Pathology of the Small Bowel Flashcards Preview

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Flashcards in Pathology of the Small Bowel Deck (34):
1

What are the 2 main causes of ischaemia of the small bowel

Mesenteric arterial occlusion
Non occlusive perfusion insufficiency

2

Is bowel ischamia acute or chronic

Usually acute but can be chronic

3

What can cause mesenteric arterial occlusion

Mesenteric artery atherosclerosis
THromboembolism from heart

4

What can cause non occlusive perfusion insufficiency

Shock
Strangulation obstructing venous return
Drugs (cocaine)
Hyperviscosity

5

What is the most metabolically active part of the bowel wall

The mucosa- most sensitive to the effects of hypoxia

6

What happens to the cyrpts in muscosal infarction

They die

7

What are 3 complications of ischaemia of the small bowel

Resolution
Fibrosis, stricture, chronic ischaemia
mesenteric angina and bstruction
Gangrene, perforation, peritonitis, sepsis and death

8

What is Meckel's Diverticulum

A congenital abnormality which is a result of incomplete regression of vitello-intestinal duct

9

What might Meckel's diverticulum mimic

Appendicitis

10

Are primary or secondary tumours more common

Secondary (metastases)

11

Tumours of the small bowel are metastases from which 3 places

Ovary
Colon
Stomach

12

What are 3 types of primary tumours of the small bowel

Lymphomas
Carcinoid tumours
Carcinomas (Adenocarcinomas)

13

What are all lymphomas of the small bowel

Non Hodkins in type

14

How can we treat lymphomas of the small bowel

Treated by surgery and chemotherapy

15

Where is the commonest site of carcinoid tumours of the small bowel

Appendix

16

Describe the typical appearance of carcinoid tumours of the small bowel

Small, yellow, slow growing tumours

17

Describe the typical appearance of carcinoid tumours of the small bowel

Small, yellow, slow growing tumours

18

What are carcinomas of the small bowel commonly associated with

Crohn's disease and Coeliac disease

19

Where do carcinomas of the small bowel metastasise to?

Lymph nodes and liver

20

What are 4 common presentations of appendicitis

Vomiting
Abdo pain
RIF tenderness
Increased WCC

21

What causes acute appendicitis

Unknown
Faecoliths (dehydration)
Lymphoid hyperplasia
Parasites
Tumours (rare)

22

What must acute inflammation involve in appendicitis

Muscle coat

23

What are 5 complications of appendicitis

Peritonitis
Rupture
Abscess
Fistula
Sepsis and liver abscess

24

What is coeliac diseased

Caused by an abnormal reaction to a constituent of what flour, gluten, which damages enterocytes and reduces absorptive capacity
It is a lifelong condition

25

What 2 things is coeliac disease associated with

dematitis herpetiformis
childhood diabetes

26

When can coeliac disease present

Childhood, middle age or adulthood

27

When can coeliac disease present

Childhood, middle age or adulthood

28

What is the suspected toxic agent

Gliadin (a protein component of gluten)

29

What are the 2 clinical features of coeliac disease

Mucosa may be endoscopically normal or appear attenuated
Lesion worse in proximal bowel so duodenal biopsy is very sensitive (not an ileal biopsy)

30

What is tested in serology

Antibodies: anti-TTG, anti-endomesial, anti-gliadin

31

What are 2 metabolic effects of coeliac disease

Malabsorbtion of sugars, fats, amino acids, water and electroyltes
Malabsorption of fats leads to steatorrhowa

32

What can reduce pancreatic secretion and bile flow leading to gallstones

Reduced intestinal hormone production

33

What are 5 presentations of coeliac disease

Loss of weight
Anaemia (Fe, Vit B12, Folate)
Abdominal bloating
Failure to thrive
Vitamin deficiencies

34

What are 4 complications of coleiac disease

T cell lymphomas of GI tract
Increased risk of small bowel carcinoma
Gall stones
Ulcerative- jejenoilleitis

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