for colorectal cancer
Primary sclerosing cholangitis
27
Types of colorectoal polyps
Pedunculated
Sessile
Flat
28
2 main types of non-neoplastic polyps
Hyperplastic
Hamartomatous
29
Describe hyperplastic polyps
1-5mm in size, often multiple. Only when large (>10mm) and on the right side are they capable of becoming malignant.
30
2 types of hamatomatous polyps
Peutz-jegher's
Juveline
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?
Teenagers and children
Spherical and pedunculated
Found in the rectum and distal colon
Associated with colorectal cancer and gastric cancer
32
AD condition- polyps
Peutz-Jeghers syndrome
33
Multiple GI tract polyps and muco-cutaneous pigmentation (lips, buccal mucosa, fingers and toes)
Peutz Jeghers
34
Peutz jeghers polyps are found where?
Small bowel
35
Peutz jeghers syndrome predisposes you to what types of cancer?
colon, pancreas, stomach
36
What type of benigh neoplastic polyp may be a precursor to colorectal cancer?
Adenoma
37
What types of adenoma are most at risk of malignant change?
'flat'
>10mm
Vilous and tubulo villous
HNPCC associated adenomas
38
Risk factors for colorectal cancer
Diet
Obesity
Alcohol
NSAIDs
HRT and oral contraceptives
Schistosomiasis
Pelvic radiation
UC, Crohns
39
What staging is used for colorectal cancer
Duke's staging
40
Dukes stage A
Confined to wall no lymph node metastasis
41
Dukes stage B
Invades through wall, no lymph node metastasis
42
Dukes stage C
Regional lymph node metastasis
43
Dukes stage D
Distant metastasis present
44
familial cancer syndrome with a 100% lifetime risk of large bowel cancer
FAP
45
Familial cancer syndrome with a mutation in the APC tumour suppressor gene
FAP
46
familial cancer syndrome with a 50-70% lifetime risk of large bowel cancer and other cancers
HNPCC
47
familial cancer syndrome with a mutation in the DNA mismatch repair gene
HNPCC
48