Pathology of the Small Bowel Flashcards Preview

JL Gastrointestinal > Pathology of the Small Bowel > Flashcards

Flashcards in Pathology of the Small Bowel Deck (36):
1

What can mesenteric artery atherosclerosis and thromboembolism from the heart (AF) cause?

Mesenteric arterial occlusion leading to small bowel ischaemia

2

What drugs can lead to non occlusive perfusion insufficiency?

Cocaine

3

What is the most metabolically active part of the bowel wall?

Mucosa, so most sensitive to hypoxia

4

In non occlusive ischaemia, what does much of the tissue damage occur after?

Reperfusion

5

What are gangrene, perforation, peritonitis, sepsis and death all complications of?

Ischaemia of the small bowel

6

What is a result of incomplete regression of vitello-intestinal duct?

Meckel's Diverticulum

7

What is the rule of twos in Meckel's Diverticulum?

2 inches long, 2 foot above ileocaecal valve in 2% of people

8

What kind of structure are Meckel's Diverticulum?

Tubular

9

What might Meckel's diverticulum contain?

Heterotopic gastric mucosa

10

What does Meckel's diverticulum mimick, with bleeding, perforation, or diverticulitis?

Appendicitis

11

What three organs can give secondary tumours to the small bowel?

Ovary, colon, stomach

12

What are three primary tumours of the small bowel?

1. Lymphomas
2. Carcinoid tumours
3. Carcinomas

13

What are lymphomas of the small bowel like in relation to type?

Non Hodkins

14

What are lymphomas of the small bowel derived from?

Maltomas (B-cell) derived

15

What does enteropathy associated T cell lymphomas (associated with coeliac disease), occur in?

Lymphomas of small bowel

16

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

Appendix

17

What are small, yellow, slow growing tumours?

Carcinoid tumours of small bowel

18

What can carcinoid tumours of small bowel cause?

Intussusception and obstruction

19

What happens when carcinoid tumour of small bowel metastases to the liver?

A carcinoid syndrome occurs producing flushing and diarrhoea

20

What two conditions is carcinoma of the small bowel associated with?

Crohn's disease and coeliac disease

21

What happens to WWC in appendicitis?

Increases

22

What are 4 pathological features of acute appendicitis?

1. Acute inflammation (neutrophils)
2. Mucosal ulceration
3. Serosal congestion, exudate
4. Pus in lumen

23

What type of exudate is seen in acute appendicitis?

Yellow surface exudate

24

What is caused by an abnormal reaction to a constituent of wheat, flour, gluten which damages enterocytes and reduces absorptive capacity?

Coeliac disease

25

What condition has a strong associated with HLA-B8 and dermatitis herpetiformis?

Coeliac disease

26

What is the suspected component of gluten that is the toxic agent in coeliac disease?

Gliadin

27

What is coeliac disease mediated by?

T lymphocytes which exist within the small intestine epithelium

28

What is the normal lifespan of an enterocyte?

72 hours

29

In coeliac disease, what is there an increasing loss of enterocytes due to?

IEL mediated damage

30

What 4 things occur as a result of increasing loss of enterocytes due to IEL mediated damage?

1. Loss of villous structure
2. Loss of surface area
3. Reduction in absorption
4. Flat duodenal mucosa

31

What is coeliac morphology like?

Flat mucosal biopsy with total villous atrophy

32

In coeliac disease, where is the lesion worse?

Proximal bowel so duodenal biopsy is very sensitive

33

What 3 antibodies can be found in serology for coeliac disease?

1. Anti-TTG
2. Anti-endomesial
3. Anti-gliadin

34

What happens to sugars, fats, amino acids, water and electrolytes in coeliac disease?

Malabsorption

35

What does malabsorption of fats lead to?

Steatorrhoea

36

What can reduced intestinal hormone production lead to? (Coeliac disease)

Reduced pancreatic secretion and bile flow leading to gallstones