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Pathology Flashcards

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1
Q

What may be the causes of acute oesophagitis?

A
  • corrosive following chemical ingestion

- immunocompromised patients

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2
Q

What causes chronic oesophagitis?

A
  • reflux disease

- rare causes include Crohn’s disease

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3
Q

What is most common? Acute or chronic Oesophagitis?

A
  • Chronic oesophagitis is most common
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4
Q

What causes reflux oesophagitis? and what causes it

A
  • inflammation of oesophagus due to refluxed low pH gastric content
  • defective sphincter mechanisms
  • hatius hernia
  • increased intra-abdominal pressure
  • abnormal oesophageal motility
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5
Q

What is the definition of Barrett’s Oesophagus?

A
  • replacement of stratified squamous epithelium by columnar epithelium
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6
Q

What may cause Barrett’s oesophagus?

A
  • persistent reflux of acid/bile

- differentiation from oesophageal stem cells

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7
Q

Allergic oesophagitis is characterised by what cell type?

A
  • eosinophills
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8
Q

Treatment for allergic oesophagitis?

A
  • steroids
  • chromoglycate (mast cell stabiliser)
  • montelukast
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9
Q

What may cause malignant squamous cell carcinoma of the oesophagus?

A
  • smoking
  • alcohol
  • vitamin A/ zinc deficiency
  • HPV
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10
Q

What would oral squamous cell carcinoma appear like?

A
  • white, red, speckled, ulcer lump

- floor of mouth, lateral border, ventral tongue, soft palate

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11
Q

What may cause acute gastritis?

A
  • irritant chemical injury
  • severe burns
  • shock
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12
Q

What is a peptic ulcer?

A
  • breach in the gastrointestinal mucosa because of acid and pepsin attack
  • failure of barrier function and increased acid secretion
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13
Q

What is another name for benign gastric tumours?

A
  • polyps
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14
Q

Patients with anti-H.pylori antibodies have higher risk of ____

A
  • cancer
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15
Q

What is the major cause of chronic gastritis?

A
  • H.pylori (bacterial infection)

- autoimmune less common

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16
Q

What may cause ischaemia of the small bowel?

A
  • mesenteric arterial occlusion

- non-occlusive perfusion insufficiency

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17
Q

What does Meckel’s diverticulum result in?

A
  • incomplete regression of Vitelli-intestinal duct
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18
Q

Appendicitis is characterised by what cell type?

A
  • neutrophils (acute inflammation)
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19
Q

Will it be an exudate or transudate fluid in appendicitis?

A
  • serosal congestion

- exudate

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20
Q

What is the pathology of coeliac disease?

A
  • Strong association with HLA-B8
  • Flat mucosal
  • villous atrophy = decreased surface area
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21
Q

complications of coeliac disease/

A
  • t-cell lymphomas of GI tract
  • gall stones (reduced CCK released)
  • increased risk of small bowel carcinoma
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22
Q

What are polyps

A
  • protrusions above epithelial surface
  • tumours (swellings)
  • doesn’t indicate benign or malignant
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23
Q

Name some benign epithelial polyp

A
  • ademona inflammatory hamartomatous
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24
Q

Name a malignant epithelial polyp?

