Pathology Flashcards
(124 cards)
1
Q
cause of acute oesophagitis
A
corrosion following chemical ingestion
2
Q
causes of chronic oesophagitis
A
GORD
Chron’s disease
3
Q
complications of chronic oesophagitis
A
ulceration
stricture
barrett’s oesophagus
4
Q
what is barrett’s oesophagus
A
replacement of stratified squamous epithelium by columnar epithelium
5
Q
consequence of barrett’s oesophagus
A
increased risk of dysplasia and carcinoma
6
Q
who does allergic oesophagitis affect mostly and what is the treatment
A
young males/asthmatics
steriods, chromolycate, montelukast
7
Q
how common are benign oesophageal tumours
A
rare
8
Q
name a benign oesophageal tumour
A
squamous papilloma
9
Q
causes of squamous cell carcinoma
A
genes
oesophagitis
HPV
Smoking/alcohol/Vitamin A and zinc deficiency
10
Q
in who is adenocarcinoma more common in
A
white, obese men
11
Q
presentation of malignant oesophageal tumours
A
dysphagia
anaemia
weight loss
fatigue
12
Q
what percentage of oral cancers are squamous cell
A
90%
13
Q
where in the mouth may oral cancer present
A
floor of mouth, lateral border/ventral tongue, tonsillar pillars
14
Q
causes of oral squamous cell carcinoma
A
tobacco alcohol betel quid viral? nutritional deficiency genes post-transplant previous oral SCC
15
Q
prognosis of oral SCC
A
40-50% in 5 years
16
Q
What antibodies are the cause of chronic autoimmune gastritis
A
anti-parietal and anti-intrinsic factor antibodies
17
Q
what is the most common cause of chronic gastritis
A
H.pylori
18
Q
what chemical agents may cause chronic gastritis
A
NSAIDs, alcohol, bile reflux
19
Q
what causes a peptic ulcer
A
breach of GI mucosa due to acid and pepsin attack
20
Q
where are peptic ulcers most common
A
stomach and duodenum
21
Q
a peptic ulcer has a layered appearance. what are the three layers
A
necrotic fibrinopurulent debris
granulation tissue
fibrotic scar tissue
22
Q
complications of peptic ulcer
A
perforation
haemorrhage
stenosis
intractable
23
Q
true/false - h.pylori has no effect on formation of adenocarcinoma
A
false - it increases the risk
24
Q
describe gastric adenocarcinoma formation
A
chronic gastritis leads to atrophy and metaplasia
dysplasia and carcinoma are formed
25
where would a gastric lymphoma be found
mucosa associated lymphoid tissue
26
describe gastric lymphoma formation
continous chronic inflammation causes B cell proliferation
| if continuous error may occur and mutated cell may replicte to cause low grade lymphoma
27
causes of mesenteric arterial occlusion
thromboembolism from heart
| atherosclerosis
28
cause of non occlusive perfusion insufficiency
shock
venous return obstruction
drugs, cocaine
hyperviscosity
29
complications of small bowel ischaemia
```
fibrosis
stricture
chronic ischaemia
obstruction
perforation
peritonitis
sepsis
death
```
30
what is meckel's diverticulum
incomplete regression of vitello-intestinal duct
31
where would you find meckel's diverticulum, how long is it and what is the incidence
2 inches long
2 foot above IC valve
2% population
32
small bowel lymphomas are __ cell derived
B
33
where are carcinoid tumours most common
appendix
34
what diseases make small bowel carcinoma more common
chron's and coeliac
35
in secondary bowel tumours, where are the primary sites most common
ovary, colon, stomach
36
in who is appendicitis most common
children
37
causes of appendicitis
foecolith
parasite
tumour
lymphoid hyperplasia
38
complications of appendicitis
```
peritonitis
rupture
abscess
fistula
sepsis and liver abscess
```
39
what is coeliac disease
abnormal reaction to gluten, reducing absorption capacity
40
what is coeliac disease associated with
childhood diabetes, dermatitis, HLA-B8
41
describe the pathology of coeliac disease
gliadin (gluten) enters cells and causes immune response
| IELS damage enterocytes so impaired illous structures, and loss of absorption
42
what type of biopsy is a sensitive way of diagnosing coeliac
duodenal biopsy
43
what serology can be done to check for coeliac disease
Anti-TTG
anti-gliadin
anti-endomesial
44
complications of coeliac
T cell lymphomas
small bowel carcinoma
gallstones
ulcerative-jejenoilleitis
45
what is the aetiology of IBD
it is unknown
46
what it chron's disease and where does it affect
inflammation and ulceration of entire GI tract, mouth to anus
47
who is chron's more common in
