Gastrointestinal Disorders Quiz
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Questions and Answers

What is a characteristic gross appearance of Crohn's disease?

  • Congested velvety mucosa
  • Shallow ulcers and pseudopolyps
  • Continuous lesion throughout the colon
  • Segmental (skip) lesions with a cobblestone appearance (correct)

    • Which of the following clinical features is NOT typically associated with Crohn's disease?

  • Recurrent episodes of diarrhea
  • Chronic abdominal cramps
  • Shallow ulcers (correct)
  • Fever lasting days to weeks

    • What type of cells are primarily involved in the microscopic characteristic lesions of Crohn's disease?

  • Epithelioid and giant cells (correct)
  • Lymphocytes and fibroblasts
  • Basophils and eosinophils
  • Neutrophils and plasma cells

    • Which complication is most associated with Crohn's disease due to intestinal narrowing?

    <p>Malabsorption syndrome (D)</p> Signup and view all the answers

    The primary site typically affected by Crohn's disease is which of the following?

    <p>Terminal ileum (C)</p> Signup and view all the answers

    In ulcerative colitis, which feature is characteristic of its gross appearance?

    <p>Continuous lesions with congested velvety mucosa (D)</p> Signup and view all the answers

    What is a common precipitating factor for the clinical manifestations of recurrent diarrhea in Crohn's disease?

    <p>Intestinal obstructions (C)</p> Signup and view all the answers

    In the context of intestinal diseases, what is the significance of 'fistula formation' in Crohn's disease?

    <p>They represent a major complication from disease progression. (C)</p> Signup and view all the answers

    Which clinical feature is commonly associated with acute appendicitis?

    <p>Peri-umbilical pain migrating to the right lower quadrant (B)</p> Signup and view all the answers

    What complication is NOT typically associated with acute appendicitis?

    <p>Peptic ulcer (D)</p> Signup and view all the answers

    Meckel's diverticulum is characterized by which of the following features?

    <p>Remnant of the vitelline duct (B)</p> Signup and view all the answers

    Which statement is true regarding colonic diverticula?

    <p>Commonly occurs in the sigmoid colon in elderly patients (A)</p> Signup and view all the answers

    Which of the following is NOT a complication of colonic diverticula?

    <p>Gangrene of the bowel (D)</p> Signup and view all the answers

    What is a common clinical feature of congenital megacolon (Hirschsprung disease)?

    <p>Constipation (D)</p> Signup and view all the answers

    Which of the following statements is correct regarding the features of Meckel's diverticulum?

    <p>Usually 2 cm in length (B)</p> Signup and view all the answers

    What histological feature is characteristic of congenital megacolon?

    <p>Absence of ganglion cells in Auerbach's and Meissner's plexuses (C)</p> Signup and view all the answers

    What is a characteristic finding of ulcerative colitis in the microscopic examination during the acute phase?

    <p>Formation of crypt abscess (B)</p> Signup and view all the answers

    Which of the following complications is NOT typically associated with ulcerative colitis?

    <p>Granuloma formation (A)</p> Signup and view all the answers

    What symptom is commonly observed in patients with ulcerative colitis?

    <p>Diarrhea with mucus and blood (A)</p> Signup and view all the answers

    In the chronic phase of ulcerative colitis, which of the following changes occurs?

    <p>Destruction of glandular epithelium (A)</p> Signup and view all the answers

    What gross appearance is typical of the colon in a patient with ulcerative colitis?

    <p>Velvety superficial mucosa with pseudopolyps (A)</p> Signup and view all the answers

    What is the most common cause of acute appendicitis?

    <p>Obstruction of the lumen (C)</p> Signup and view all the answers

    What type of necrosis can occur in severe cases of acute appendicitis?

    <p>Gangrenous necrosis (A)</p> Signup and view all the answers

    Which of the following statements correctly describes Crohn's disease in comparison to ulcerative colitis?

    <p>Crohn's disease has transmural inflammation (B)</p> Signup and view all the answers

    Flashcards

    Ulcerative Colitis

    A common inflammatory bowel disease that affects only the colon. Characterized by ulcers, pseudopolyps, and a velvety, superficial mucosa.