A
  • polypoid adenocarcinomas
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25
Name a benign mesenchymal polyp
- lipoma | - fibromass
26
Name a malignant mesenchymal polyp
- sarcomas | - lymphomatous polyps
27
What may be the differential diagnosis of a polyp?
- adenoma - serrated polyp - polypoid carcinoma
28
All adenomas are _______
- dysplastic | - pre malignant so must be removed
29
Explain the sequence of events of adenoma-carcinoma formation
- normal mucosa - adenoma - adenocarcinoma
30
What are precursors of colorectal carcinomas?
- adenomas
31
What treatment should be done to colorectal adenomas?
- removed (surgically or endoscopically) | - as they are precursors of carcinomas
32
What colorectal carcinoma scoring system is used?
- Dukes Staging
33
Explain Dukes A
- confined by muscularis propria
34
Explain Dukes C
- Metastatic to lymph nodes
35
What may be the symptoms of left sided colorectal carcinoma?
- blood PR - altered bowel habit - obstruction
36
What may be the symptoms of right sided colorectal carcinoma?
- anaemia | - weight loss
37
Where are the sites of local invasion of a colorectal carcinoma?
- mesorectum | - peritoneum
38
Explain hereditary non-polyposis coli
- <100 polyps - late onset - autosomal dominant - right sided tumours
39
Explain familial adenomatous polyposis
- >100 polyps - autosomal dominant - thought colon - early onset
40
What are common diseases of the large bowel?
- polyps - adenomas - adenocarcinomas
41
Define Cholelithiasis?
- gallstones | - hard stone like material formed within the biliary system most commonly the gallbladder
42
What procedure is conducted to remove cholelithiasis (gallstones)?
- cholecystectomies
43
Explain the composition of normal bile?
- micelles of cholesterol, phospholipids, bile salts and bilirubin
44
Where is bile stored and concentrated?
- gallbladder
45
Why are gallstones formed?
- imbalance between the ratio of cholesterol to the ratio of bile salts - disrupts micelle formation
46
What are the 2 types of gallstones?
- pigment stones | - cholesterol stones
47
How are cholesterol stones formed?
- excess cholesterol in bile
48
How are pigment stones formed?
- excess bilirubin
49
Define cholecystitis?
- inflammation of the gallbladder | - usually associated with gallstones
50
Explain acute cholecystitis?
- gallstones obstructing outflow of bile | - indicated by neutrophils
51
Explain chronic cholecystis
- gallbladder wall thickened due to fibrosis
52
What causes obstructive jaundice?
- stone (blockage) of common bile duct
53
Cholangiocarcinoma?
- carcinoma of the bile ducts
54
What is cholangiocarcinoma associated with?
- ulcerative colitis | - primary sclerosing cholangitis
55
Define pancreatitis?
- inflammation of the pancrease
56
Explain acute pancreatitis?
- adults - sudden onset of abdo pain - elevated serum amylase
57
lipases in acute pancreatitis released by what?
- intra and peri- pancreatic fat necrosis
58
Proteases in acute pancreatitis released by what?
- tissue destructing and haemorrhage
59
Explain chronic pancreatitis?
- relapsing disorder may develop insidiously of following bouts of acute pancreatitis
60
What are the symptoms of gallstones?
- Stone impacts in cystic duct - Gradual build-up pain in RUQ - Radiates to back/shoulders - Associated with indigestion/nausea
61
What is the differential diagnoisis of acute epigastric pain?
- Biliary colic (gallstones) - peptic ulcer disease - oesophageal spasm - myocardial infarction - acute pancreatitis
62
How might gallstones be diagnosed?
- ultrasound | - CT scan
63
What is ascending cholangitis?
- inflammation of the bile ducts - by ascending bacteria from the gut - tends to be if bile flow is bloked, by a gallstone in the common bile duct
64
Functions of the pancreas?
- Exocrine - Acinar cells secrete pancreatic enzymes | - Endocrine- Islets of Langerhans secrete hormones into blood
65
Define pancreatitis?
- An acute inflammatory process in the pancreas
66
Clinical presentation of pancreatitis?
- Acute onset epigastric pain - Radiating through to back - Very serve - Nausea and vomiting - Jaundice
67
Name some pancreatic tumours
