Pathology Flashcards
(110 cards)
1
Q
What may be the causes of acute oesophagitis?
A
- corrosive following chemical ingestion
- immunocompromised patients
2
Q
What causes chronic oesophagitis?
A
- reflux disease
- rare causes include Crohn’s disease
3
Q
What is most common? Acute or chronic Oesophagitis?
A
- Chronic oesophagitis is most common
4
Q
What causes reflux oesophagitis? and what causes it
A
- inflammation of oesophagus due to refluxed low pH gastric content
- defective sphincter mechanisms
- hatius hernia
- increased intra-abdominal pressure
- abnormal oesophageal motility
5
Q
What is the definition of Barrett’s Oesophagus?
A
- replacement of stratified squamous epithelium by columnar epithelium
6
Q
What may cause Barrett’s oesophagus?
A
- persistent reflux of acid/bile
- differentiation from oesophageal stem cells
7
Q
Allergic oesophagitis is characterised by what cell type?
A
- eosinophills
8
Q
Treatment for allergic oesophagitis?
A
- steroids
- chromoglycate (mast cell stabiliser)
- montelukast
9
Q
What may cause malignant squamous cell carcinoma of the oesophagus?
A
- smoking
- alcohol
- vitamin A/ zinc deficiency
- HPV
10
Q
What would oral squamous cell carcinoma appear like?
A
- white, red, speckled, ulcer lump
- floor of mouth, lateral border, ventral tongue, soft palate
11
Q
What may cause acute gastritis?
A
- irritant chemical injury
- severe burns
- shock
12
Q
What is a peptic ulcer?
A
- breach in the gastrointestinal mucosa because of acid and pepsin attack
- failure of barrier function and increased acid secretion
13
Q
What is another name for benign gastric tumours?
A
- polyps
14
Q
Patients with anti-H.pylori antibodies have higher risk of ____
A
- cancer
15
Q
What is the major cause of chronic gastritis?
A
- H.pylori (bacterial infection)
- autoimmune less common
16
Q
What may cause ischaemia of the small bowel?
A
- mesenteric arterial occlusion
- non-occlusive perfusion insufficiency
17
Q
What does Meckel’s diverticulum result in?
A
- incomplete regression of Vitelli-intestinal duct
18
Q
Appendicitis is characterised by what cell type?
A
- neutrophils (acute inflammation)
19
Q
Will it be an exudate or transudate fluid in appendicitis?
A
- serosal congestion
- exudate
20
Q
What is the pathology of coeliac disease?
A
- Strong association with HLA-B8
- Flat mucosal
- villous atrophy = decreased surface area
21
Q
complications of coeliac disease/
A
- t-cell lymphomas of GI tract
- gall stones (reduced CCK released)
- increased risk of small bowel carcinoma
22
Q
What are polyps
A
- protrusions above epithelial surface
- tumours (swellings)
- doesn’t indicate benign or malignant
23
Q
Name some benign epithelial polyp
A
- ademona inflammatory hamartomatous
24
Q
Name a malignant epithelial polyp?
A
- polypoid adenocarcinomas
25
Name a benign mesenchymal polyp
- lipoma
| - fibromass
26
Name a malignant mesenchymal polyp
- sarcomas
| - lymphomatous polyps
27
What may be the differential diagnosis of a polyp?
- adenoma
- serrated polyp
- polypoid carcinoma
28
All adenomas are _______
- dysplastic
| - pre malignant so must be removed
29
Explain the sequence of events of adenoma-carcinoma formation
- normal mucosa
- adenoma
- adenocarcinoma
30
What are precursors of colorectal carcinomas?
- adenomas
31
What treatment should be done to colorectal adenomas?
- removed (surgically or endoscopically)
| - as they are precursors of carcinomas
32
What colorectal carcinoma scoring system is used?
- Dukes Staging
33
Explain Dukes A
- confined by muscularis propria
34
Explain Dukes C
- Metastatic to lymph nodes
35
What may be the symptoms of left sided colorectal carcinoma?
