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