Podcast
Questions and Answers
What characteristic of the mucosa is described as having a cobblestone appearance?
What characteristic of the mucosa is described as having a cobblestone appearance?
What type of inflammation features deep ulcers and neutrophils?
What type of inflammation features deep ulcers and neutrophils?
Which of the following is a complication typically associated with chronic inflammation of the mucosa?
Which of the following is a complication typically associated with chronic inflammation of the mucosa?
How does chronic active inflammation affect the layers of the wall?
How does chronic active inflammation affect the layers of the wall?
Signup and view all the answers
What type of abscess is associated with chronic inflammation?
What type of abscess is associated with chronic inflammation?
Signup and view all the answers
What is a key feature of granulomas observed in chronic inflammation?
What is a key feature of granulomas observed in chronic inflammation?
Signup and view all the answers
What is indicated by the presence of pseudo-polyps in long-standing chronic inflammation?
What is indicated by the presence of pseudo-polyps in long-standing chronic inflammation?
Signup and view all the answers
What does the chronic phase of inflammation NOT demonstrate?
What does the chronic phase of inflammation NOT demonstrate?
Signup and view all the answers
What clinical feature is likely to be present in a patient with mesenteric artery thrombosis or embolism?
What clinical feature is likely to be present in a patient with mesenteric artery thrombosis or embolism?
Signup and view all the answers
Which complication is associated with gangrene in the context of mesenteric artery obstruction?
Which complication is associated with gangrene in the context of mesenteric artery obstruction?
Signup and view all the answers
Which condition is NOT a functional cause of chronic intestinal obstruction?
Which condition is NOT a functional cause of chronic intestinal obstruction?
Signup and view all the answers
What is a potential complication of diverticular disease of the colon?
What is a potential complication of diverticular disease of the colon?
Signup and view all the answers
Which organism is commonly associated with acute diffuse suppurative appendicitis?
Which organism is commonly associated with acute diffuse suppurative appendicitis?
Signup and view all the answers
Which of the following is a characteristic of celiac disease?
Which of the following is a characteristic of celiac disease?
Signup and view all the answers
Which of the following is a common predisposing factor for acute appendicitis in adults?
Which of the following is a common predisposing factor for acute appendicitis in adults?
Signup and view all the answers
What is a defining characteristic of malabsorption syndromes?
What is a defining characteristic of malabsorption syndromes?
Signup and view all the answers
What is the primary characteristic of giardiasis?
What is the primary characteristic of giardiasis?
Signup and view all the answers
Which of the following conditions can lead to secondary malabsorption?
Which of the following conditions can lead to secondary malabsorption?
Signup and view all the answers
What type of organism causes typhoid fever?
What type of organism causes typhoid fever?
Signup and view all the answers
Which of the following is NOT a complication of typhoid fever?
Which of the following is NOT a complication of typhoid fever?
Signup and view all the answers
How is primary intestinal tuberculosis primarily contracted?
How is primary intestinal tuberculosis primarily contracted?
Signup and view all the answers
What feature is common in the pathology of typhoid fever?
What feature is common in the pathology of typhoid fever?
Signup and view all the answers
Which symptom is commonly associated with secondary malabsorption?
Which symptom is commonly associated with secondary malabsorption?
Signup and view all the answers
Which method is required for secondary intestinal tuberculosis infection?
Which method is required for secondary intestinal tuberculosis infection?
Signup and view all the answers
What is a feature of ulcers found in tuberculous lymphadenitis?
What is a feature of ulcers found in tuberculous lymphadenitis?
Signup and view all the answers
What generally characterizes the fate of tuberculous infections in individuals with low body resistance?
What generally characterizes the fate of tuberculous infections in individuals with low body resistance?
Signup and view all the answers
What type of necrosis is typically associated with Bacilli reaching Peyer’s patches?
What type of necrosis is typically associated with Bacilli reaching Peyer’s patches?
Signup and view all the answers
In the case of tuberculous girdle ulcers, which of the following features is noted?
In the case of tuberculous girdle ulcers, which of the following features is noted?
Signup and view all the answers
What is a common outcome of tuberculous lymphangitis?
What is a common outcome of tuberculous lymphangitis?
Signup and view all the answers
What type of ulcers are commonly seen in the context of terminal ileal involvement?
What type of ulcers are commonly seen in the context of terminal ileal involvement?
Signup and view all the answers
What is a direct complication of tuberculosis according to the discussed information?
What is a direct complication of tuberculosis according to the discussed information?
Signup and view all the answers
How does good body resistance affect tuberculous infections?
How does good body resistance affect tuberculous infections?
Signup and view all the answers
What is the primary characteristic of tubular adenomas?
What is the primary characteristic of tubular adenomas?
Signup and view all the answers
Which of the following is NOT a type of neoplastic polyp?
Which of the following is NOT a type of neoplastic polyp?
Signup and view all the answers
Which of the following conditions is related to Peutz-Jeghers polyps?
Which of the following conditions is related to Peutz-Jeghers polyps?
Signup and view all the answers
What is the risk factor for malignancy correlated with adenomas?
What is the risk factor for malignancy correlated with adenomas?
Signup and view all the answers
What percentage of patients with familial adenomatous polyposis (FAP) will develop colorectal carcinoma by the age of 30?
What percentage of patients with familial adenomatous polyposis (FAP) will develop colorectal carcinoma by the age of 30?
