GI Pathology 2 Flashcards

1
Q

Bling ended out pouchings of bowel

A

Diverticular disease

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2
Q

give an example of aquired diverticular disease

A

Meckle’s

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3
Q

Where are diverticula commonly found?

A

Sigmoid colon, between mesenteric and anti-mesenteric taenia coli

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4
Q

What is the cause of diverticular disease

A

Uncoordinated peristalsis- increase in intraluminal pressure

Points of relative weakness in the bowel wall

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5
Q

Where in the bowel wall do penetrations occur?

A

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

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6
Q

Clinical presentation of diverticula disease

A

Cramping abdominal pain

Alternating diarrhoea and constipation

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7
Q

3 acute complications of diverticular disease

A

Diverticulitis/peridiverticular abscess
Perforation
Haemorrhage

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8
Q

4 chronic complicatioons of diverticular disease

A

Intestinal obstruction
Fistula
Diverticular colitis
Polypoind prolapsing mucosal fold

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9
Q

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

A

Mucosa

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10
Q

Give 3 causes of acute colitis

A

Acute infection (camplylocbacter, salmonella, CMV)
Antibiotics
Drugs

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11
Q

Give a cause of chronic colitis

A

Chronic idiopathic inflammatory bowel disease

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12
Q

What 2 diseases come under idiopathic inflammatory bowel disease

A

Crohns and UC

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13
Q

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

A

a) Crohns b)UC

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14
Q

Which part of the colon do you find UC

A

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

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15
Q

Crypt abscesses in crohn’s or UC?

A

UC

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16
Q

Complications of UC

A

Toxic megacolon and perforation
Haemorrhage
Stricture
Carcinoma

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17
Q

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

A

Mouth to anus (most common form is ileocolic)

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18
Q

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

A

Crohn’s

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19
Q

Mainly mucosal inflammation

A

UC

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20
Q

transmural inflammation

A

Crohn’s

21
Q

Anal lesions more common

A

Crohn’s

22
Q

Fistulae more common

A

Crohn’s

23
Q

Strictures more common

A

Crohn’s

24
Q

Serositis

A

Crohn’s

25
Q

Inflammatory polyps more common

A

UC

26
Q

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

A

Primary sclerosing cholangitis

27
Q

Types of colorectoal polyps

A

Pedunculated
Sessile
Flat

28
Q

2 main types of non-neoplastic polyps

A

Hyperplastic

Hamartomatous

29
Q

Describe hyperplastic polyps

A

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

30
Q

2 types of hamatomatous polyps

A

Peutz-jegher’s

Juveline

31
Q

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?

A

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

32
Q

AD condition- polyps

A

Peutz-Jeghers syndrome

33
Q

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

A

Peutz Jeghers

34
Q

Peutz jeghers polyps are found where?

A

Small bowel

35
Q

Peutz jeghers syndrome predisposes you to what types of cancer?

A

colon, pancreas, stomach

36
Q

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

A

Adenoma

37
Q

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

A

‘flat’
>10mm
Vilous and tubulo villous
HNPCC associated adenomas

38
Q

Risk factors for colorectal cancer

A
Diet
Obesity
Alcohol
NSAIDs
HRT and oral contraceptives
Schistosomiasis
Pelvic radiation
UC, Crohns
39
Q

What staging is used for colorectal cancer

A

Duke’s staging

40
Q

Dukes stage A

A

Confined to wall no lymph node metastasis

41
Q

Dukes stage B

A

Invades through wall, no lymph node metastasis

42
Q

Dukes stage C

A

Regional lymph node metastasis

43
Q

Dukes stage D

A

Distant metastasis present

44
Q

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

A

FAP

45
Q

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

A

FAP

46
Q

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

A

HNPCC

47
Q

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

A

HNPCC

48
Q

Most common colorectal cancer

A

Adenocarcinoma (>95%)