- Adenocarcinoma (exocrine) | - Gastrinoma (endocrine)
68
Symptoms of pancreatic tumours?
o Jaundice o Weight loss o Back pain
69
Name some complications of reflux
- ulceration - stricture - Barrett's oesophagus
70
What is the Z line?
- where the squamous mucosa of the oesophagus meets the columnar mucosa of the stomach
71
What would be seen down a microscope for reflux oesophagitis?
- intraepithelial neutrophils, lymphocytes and eosinophils | - basal zone hyperplasia
72
Name a benign tumour of the oseophagus?
- squamous papilloma
73
Name 2 malignant tumours of the oesophagus
- squamous cell carcinoma | - adenocarcinoma
74
What are the 3 mechanisms of metastases?
- direct invasion - lymohatic permeation - vascular invasion
75
Explain adjuvant therapy
- therapy given in addition to primary or inital therapy, to mazimise its effectiveness
76
3 factors which may lead to chronic gastritis?
- autoimmume - bacteria - chemical
77
H.pylori is a gram_________
gram negative curvilinear rod
78
What causes chronic peptic ulcers?
- increased acid production | - failure of mucosal defence
79
What is maltoma?
- gastric lymphoma
80
Explain Zolinger Ellison Syndrome
- gastrin secreting tumour - damages the mucosa - can cause recurrent peptic ulcers
81
Where might carcinoid tumours originate?
- appendix
82
What are the 3 zones of the liver called?
Zone 1 = periportal Zone 2 = mid acinar Zone 3 = pericentral
83
What are the potential consequences of acute liver failure?
- complete recovery - chronic liver disease - death from liver failure
84
Explain pre-hepatic jaundice?
- too much haem breakdown
85
Explain hepatic jaundice?
- liver cells injured
86
Explain post-hepatic jaundice?
- blockage of bile to the bowel
87
What are the complications of ccirrhosis?
- portal hypertension - ascites - liver failure
88
What are the complication of portal hypertension?
- oesophageal varcies - captu medusa - haemorrhoids
89
NASH stands for?
- Non-Alcoholic SteatoHepatitis
90
What patients get NASH?
- diabetic - obese - hyperlipideamia
91
Explain hep A
- faecal-oral spread - no carriers exist - poor hygiene - hepatitis A IgM test
92
Explain hep B
- sex, blood, mother to child - carriers exist - HBsAg test
93
What is hep D associated with?
- only in co-existance with Hep B
94
Explain hep C
- similar to spread of hep B, less sex route - often asymptomatic - PCR test for RNA
95
What are some causes of chronic hepatitis?
- autoimmune hepatitis - hep B and C - primary biliary cirrhosis - primary sclerosis cholangitis
96
Explain primary biliary cirrhosis
- autoimmune - female - granulomas and bile duct loss seen - leads to cholestasis --> cirrhosis
97
Explain autoimmune hepatitis
- seen in pts. with additional allergies | - may have triggers
98
Explain primary sclerosis cholengitis
- associated with UC and Males | - increased risk of malignancy
99
Define haemochromatosis?
- excess iron within the liver
100
Explain primary haemochromatosis?
- autosomal recessive | - genetic condition
101
What is Wilson's disease?
- autosomal recessive | - copper accumulates in the liver and brain
102
What are common diseases of the large bowel?
- diverticular disease - ischaemia - antibiotic induced colitis
103
Explain diverticular disease
- common - asymptomatic - related to low fibre diet and increased intralumenal pressure
104
What are possible complications of diverticular disease?
- diverticulitis - rupture - abscess - fistula - bleed
105
Explain ischaemia of the bowel causes
- left sided - CVS - AF - Embolus - shock - atherosclerosis
106
Withering of crypts and pink smudy lamina propria, are signs of______
- large bowel ischaemia
107
Antibiotic induced colitis aetiology
- patients on broad spectrum antibiotics - c.difficle toxin a and b - massive diarrhoea and bleeding
108
Explosive lesions on mucosa are signs of
- antibiotic induced colitis
109
Explain collagenous colitis
- thickened basement membrane - patchy disease - no chronic architectural changes - water diarrhoea
110
Explain the main sign of lymphocytic colitis
- intraepithelial lymphocytes raised
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