Large Intestine Disease Flashcards Preview

Unit 6: Pathology > Large Intestine Disease > Flashcards

Flashcards in Large Intestine Disease Deck (31):
1

What are the most common causes of appendicitis in children and adults?

1. lymphoid hyperplasia - child
2. fecalith - adults (impacted feces)

2

What are the usual symptoms of appendicitis?

periumbilical pain --> then localizes to RLQ
-fever, nausea, guarding and rebound tenderness

3

What is IBD? what do they think is the cause?

chronic relapsing inflam of bowel
abnormal immune response to enteric flora

4

Who is the classic patient with IBD and what are the usual symptoms?

young women - west, caucasians, eastern european
-bloody diarrhea, abdominal pain

5

Where does ulcerative colitis occur?

mucosal and submucosal layers
begins in rectum and can extend proximally to cecum

6

What are the symptoms of ulcerative colitis?

LLQ pain, bloody diarrhea, cramping, fever

7

What are the typical pathognomonic signs of ulcerative colitis?

crypt abscesses with neutrophils
pseudopolyps
loss of haustra " lead pipe " sign

8

What are some complications of ulcerative colitis? What is the risk based on?

toxic megacolon and carcinoma
- extent of involvement and duration

9

What are some systemic associations of ulcerative colitis?

Primary sclerosing cholangitis – liver disease
pANCA positivity, thromboembolism, DVTs
Arthritis, uveitis, erythema nodosum
Pyoderma gangrenosum – noninfective deep purulent ulcers - serious

10

Is smoking protective against ulcerative colitis or crohns disease?

ulcerative colitis

11

Where are the lesions found in crohns disease?

FULL THICKNESS
anywhwere from mouth to anus
terminal ileum is most common*

12

Are skip lesions seen in ulcerative colitis or crohn disease?

crohn disease

13

What are the symptoms of crohns disease?

RLQ pain
non bloody diarrhea
recurrent fever

14

What are the typical pathognomonic signs of crohn's disease?

noncaseating granulomas in the submucosa
cobblestone appearance
submucosal fibrosis
strictures - narrow lumen
"creeping fat"

15

What are some complications of Crohns disease?

malabsorption with nutritional deficiency
calcium oxalate nephrolithiasis
Fistula formation – rupture and connection
Carcinoma – only if colonic disease is present
Liver disease – sclerosing cholangitis
amyloidosis

16

What are some systemic associations of crohns disease?

o Ankylosing spondylitis
o Sacrolitis
o Migratory polyarthritis
o Erythema nodosum
o Uveitis – visual disturbance

17

What is hirshsprungs disease?

defective relaxation and peristalsis of rectum and distal sigmoid colon
-segmental absence of ganglion cells - failure to descend from neural crest

18

What is hirsphrungs disease highly associated with?

down syndrome

19

What are some clinical features of hirshsprungs disease?

o Failure to pass meconium
o Empty rectal vault on DRE
o Massive dilation of bowel proximal to obstruction
o Inc in nonmyelinated cholinergic nerve fibers

20

How would you diagnose hirshsprungs disease?

rectal suction biopsy
-look for lack of ganglion cells

21

What is colonic diverticulosis?

outpouching of mucosa and submucosa through muscularis propria

22

What is believed to be the cause of colonic diverticulosis?

low fiber diet , constipation

23

Where do colonic diverticula typically occur?

where vasa recta traverse muscularis propria
-sigmoid colon

24

Although diverticula are usually asymptomatic, what are some possible complications?

Alternating Constipation and Diarrhea,
colicky abdominal pain, flatulence
Rectal bleeding – hematochezia
Diverticulitis – appendicitis like symptoms
fistula

25

What is angiodysplasia?

acquired malformation of mucosal and submucosal capillary beds

26

Where does angiodysplasia occur?

cecum and right colon due to high wall tension

27

What is the presentation of angiodysplasia?

hematochezia in an older adult

28

What are hemorrhoids?

dilated venous channels of hemorrhoidal plexus

29

Where would atherosclerosis affect the colon?

the SMA - splenic flexure is typically affected

30

How does ischemic colitis present?

postprandial pain
(digestion requires inc blood)

31

What is IBS?

relapsing abd pain with bloating and flatulence
-change in bowel habits
-improves with defecation
-related to disturbed intestinal motility