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Flashcards in Pathology Deck (75):
1

What is the most common pathology of the biliary tract?

Cholelithiasis

2

What is cholelithiasis?

Gall stones

3

How do you remove gall stones?

Surgery is the number one choice
Can also use ursodeoxycholic acid

4

What is the main component of gall stones?

Cholesterol

5

Name the two inflammatory disorders of the oesophagus

Acute oesophagitis
Chronic oesophagitis

6

What is another name for chronic oesophagitis?

Reflux oesophagitis

7

What causes basal cell hyperplasia in the oesophagus?

reflux/chronic oesophagitis

8

Name 3 complications of reflux oesophagitis

Ulceration (bleeding)
Stricture
Barrett's oeosophagus

9

What is Barrett's Oesophagus?

Replacement of stratified squamous epithelium by columnar epithelium

10

If chronic oesophagitis causes hyperplasia, what does Barrett's oesophagus cause?

Metaplasia

11

What is metaplasia?

Cell changes its identity/composition to deal with stress

12

How would you describe the mucosa of the oesophagus in a patient with Barrett's oesophagus?

Red Velvet

13

What is the main risk for patients with Barrett's Oesophagus?

Carcinoma

14

What is another name for allergic oesophagitis?

Eosinophillic oesophagitis

15

What are the risk factors for allergic oesophagitis?

Atopy
Asthma
Young
Male

16

What is the cardinal sign of eosinophillic oesophagitis?

Increased eosinophils in the blood

17

What does the oesophagus look like in allergic oesophagitis?

Corrugated (macroscopic) or spotty (microscopic)

18

Name the two main malignant oesophageal tumours

Squamous cell carcinoma
Adenocarcinoma

19

What are the risk factors for squamous cell carcinoma?

Vit A/Zinc deficiency
Tannin
Smoking/Alcohol
HPV
Oesophagitis

20

Which cancer can develop following Barrett's eosophagus

Adenocarcinoma

21

Where can oesophageal carcinoma metastasise to?

Lymph
Liver

22

How can oral squamous cell carcinoma present?

White, red, speckled, ulcer, lump

23

What are the risk factors for oral squamous cell carcinoma?

Smoking
Alcohol
Chewing tobacco and Paan
HPV
Poor nutrition

24

What are the 2 main inflammatory disorders of the stomach?

Acute gastritis
Chronic gastritis

25

What can cause acute gastritis?

Shock
Burns
Chemicals
Head injury
Trauma

26

What can cause chronic gastritis?

Autoimmune conditions
Bacteria (H.Pylori)
Chemicals (NSAID's, Alcohol, Bile)

27

Name the 3 types of malignantgastric tumours

Carcinomas (adenocarcinomas)
Lymphomas (Maltoma)
Gastrointestinal stromal tumours

28

What is the pathogenesis for a gastric adenocarcinoma caused by a h.pylori infection?

H.Pylori Infection > Chronic gastritis> Metaplasia/Atrophy>
Dysplasia> Carcinoma

29

Where do gastric lymphomas orginate?

MALT
Mucosa associated lymphoid tissue

30

What can cause small bowel ischaemia?

Mesenteric artery atherosclerosis
Thromboembolism from the heart
Shock
Strangulation (e.g hernia, adhesion)
Drugs (e.g cocaine)
Hyperviscosity)

31

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

32

What is Meckel's diverticulum?

Rule of 2s
2 inches long
2 foot above Ileocaecal valve 2% of people

33

Tumours of the small bowel are rare, metastases from which areas are more common?

Ovary
Colon
Stomach

34

Malignant tumours in the small bowel are associated with..?

Coeliac disease and crohn's disease

35

What is the most common site for small bowel carcinoid tumours?

Appendix

36

If carcinoid tumours of the small bowel metastasise to the liver, what can occur?

Carcinoid syndrome

37

What are the main symptoms of carcinoid syndrome?

Facial flushing and diarrhoea

38

What kind of cells in the small bowel can be damaged and lost due to coeliac disease?

Enterocytes
Villi

39

What kind of change in bowel habits can coeliac disease cause?

Diarrhoea
Steatorrhoea

40

What are the main effects of coeliac disease?

