GI pathology II

Question 1

What is the first phase of nutrient absorption?

Answer 1

Intraluminal digestion: proteins, carbohydrates and fats are broken down to forms suitable for digestion

Question 2

Describe the terminal digestion phase

Answer 2

Hydrolysis of carbohydrates and peptides by disacchardiases and peptidases at brush border of small bowel

Question 3

Describe transepithelial transport phase

Answer 3

Nutrients, fluid and electrolytes are transported across the epithelial cell membrane and processed within the cell

Question 4

What is the common protein involved in celiac?

Answer 4

Gliadin

Question 5

What is the best serologic test for GSE (Celiac)?

Answer 5

Anti-tissue transglutaminase (tTG)

Question 6

What are oral manifestations of GSE?

Answer 6

Apthous stomatitis

Question 7

What are some etiologies of colitis?

Answer 7

• Infections
• Necrotizing enterocolitits
• Antibiotic associated (Pseudomembranous colitis)
• Ischemic colitis
• Idiopathic inflammatory bowel disease

Question 8

Pseudo membranous colitis is associated with what?

Answer 8

Broad spectrum antibiotic use

Question 9

How does pseudo membranous colitis appear histologically?

Answer 9

MUSHROOM CLOUD!

Surface epi denuded

Superficially damaged crypts distended by mucopurulent exudate which erupts to form a mushroom cloud

Question 10

What are some pseudomembranous colitis oral cavity manifestations?

Answer 10

Oral candidiasis

Question 11

Describe crohn’s disease

Answer 11

Granulomatous inflammation which can affect any part of GIT from mouth to anus

Question 12

Describe ulcerative colitis

Answer 12

Non granulomatous inflammation limited to colon and affecting mucosa and sub mucosa

Question 13

Ulcerative colitits starts in rectum and then extends

Answer 13

proximally to involve the whole colon

Question 14

Ulcerative colitis is associated with

Answer 14

Primary sclerosing cholangitis

Question 15

How is Crohn’s Disease characterized?

Answer 15

• Sharply delimited and transmural involvement by an inflammatory process
• Presence of non caseating granulomas
• Mucosal fissuring with formation of fistulas

Question 16

Crohn’s disease has long narrow thickened segments of

Answer 16

SI (string sign)

Question 17

What are some extra intestinal manifestations of IBD?

Answer 17

• Migratory polyarthritis
• Sacroeileitis
• Ankylosing spondylitis
• Erythema nodosum
• Clubbing of finger tips
• Sclerosing cholangitis

Question 18

What are oral manifestations associated with IBD?

Answer 18

• Apthous ulcers
• Swollen gums
• Cobblestone lesions

Question 19

Is neoplasia more common in UC or CD?

Answer 19

Ulcerative colitis

Question 20

Peutz-Jegher syndrome is an inherited cancer syndrome characterized by what?

Answer 20

Mucocutaneous melanin pigmentation and hamartomatous intestinal polyposis

Question 21

What are oral manifestations of peutz-jegher syndrome?

Answer 21

Melanin pigmented mucocutanous polyps

Question 22

Large bowel tumors, adenomas have

Answer 22

dysplasia

Question 23

What is the most important criteria for large bowel tumors, ademonas?

Answer 23

Polyp size

Question 24

Familial adenomatous polyposis is a condition that predisposes to what?

Answer 24

Adenomatous polyps and thus colorectal cancer

Question 25

Gardner syndrome is FAP with prominent extraintestinal manifestations, which can include

Answer 25

- Multiple tubular adenomas - Osteomas - Desmoid tumors - Congenital hypertrophy of retinal pigment epithelium - Fibromas and multiple lipomas - epidermal inclusion cysts

Question 26

What are some common oral manifestations of Gardner's syndrome?

Answer 26

- Supernumerary teeth/dental abnormalities - Osteomas of jaw