Small intestine and colon Pathology Flashcards
Compare and contrast the key pathologic findings of ulcerative colitis and Crohn’s disease.
Both inflammatory Bowel Diseases with genetic component common in developed countries.
UC - mucosa and submucosa of colon and rectum. Continuous, no skip lesions. histology - distortion of crypts and less of them.
CD - transmural. anywhere in GI. Non-continuous (skip lesions). Deep fissures. non-caseating granuloma. “cobblestone” appearance. Can have fistulas
Define and describe diversion colitis, radiation enterocolitis, and neonatal necrotizing enterocolitis.
Diversion - deficiency of short chain fatty acids in your ass hole because you have a colostomy, so nothing get’s there. Treatment - surgery to re-join the color and rectum, or fat enema!
Radiation - after radiation. ischemic from occlusion. can lead to ulcer, stricture, fistula or adhesions. Mucosa is red and had “radiation fibroblasts”
Neonatal necrotizing - 1st week. transmural necrosis of small and large bowel. Can get bacterial overgrowth leads to gas.
Describe the two types of microscopic colitis and state the typical pathologic and clinical presentation for these disorders.
Chronic watery diarrhea with normal colonoscopy. Also, crypts are intact.
Lymphocytic - intraepithelial lymphocytes
Collagenous - sub-epithelial collagen
both are autoimmune and tx with glucocorticoids.
Know the class of drugs commonly implicated in drug induced enterocolitis.
NSAIDS
Chemo drugz
Antibiotics - C dif infection after antibiotics that leads to pseudomembanous colitis.
Define and describe irritable bowel syndrome.
Pain, discomfort, bloating, diarrhea or constipation with no cause
No microscopic, endoscopic, colonoscopic changes.
Define and describe sigmoid diverticulitis. Know the common complications of this disorder.
Inflammation of diverticula - outpouching of mucosa and submucosa. Can also cause GI bleed. Complicated cases have abscess, obstruction, perforation and fistulas.
TX - lots of fluid, antibiotics, fiber
Define and describe solitary rectal ulcer syndrome.
malfunction of puborectalis muscle –> excessive straining –> rectal prolapse –> that ulcers on the anterior rectal wall. So many thing have to go wrong for that to happen!!
Usually young health adults with blood in stool, hurts to poop.
Looks like adenocarcinoma
Describe the clinical significance and morphology of inflammatory polyp, juvenile (retention) polyp, Peutz-Jeghers polyp, hyperplastic polyp, as well as the adenoma (adenomatous polyp) and the sessile serrated adenoma. Describe the features of Peutz-Jeghers syndrome, FAP, Lynch syndrome (HNPCC), Gardner’s syndrome, and Turcot syndrome.
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Describe, morphology, clinical presentation, screening, and prevention of colorectal cancer. Describe the rationale for mismatch repair protein testing and KRAS testing in colon cancer
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Describe the most common location and risk factors for small bowel adenocarcinoma.
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Describe the various typical presentations of GI tract neuroendocrine tumors (i.e. those arising in small bowel, appendix, colon, and rectum).
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Describe melanosis coli and lymphomatosis polyposis.
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Describe the pathogenesis, morphologic findings, clinical presentation, helpful diagnostic tests, and potential complications of acute appendicitis.
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Describe the typical morphology of appendiceal carcinoma and pseudomyxoma peritonei.
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Define and describe anal hemorrhoids, fissure, and fistula.
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