younger patients and men
48
true/false - all patients with chrons have lifelong exacerbation and remission
false - some go into lasting remission within 3 years
49
how would chron's disease look histologically
increased infammatory cells and in 50% patients non caeseating granuloma
50
true/false - chrons has skip lesions and is segmental
true
51
true/false - ulcerative colitis has skip lesions and is segmental
false
52
complications of chrons
```
malabsorption
fistulas
anal disease
intractable disease
obstruction
perforation
malignancy
amyloid
toxic megacolon
```
53
what increases trigger risk for chrons
smoking and viral and mycobacterial agents
54
what is ulcerative colitis and who is more likely to have it
inflammation and ulceration confined only to rectum and colon
younger patients and males
55
complications of ulcerative colitis
```
intractable disease
toxic megacolon
colorectal carcinoma
blood loss
electrolyte disturbance
```
56
what are the extra-GI manifestations of ulcerative colitis
```
uveitis
pyoderma gangrenosum
erythema nodosum
arthritis
primary sclerosing cholangitis
```
57
true/false - chrons is more likely to cause colorectal carcinoma
false- ulcerative colitis is
58
what is a polyp?
protrusion above epithelial surface- unspecified aetiology
59
why must adenoma polyps be removed?
they may become adenocarcinoma
60
primary treatment of adenocarcinoma
surgery
61
3 stages of differentiation of adenocarcinoma
moderately differentiated
necrosis
invasive through muscularis propria
62
what would a dukes A colorectal carcinoma look like?
confined by muscularis propria
63
what would a dukes B colorectal carcinoma look like?
throught muscularis propria
64
what would a dukes C colorectal carcinoma look like?
metastatic to lymph nodes
65
most colorectal carcinoma is right/left sided
left
66
symptoms of left sided colorectal carcinoma
blood PR, altered bowel habit obstruction
67
symptoms of right sided colorectal carcinoma
anaemia, weight loss
68
in what 3 ways may colorectal carcinoma appear
polypoid
stricturing
ulcerating
69
where may colorectal carcinoma spread to locally, and most likely organ to spread to
mesorectum
peritoneum
liver
70
what lymph nodes may colorectal carcinoma spread to
mesenteric
71
features of HNPCC
```
<100 polyps
right sided
mucinous
chrons like inflammation
association with gasric/endometrial carcinoma
```
72
features of FAP
>100 polyps
throughout colon
no specific inflammatory response
associated with desmoid tumours and thyroid carcinoma
73
what factors relate to diverticular disease
increased intralumenal pressure
| Low fibre diet
74
complications of diverticular disease
```
inflammation
rupture
abscess
fistula
massive bleed
```
75
to who and where does ischaemic colitis affect
elderly
| left side of bowel
76
cause of ischaemic colitis
```
AF
emboli
shock
vasculitis
atherosclerosis of mesenteric vessels
```
77
complications of ischaemic colitis
massive bleed
rupture
stricture
78
withering of crypts, pink smudgy lamina propria and fewer chronic inflammatory cells are signs of
ischaemic colitis
79
what is the cause of antibiotic induced colitis
broad spectrum antibiotics causing c diff overgrowth
80
treatment of antibiotic related colitis
vancomycin/metronidazole
| colectomy if severe
81
what is raised in lymphocytic and collagenous colitis
IELs
82
unique feature of radiation colitis
telangectasia
83
describe the pathogenesis of liver disease
insult to hepatocytes causes inflammation leading to fibrosis and cirrhosis
84
causes of acute liver failure q
alcohol
drugs
viral infection
bile duct obstruction
85
outcomes of acute liver failure
death from liver failure
complete recovery
chronic liver disease
86
what is pre hepatic jaundice and causes
too much haem broken down
haemolytic anaemia
haemolysis
87
what is hepatic jaundice and causes
```
dead/injured liver cells
alcoholic hepatitis
acute liver failure
cirrhosis
bile duct loss
pregnancy
```
88
what is post hepatic jaundice and causes
```
bile cannot escape into bowel
congenital biliary atresia
gallstones block CBD
Stricture of CBD
tumour at head of pancreas
```
89
causes of liver cirrhosis
```
alcohol
hep B/C
iron overload
autoimmune disease
gallstones
```
90
complications of cirrhosis
portal hypertension
ascites
liver failure
91
is an alcoholic fatty liver reversible?
