GI Pathology III: Small Intestine Flashcards Preview

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Flashcards in GI Pathology III: Small Intestine Deck (44):
1

What are the clinical features and histological findings in Hirschsprung disease?

Constipation with lack of ganglion cells on histology

2

What is the infectious agent in pseudomembranous colitis?

C. difficile

3

What is the common parasitic infection that presents with bloody diarrhea?

E. histolytica

4

What is the gene mutation in familial adenomatous polyposis (FAP)?

Autosomal dominant mutation of the APC gene

5

Plicae Circularis

Plicae circularis are folds of the mucosa and submucosa

6

Paneth Cells

Function in cell defense in the intestine. Paneth cells have lysozymes and defensins.

7

What are features specific to the duodenum?

Brunner's Glands

8

What are features specific to the ileum?

Peter's Patches

9

What is the main function of the large intestine?

Absorption of water

10

Where is Meissner Plexus located?

In the submucosa

11

Where is Auerbach's Plexus located?

Between the circular and longitudinal muscle in the muscularis propria

12

Intussusception

Telescoping of bowel segment into distal segment often at the ileocecal junction

13

Volvulus

Twisting of the bowel around its mesentery leading to obstruction and can compromise blood flow

14

Where does volvulus occur in children? Adults?

Children - midgut
Adults - sigmoid

15

Necrotizing Entercolitis

Most common GI emergency in premature neonates with acute necrotizing inflammation of the small and large bowels

16

Meckel's Diverticulum

Disease of 2's
- 2:1 male to female
- 2 major complications are pain with inflammation and hemorrhage with ulcer

17

Who is most affected by Hirschsprung disease?

Males in a 4:1 ratio

18

What is Hirschsprung disease associated with?

Down syndrome

19

What can pancreatic insufficiency be caused by and what does it result in the malabsorption of?

- Pancreatitis/Cancer
It will affect the absorption of fat and vitamins A, D, E and K

20

What is the most common type of disaccharide deficiency and what are the symptoms?

Lactase. Osmotic diarrhea.

21

Abetalipoproteinemia

Decreased synthesis of apolipoprotein B which decreases the amount of chylomicrons leading to the accumulation of fat and cholesterol in the enterocytes - presents as failure to thrive

22

Celiac Disease

Autoimmune disorder that results in the damage of small intestinal lining when gluten is eaten

23

Who is celiac disease seen most often in?

Caucasians and Europeans

24

What is the pathogenesis of celiac disease?

Gluten is converted to gliadin which is deaminated by TTG and is presented to a T cell. The T cell will attack the enterocytes and activate B-cells leading to Ab formation

25

What happens to the villi in celiac disease?

They are lost from the inflammation

26

What are the prominent cells seen in celiac disease?

CD8+ T cells

27

What are the important tests for celiac disease?

- Serologic test for TTG and gliadin Ab
- Biopsy showing villous atrophy

28

What are some bacterial causes of enterocolitis?

- Cholera
- Campylobacter
- Yersinia
- E. coli
- Shigella
- Salmonella

29

What are some viral causes of enterocolitis?

- Norovirus
- Rotavirus

30

What are some of the parasitic causes of enterocolitis?

- Nematodes
- Flatworms
- Protozoans (Giardia, E. histolytica)

31

What is the histological characteristic of E. histolytica infection?

Flask shaped ulcer

32

What is the histological finding in pseudomembranous enterocolitis?

Mushroom pseudomembrane

33

Who is generally affected by collagenous enterocolitis?

Middle to older age women

34

What is the histological finding of collagenous enterocolitis?

Presence of collagen (blue with trichrome stain)

35

What is lymphocytic enterocolitis associated with?

Autoimmune diseases

36

What will be seen on histology of lymphocytic enterocolitis?

Lymphocytes

37

Whipple Disease

Rare and found in men more commonly. It is caused by Tropheryma whippleli and is engulfed by macrophages where they fill the lamina propria and distend it.

38

Crohn's Disease

It is a disordered response to bacteria. Usually affects the terminal ileum but can affect any part of the GI tract and it will show with strictures and serosal creeping fat.

39

What is seen on histology of Crohn's disease?

- Transmural inflammation - full thickness of the wall
- Ulceration and non-caseating granulomas

40

Ulcerative Colitis

Autoimmune with relapsing attacks of bloody mucoid diarrhea with pain with diffuse continuous inflammation

41

What layers does ulcerative colitis affect?

Only the mucosa and submucosa, and there are NO non-caseating granulomas

42

What is the diarrhea of Crohn's like?

Non-bloody

43

What is the diarrhea of ulcerative colitis like?

Bloody

44

What is a distinguishing feature in the how the intestines are affected in Crohn's VS ulcerative colitis?

Crohn's will have skip areas and thus is focal.

UC is continuous and therefore diffuse.

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