Pathology of the Small and Large Intestine 1

Question 1

What are the microscopic features of ischaemic bowel?

Answer 1

Sloughing

Haemorrhagic suffusion of lamina propria

Question 2

What are the causes of ischaemic bowel?

Answer 2

Arterial
- Thrombotic
- Embolic
Non-oocclusive
Venous
Other
- Trauma
- Vasculitis
- Radiotherapy
- Strangulation

Question 3

What are the complications of ischaemic bowel?

Answer 3

Perforation

Risk of death after perforation ~90%

Question 4

What are the general features of malabsorption syndrome?

Answer 4

Chronic diarrhoea
Weight loss
Anaemia
Itchy rash

Question 5

What is dermatitis hepatoformis?

Answer 5

Rash associated with coeliac’s disease and IBD
Symmetrically on extensor surfaces
IgA in dermal papillae

Question 6

What are the microscopic features of coeliac’s disease?

Answer 6

Intra-epithelial leukocytic infiltration
Villous atrophy
Crypt hyperplasia

Question 7

Increased risk of what cancers is associated with coeliac’s disease?

Answer 7

MALT lymphoma
Oesophageal cancer
Small intestinal cancer

Question 8

What are the macroscopic features of Clostridium difficile pseudomembranous colitis

Answer 8

Inflamed granular mucosa

Multiple white plaques = pseudomembrane

Question 9

What is the antibiotic treatment of Clostridium difficile pseudomembranous colitis?

Answer 9

Oral vancomycin
Metronidazole
Tazocin

Question 10

What are the microscopic features of pseudomembranous colitis?

Answer 10

Mushroom-like cloud of exudate from crypts > adheres to surface
Patchy necrosis of crypts
Adjacent mucosa may look normal

Question 11

What are the main risk factors for pseudomembranous colitis?

Answer 11

Multiple and duration of Abx
Hospital stay
Age