- blood PR
- altered bowel habit
- obstruction
36
What may be the symptoms of right sided colorectal carcinoma?
- anaemia
| - weight loss
37
Where are the sites of local invasion of a colorectal carcinoma?
- mesorectum
| - peritoneum
38
Explain hereditary non-polyposis coli
- <100 polyps
- late onset
- autosomal dominant
- right sided tumours
39
Explain familial adenomatous polyposis
- >100 polyps
- autosomal dominant
- thought colon
- early onset
40
What are common diseases of the large bowel?
- polyps
- adenomas
- adenocarcinomas
41
Define Cholelithiasis?
- gallstones
| - hard stone like material formed within the biliary system most commonly the gallbladder
42
What procedure is conducted to remove cholelithiasis (gallstones)?
- cholecystectomies
43
Explain the composition of normal bile?
- micelles of cholesterol, phospholipids, bile salts and bilirubin
44
Where is bile stored and concentrated?
- gallbladder
45
Why are gallstones formed?
- imbalance between the ratio of cholesterol to the ratio of bile salts
- disrupts micelle formation
46
What are the 2 types of gallstones?
- pigment stones
| - cholesterol stones
47
How are cholesterol stones formed?
- excess cholesterol in bile
48
How are pigment stones formed?
- excess bilirubin
49
Define cholecystitis?
- inflammation of the gallbladder
| - usually associated with gallstones
50
Explain acute cholecystitis?
- gallstones obstructing outflow of bile
| - indicated by neutrophils
51
Explain chronic cholecystis
- gallbladder wall thickened due to fibrosis
52
What causes obstructive jaundice?
- stone (blockage) of common bile duct
53
Cholangiocarcinoma?
- carcinoma of the bile ducts
54
What is cholangiocarcinoma associated with?
- ulcerative colitis
| - primary sclerosing cholangitis
55
Define pancreatitis?
- inflammation of the pancrease
56
Explain acute pancreatitis?
- adults
- sudden onset of abdo pain
- elevated serum amylase
57
lipases in acute pancreatitis released by what?
- intra and peri- pancreatic fat necrosis
58
Proteases in acute pancreatitis released by what?
- tissue destructing and haemorrhage
59
Explain chronic pancreatitis?
- relapsing disorder may develop insidiously of following bouts of acute pancreatitis
60
What are the symptoms of gallstones?
- Stone impacts in cystic duct
- Gradual build-up pain in RUQ
- Radiates to back/shoulders
- Associated with indigestion/nausea
61
What is the differential diagnoisis of acute epigastric pain?
- Biliary colic (gallstones)
- peptic ulcer disease
- oesophageal spasm
- myocardial infarction
- acute pancreatitis
62
How might gallstones be diagnosed?
- ultrasound
| - CT scan
63
What is ascending cholangitis?
- inflammation of the bile ducts
- by ascending bacteria from the gut
- tends to be if bile flow is bloked, by a gallstone in the common bile duct
64
Functions of the pancreas?
- Exocrine - Acinar cells secrete pancreatic enzymes
| - Endocrine- Islets of Langerhans secrete hormones into blood
65
Define pancreatitis?
- An acute inflammatory process in the pancreas
66
Clinical presentation of pancreatitis?
- Acute onset epigastric pain
- Radiating through to back
- Very serve
- Nausea and vomiting
- Jaundice
67
Name some pancreatic tumours
- Adenocarcinoma (exocrine)
| - Gastrinoma (endocrine)
68
Symptoms of pancreatic tumours?
o Jaundice
o Weight loss
o Back pain
69
Name some complications of reflux
- ulceration
- stricture
- Barrett's oesophagus
70
What is the Z line?
- where the squamous mucosa of the oesophagus meets the columnar mucosa of the stomach
71
What would be seen down a microscope for reflux oesophagitis?
