Flashcards in Pathology Deck (75):
What is the most common pathology of the biliary tract?
What is cholelithiasis?
How do you remove gall stones?
Surgery is the number one choice
Can also use ursodeoxycholic acid
What is the main component of gall stones?
Name the two inflammatory disorders of the oesophagus
What is another name for chronic oesophagitis?
What causes basal cell hyperplasia in the oesophagus?
Name 3 complications of reflux oesophagitis
What is Barrett's Oesophagus?
Replacement of stratified squamous epithelium by columnar epithelium
If chronic oesophagitis causes hyperplasia, what does Barrett's oesophagus cause?
What is metaplasia?
Cell changes its identity/composition to deal with stress
How would you describe the mucosa of the oesophagus in a patient with Barrett's oesophagus?
What is the main risk for patients with Barrett's Oesophagus?
What is another name for allergic oesophagitis?
What are the risk factors for allergic oesophagitis?
What is the cardinal sign of eosinophillic oesophagitis?
Increased eosinophils in the blood
What does the oesophagus look like in allergic oesophagitis?
Corrugated (macroscopic) or spotty (microscopic)
Name the two main malignant oesophageal tumours
Squamous cell carcinoma
What are the risk factors for squamous cell carcinoma?
Vit A/Zinc deficiency
Which cancer can develop following Barrett's eosophagus
Where can oesophageal carcinoma metastasise to?
How can oral squamous cell carcinoma present?
White, red, speckled, ulcer, lump
What are the risk factors for oral squamous cell carcinoma?
Chewing tobacco and Paan
What are the 2 main inflammatory disorders of the stomach?
What can cause acute gastritis?
What can cause chronic gastritis?
Chemicals (NSAID's, Alcohol, Bile)
Name the 3 types of malignantgastric tumours
Gastrointestinal stromal tumours
What is the pathogenesis for a gastric adenocarcinoma caused by a h.pylori infection?
H.Pylori Infection > Chronic gastritis> Metaplasia/Atrophy>
Where do gastric lymphomas orginate?
Mucosa associated lymphoid tissue
What can cause small bowel ischaemia?
Mesenteric artery atherosclerosis
Thromboembolism from the heart
Strangulation (e.g hernia, adhesion)
Drugs (e.g cocaine)
What are the 3 kinds of ischaemic small bowel?
Mucosal infarct - can regenerate
Mural infarct - can repair and form fibrous stricture
Transmural infarct - Can cause gangrene and death. Bowel should be resected
What is Meckel's diverticulum?
Rule of 2s
2 inches long
2 foot above Ileocaecal valve 2% of people
Tumours of the small bowel are rare, metastases from which areas are more common?
Malignant tumours in the small bowel are associated with..?
Coeliac disease and crohn's disease
What is the most common site for small bowel carcinoid tumours?
If carcinoid tumours of the small bowel metastasise to the liver, what can occur?
What are the main symptoms of carcinoid syndrome?
Facial flushing and diarrhoea
What kind of cells in the small bowel can be damaged and lost due to coeliac disease?
What kind of change in bowel habits can coeliac disease cause?
What are the main effects of coeliac disease?
Anaemia (Fe, Vit B12, Folate)
Failure to thrive
What are patients with coeliac disease at risk of?
T-cell lymphomas of the GI tract
Small bowel carcinoma
How is Crohn's disease characterised?
Patchy, segmental with skip lesions anywhere on the GI tract
What are the main complications of chrohn's disease?
Toxic megacolon (rare)
Which population is most likely to get Crohn's?
Which part of the GI tract is UC confined to ?
Colon and rectum
How deep is the inflammation in UC?
Mucosal and submucosal
How do patients with UC present?
Diarrhoea, mucus, PR blood
What are patients with UC at risk of?
What are the extra GI complications of UC?
Liver- Primary sclerosing cholangitis
Joints - Arthritis, ankylosing spondylitis
Skin - Eyrthema nodosum
What is the pathogenesis of liver disease?
Insult to hepatocytes > Inflammation > Fibrosis > Cirrhosis
What are the causes of pre-hepatic jaundice?
What are the causes of hepatic jaundice?
Acute liver failure
Bile duct loss
What are the causes of post-hepatic jaundice?
What causes the formation of gallstones?
An imbalance between the ratio of cholesterol to bile salts disrupting micelle formation
What are the risk factors for gallstones?
What can gallstones cause?
What is cholecystitis?
Inflammation of the gallbladder
What is the gold standard test for acute pancreatitis?
Elevated serum amylase
What can cause acute pancreatitis?
Iatrogenic (e.g ERCP)
What kind of complications can arise from pancreatitis?
What can cause chronic pancreatitis?
What is the type of cancer that occurs in the pancreas?
Where can adenocarcinoma of the pancreas spread to?
Direct spread to Duodenum, Biliary tree, stomach and spleen
Spread to local lymph nodes
Metastases to liver
What is a colonic polyp?
A portrusion from the epithelial wall. Either benign or malignant
What is the main differential diagnosis of a colonic polyp?
Is adenoma of the colon, benign or malignant?
What kind of cancer is colonic adenoma a precursor of?
What is the first step in the treatment of colonic adenocarcinoma?
Section of bowel is removed and sent to be staged
Explain Dukes staging of colorectal cancer
Dukes A - Confined to muscle wall
Dukes B - Spread through bowel wall
Dukes C - Metastasised to lymph nodes
What are the complications of diverticular disease?
What is cirrhosis on a microscopic level?
Bands of irreversibly damaged tissue that is now fibrotic that seperated regenenerative nodules of hepatocytes
What is the pathogenesis for developing alcohol related cirrhosis?
Days - Fatty Liver - reversible
Weeks - Hepatitis - reversible
Months - Fibrosis - irreversible
Years - Cirrhosis - irreversible
What is haemochromatosis?
Excess iron stored in the liver
What is Wilson's disease?
The accumulation of excess copper in the liver and brain