Signup and view all the answers
Which type of polyp is most likely to present with rectal bleeding in children?
Which type of polyp is most likely to present with rectal bleeding in children?
Signup and view all the answers
The term 'adenomas' encompasses which characteristic?
The term 'adenomas' encompasses which characteristic?
Signup and view all the answers
What is the initial treatment option for patients discovered to have APC mutations?
What is the initial treatment option for patients discovered to have APC mutations?
Signup and view all the answers
Study Notes
Crohn's Disease
- Gross Appearance: Cobblestone appearance of the mucosa, adherent creeping mesenteric fat, deep fissures, fistula tracts and fibrosis
- Microscopic Features: Chronic active inflammation with deep ulcers, fissures, & neutrophils. All wall layers are affected (transmural) with fibrosis, granulomas (35% non-caseating), and no dysplasia.
- Complications: Thrombosis or embolism of mesenteric artery leading to infarction of a segment, septic peritonitis, and gangrene.
Chronic Intestinal Obstruction
- Definition: Gradual incomplete obstruction of the intestinal lumen.
- Causes: Functional (Hirschsprung disease) or organic (adhesions, endophytic tumor, fibrous stricture)
- Gross Appearance: Proximal segment markedly dilated and hypertrophic, distal segment collapsed.
Diverticular Disease of The Colon
- Definition: Acquired herniations of mucosa and submucosa into the intestinal wall.
- Complications: Diverticulitis or abscess, bleeding, perforation & septic peritonitis, fibrosis & stricture.
Acute Diffuse Suppurative Appendicitis
- Etiology: Obstruction with fecolith & seeds (adults), lymphoid hyperplasia (children), or carcinoid tumor. Organisms include Staphylococci and E. coli.
- Complications: Perforation & septic peritonitis, peri-appendicular inflammatory mass/ abscess, gangrene, portal pyemia, mucocele (mucus-filled bag), empyema (pus-filled bag), and chronic appendicitis.
Malabsorption
- Definition: Defective absorption of fats, proteins, carbohydrates, water, electrolytes, minerals, and vitamins.
- Etiology: Celiac disease (gluten-induced enteropathy), tropical sprue, Giardiasis, secondary malabsorption due to various factors (inflammation, tumors, post-surgical resections). Patients generally present with chronic diarrhea, steatorrhea, and weight loss.
Typhoid Fever
- Definition: Systemic infective disease of the small intestine and other organs caused by Salmonella typhi, predominantly affecting children and adolescents.
- Route of infection: Ingestion of contaminated water or food.
- Pathogenesis: Pathological features include enlarged and swollen Peyer's patches, oval longitudinal ulcers in the intestinal mucosa, and enlarged spleen.
- Complications: Hemorrhage, perforation, secondary amyloidosis, and dysplasia/adenocarcinoma.
Primary Intestinal Tuberculosis
- Mode of infection: Swallowing of human or bovine tubercle bacilli.
- Pathology: Primary complex includes an initial lesion with a group of tubercles in Peyer's patches forming a small nodule and minimal ulceration of the covering mucosa, tuberculous lymphangitis, and tuberculous lymphadenitis (Tabes Mesenterica).
- Fate and Complications: With good body resistance, the disease localizes. With low body resistance, the disease spreads. Direct spread leads to TB peritonitis, while lymphatic spread leads to TB lymphadenitis. Other complications include hemorrhage, fissures, fistulae, fibrosis with strictures, secondary amyloidosis, and malabsorption.
Secondary Intestinal Tuberculosis
- Mode of infection: Ingestion of infected sputum from patients with pulmonary TB.
- Pathology: Lesions typically occur in the terminal ileum and caecum, with bacilli reaching Peyer's patches and solitary follicles, leading to caseous necrosis and erosion of the covering mucosa. Multiple tuberculous ulcers result, located in the terminal ileum, transversely (girdle), and undermined edges with a caseous floor. Mesenteric lymph nodes show minimal lesions.
- Fate and Complications: Spread can occur directly, leading to TB peritonitis, or lymphatically, leading to TB lymphadenitis. Other complications include hemorrhage, perforation, secondary amyloidosis, dysplasia/adenocarcinoma, and liver damage (associated with primary sclerosing cholangitis).
Intestinal Polyps and Tumors
- Non Neoplastic Polyps: Bilharzial polyps, pseudopolyps (in ulcerative colitis), hyperplastic polyps, and hamartomatous polyps (including juvenile polyps and Peutz-Jeghers polyps).
- Neoplastic Polyps (Adenomas): Tubular adenoma (pedunculated, small), villous adenoma (sessile, large), tubulo-villous adenoma (combined). Adenomas are very common, their incidence increases with age, and they are considered precursors to colorectal cancers. The risk of malignancy is correlated to the size of the adenoma and the degree of dysplasia.
- Familial Adenomatous Polyposis (FAP): Autosomal dominant hereditary disease characterized by numerous colorectal adenomas during teenage years, caused by mutations in the APC gene. Diagnosis requires at least 100 polyps. Colorectal carcinoma develops in 100% of patients before age 30. Prophylactic colectomy is standard therapy for patients carrying APC mutations.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the essential characteristics and complications of Crohn's disease, chronic intestinal obstruction, and diverticular disease of the colon. This quiz will test your understanding of their gross and microscopic features along with their clinical implications. Perfect for students of gastroenterology or medical professionals.