- intraepithelial neutrophils, lymphocytes and eosinophils
| - basal zone hyperplasia
72
Name a benign tumour of the oseophagus?
- squamous papilloma
73
Name 2 malignant tumours of the oesophagus
- squamous cell carcinoma
| - adenocarcinoma
74
What are the 3 mechanisms of metastases?
- direct invasion
- lymohatic permeation
- vascular invasion
75
Explain adjuvant therapy
- therapy given in addition to primary or inital therapy, to mazimise its effectiveness
76
3 factors which may lead to chronic gastritis?
- autoimmume
- bacteria
- chemical
77
H.pylori is a gram_________
gram negative curvilinear rod
78
What causes chronic peptic ulcers?
- increased acid production
| - failure of mucosal defence
79
What is maltoma?
- gastric lymphoma
80
Explain Zolinger Ellison Syndrome
- gastrin secreting tumour
- damages the mucosa
- can cause recurrent peptic ulcers
81
Where might carcinoid tumours originate?
- appendix
82
What are the 3 zones of the liver called?
Zone 1 = periportal
Zone 2 = mid acinar
Zone 3 = pericentral
83
What are the potential consequences of acute liver failure?
- complete recovery
- chronic liver disease
- death from liver failure
84
Explain pre-hepatic jaundice?
- too much haem breakdown
85
Explain hepatic jaundice?
- liver cells injured
86
Explain post-hepatic jaundice?
- blockage of bile to the bowel
87
What are the complications of ccirrhosis?
- portal hypertension
- ascites
- liver failure
88
What are the complication of portal hypertension?
- oesophageal varcies
- captu medusa
- haemorrhoids
89
NASH stands for?
- Non-Alcoholic SteatoHepatitis
90
What patients get NASH?
- diabetic
- obese
- hyperlipideamia
91
Explain hep A
- faecal-oral spread
- no carriers exist
- poor hygiene
- hepatitis A IgM test
92
Explain hep B
- sex, blood, mother to child
- carriers exist
- HBsAg test
93
What is hep D associated with?
- only in co-existance with Hep B
94
Explain hep C
- similar to spread of hep B, less sex route
- often asymptomatic
- PCR test for RNA
95
What are some causes of chronic hepatitis?
- autoimmune hepatitis
- hep B and C
- primary biliary cirrhosis
- primary sclerosis cholangitis
96
Explain primary biliary cirrhosis
- autoimmune
- female
- granulomas and bile duct loss seen
- leads to cholestasis --> cirrhosis
97
Explain autoimmune hepatitis
- seen in pts. with additional allergies
| - may have triggers
98
Explain primary sclerosis cholengitis
- associated with UC and Males
| - increased risk of malignancy
99
Define haemochromatosis?
- excess iron within the liver
100
Explain primary haemochromatosis?
- autosomal recessive
| - genetic condition
101
What is Wilson's disease?
- autosomal recessive
| - copper accumulates in the liver and brain
102
What are common diseases of the large bowel?
- diverticular disease
- ischaemia
- antibiotic induced colitis
103
Explain diverticular disease
- common
- asymptomatic
- related to low fibre diet and increased intralumenal pressure
104
What are possible complications of diverticular disease?
- diverticulitis
- rupture
- abscess
- fistula
- bleed
105
Explain ischaemia of the bowel causes
- left sided
- CVS
- AF
- Embolus
- shock
- atherosclerosis
106
Withering of crypts and pink smudy lamina propria, are signs of______
- large bowel ischaemia
107
Antibiotic induced colitis aetiology
- patients on broad spectrum antibiotics
- c.difficle toxin a and b
- massive diarrhoea and bleeding
108
Explosive lesions on mucosa are signs of
- antibiotic induced colitis
109
Explain collagenous colitis
- thickened basement membrane
- patchy disease
- no chronic architectural changes
- water diarrhoea
110
Explain the main sign of lymphocytic colitis
- intraepithelial lymphocytes raised