Weight loss
Anaemia (Fe, Vit B12, Folate)
Abdominal bloating
Failure to thrive
Vit deficiencies

41

What are patients with coeliac disease at risk of?

T-cell lymphomas of the GI tract
Small bowel carcinoma
Gall stones
Ulcerative jejunoilleitis

42

How is Crohn's disease characterised?

Patchy, segmental with skip lesions anywhere on the GI tract
Cobblestone appearance
Transmural
Granulomatous

43

What are the main complications of chrohn's disease?

Fistulas
Anal disease
Non-curative disease
Bowel obstruction
Perforation
Malignancy
Amyloidosis
Toxic megacolon (rare)

44

Which population is most likely to get Crohn's?

Jewish people

45

Which part of the GI tract is UC confined to ?

Colon and rectum

46

How deep is the inflammation in UC?

Mucosal and submucosal

47

How do patients with UC present?

Diarrhoea, mucus, PR blood

48

What are patients with UC at risk of?

Toxic megacolon

49

What are the extra GI complications of UC?

Eyes- Uveitis
Liver- Primary sclerosing cholangitis
Joints - Arthritis, ankylosing spondylitis
Skin - Eyrthema nodosum

50

What is the pathogenesis of liver disease?

Insult to hepatocytes > Inflammation > Fibrosis > Cirrhosis

51

What are the causes of pre-hepatic jaundice?

Haemolysis
Haemolytic anaemia
Unconjugated bilirubin

52

What are the causes of hepatic jaundice?

Acute liver failure
Alcoholic hepatitids
Decompensated cirrhosis
Bile duct loss
Pregnancy

53

What are the causes of post-hepatic jaundice?

Congenital

54

What causes the formation of gallstones?

An imbalance between the ratio of cholesterol to bile salts disrupting micelle formation

55

What are the risk factors for gallstones?

Female
Obesity
Diabetes
Genetics

56

What can gallstones cause?

Acute cholecystitis
Chronic cholecystitis
Mucocoele
Empyema
Carcinoma
Ascending cholangitis
Obstructive jaundice
Gallstone ileus
Acute pancreatitis
Chronic pancreatitis

57

What is cholecystitis?

Inflammation of the gallbladder

58

What is the gold standard test for acute pancreatitis?

Elevated serum amylase

59

What can cause acute pancreatitis?

Alcohol
Cholelithiasis
Shock
Mumps
Hyperparathyroidism
Hypothermia
Trauma
Iatrogenic (e.g ERCP)

60

What kind of complications can arise from pancreatitis?

Death
Shock
Pseudocyst formation
Abscess formation
Hypocalcaemia
Hypergylcaemia

61

What can cause chronic pancreatitis?

Alcohol
Cholelithiasis
Cystic fibrosis
Hyperparathyroidism
Familial

62

What is the type of cancer that occurs in the pancreas?

Adenocarcinoma

63

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

64

What is a colonic polyp?

A portrusion from the epithelial wall. Either benign or malignant

65

What is the main differential diagnosis of a colonic polyp?

Adenoma
Serrated polyp
Polypoid carcinoma
Other

66

Is adenoma of the colon, benign or malignant?

Benign

67

What kind of cancer is colonic adenoma a precursor of?

Colonic adenocarcinoma

68

What is the first step in the treatment of colonic adenocarcinoma?

Section of bowel is removed and sent to be staged

69

Explain Dukes staging of colorectal cancer

Dukes A - Confined to muscle wall
Dukes B - Spread through bowel wall
Dukes C - Metastasised to lymph nodes

70

What are the complications of diverticular disease?

Inflammation
Rupture
Abscess
Fistula
Bleeding

71

What is cirrhosis on a microscopic level?

Bands of irreversibly damaged tissue that is now fibrotic that seperated regenenerative nodules of hepatocytes

72

What is the pathogenesis for developing alcohol related cirrhosis?

Days - Fatty Liver - reversible
Weeks - Hepatitis - reversible
Months - Fibrosis - irreversible
Years - Cirrhosis - irreversible

73

What is haemochromatosis?

Excess iron stored in the liver

74

What is Wilson's disease?

The accumulation of excess copper in the liver and brain

75

What does alpha-1-antitrypsin deficiency cause?

Emphysema and cirrhosis