| what can it lead to?
yes, leads to hepatitis, reversible
| leads to irreversible fibrosis and cirrhosis
92
complications of alcoholic liver disease
cirrhosis
hepatocellular carcinoma
portal hypertension
malnutrition
93
causes of NASH and who does it affect
non drinkers
hyperlipidaemia
diabetes
obesity
94
outine Hep A
faecal-oral, short incubation
sporadic/endemic
mild illness, usually full recovery
95
how is liver damage caused by hep B and describe its spread
antiviral immune response
| blood/transfusion/sexually/vertically
96
hep c is usually acute/chronic and its spread is ____
chronic
| blood/transfusion/sexually
97
rare causes viral hepatitis
```
delta agent
EBV
Yellow fever
HSV
CMV
```
98
causes of chronic hepatitis
viral - Hep B/C
drugs
autoimmune disease
99
autoimmune chronic hepatitis is more common in?
females
| other autoimmune disease
100
who is affected by primary biliary cirrhosis and how does biopsy appear
90% women
| granulomas/bile duct loss
101
who gets primary sclerosing cholangitis and what does it lead to
```
men, UC
malignancy possible
periductal fibrosis
duct destruction
jaundice
```
102
what is haemochromatosis
excess iron in liver
103
secondary haemochromotosis
iron overload from diet/transfusion/iron therapy
104
primary haemocromotosis?
autosomal recessive
worse men
excess absorption from metabolism
fibrosis and cirrhosis
105
complications of primary haemochromotosis
diabetes
heart failure
impotence
106
what is alpha-1-antitrypsin deficiency
autosomal recessive disorder of enzyme inhibitor
| causes emphysema and cirrhosis
107
what is wilsons disease
recessive disorder of copper metabolism
108
what does wilsons disease lead to
chronic hepatitis
| neurological deterioration
109
hepatocellular adenoma is benign/malignant, more common in men/women
benign
| women
110
complication of hepatocellular adenoma
bleed/rupture
111
hepatocellular carcinoma is associated with?
| prognosis?
HBV, HCV, cirrhosis
| poor
112
where are secondary mets to liver common from?
```
colon
pancreas
stomach
breast
lung
```
113
risk factors for cholesterol stones
female
obesity
genes
smoking
114
risk factor for pigment stones
haemolytic anaemia
115
complications of acute cholecystitis
infected bile forms empyema, rupture and peritonitis
116
how does a chronically inflamed gallbladder look
thickened wall, no distention
117
what type of cancer is gallbladder carcinoma
adenocarcinoma
118
what type of carcinoma is cholangiocarcinoma and associations?
adenocarcinoma
| primary sclerosing cholangitis and UC
119
cause of acute pancreatitis
```
alcohol
gallstones
shock
mumps
hyperparathyroidism
hypothermia
trauma
iatrogenic
```
120
what do lipases digest in autodigestion
intra/peripancreatic fat
121
what do proteases digest in pancreatic autodigestion
tissue, causes haemorrhage
122
complications of acute pancreatitis
```
death
shock
pseudocyst
abscess
hypocalcaemia
hyperglycaemia
```
123
cause of chronic pancreatitis
```
alcohol
gallstones
CF
hyperparathyroidism
FHx
```
124
where does pancreatic carcinoma spread to
```
duodenum
stomach
spleen
lymph nodes
liver
```