    Crypt Abscesses

    Small, pus-filled pockets that occur in the lining of the colon during ulcerative colitis. They are a hallmark of the disease.

    Toxic Megacolon

    A condition where the colon becomes severely enlarged and loses its ability to contract. It can be a serious complication of ulcerative colitis.

    Crohn's Disease

    A chronic inflammatory bowel disease that can affect any part of the digestive tract, from the mouth to the anus. Characterized by transmural inflammation, non-caseating tubercles, and cobble-stone appearance.

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    Acute Appendicitis

    Inflammation of the appendix, a small, finger-like projection from the colon. It's a common cause of acute abdominal pain.

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    Fecolith

    A hard mass of feces that can block the lumen of the appendix, leading to inflammation.

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    Gangrenous Necrosis

    A condition where the lining of the appendix is damaged and dies due to lack of blood supply.

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    Polymorphonuclear Leukocytes (PNLs)

    A group of different types of white blood cells that are involved in fighting infection. They are often found in large numbers in the inflamed tissue of appendicitis.

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    Submucosal Tubercles

    The classic lesion associated with Crohn's disease, consisting of a cluster of epithelioid and giant cells.

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    String Sign in Crohn's Disease

    A distinctive feature of Crohn's disease where the intestinal wall is thickened, the lumen is narrow, and the serosa is covered with fat.

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    Pseudopolyps

    Abnormal growths of tissue in the colon that can develop in ulcerative colitis due to inflammation.

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    Intestinal Obstruction in Crohn's Disease

    A common complication of Crohn's disease where the lumen of the bowel is obstructed due to thickening of the intestinal wall.

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    Appendicitis

    Inflammation of the appendix, a small finger-like projection from the colon.

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    Diverticula of the Intestine

    Small pouches that form in the lining of the digestive tract, primarily the colon.

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    Intestinal Diverticula

    Outward pouches or bulges in the wall of the intestine, often caused by increased pressure in the colon.

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    Meckel's Diverticulum

    A congenital diverticulum (outpouching) in the small intestine, a remnant of the yolk sac.

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    Meckel's Diverticulitis

    Inflammation of Meckel's diverticulum, often caused by ectopic gastric mucosa or other factors.

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    Colonic Diverticula (Acquired)

    Acquired diverticula usually found in the sigmoid colon, often caused by chronic constipation and high pressure in the colon.

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    Colonic Diverticulitis

    Inflammation of colonic diverticula, potentially leading to complications like fistula formation or perforation.

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    Congenital Megacolon (Hirschsprung Disease)

    A condition caused by a lack of ganglion cells in a segment of the colon, leading to dilatation (widening) of the colon above the affected segment.

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    Enterocolitis

    A potentially life-threatening complication of Hirschsprung disease, characterized by inflammation and infection of the bowel.

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    Study Notes

    Intestinal Diseases - Overview

    • Intestinal diseases encompass a range of conditions affecting the intestines
    • Key types discussed include idiopathic intestinal inflammations, appendicitis, intestinal diverticula, and congenital megacolon.

    Idiopathic Intestinal Inflammations

    • Included diseases are Crohn's disease (regional enteritis) and ulcerative colitis.
    • Crohn's disease: A chronic, non-specific granulomatous disease.
      • Cause unknown
      • Typically affects the terminal ileum, but may affect other parts of the intestines.
      • Gross appearance includes segmental (skip) lesions, cobblestone appearance of mucosa, deep ulcers, thickened intestinal wall, and narrowed lumen (string sign on X-ray).
      • Microscopic features include diffuse infiltration of all intestinal layers by mononuclear cells, presence of submucosal tubercles composed of epithelioid and giant cells, no caseation necrosis and fibrosis in late stages.
      • Clinical features often include recurrent diarrhea, abdominal cramps, and fever lasting from days to weeks. Age peaks in two ranges: 10-30 and 50-70.
      • Complications include intestinal obstruction, perforation with peritonitis or fistula formation, malabsorption syndrome, bleeding and anemia, mucosal dysplasia (increased risk of malignancy).
    • Ulcerative colitis: An inflammatory condition of colon and rectum, initially acute, but progressing to chronic with periods of remission.
      • Cause unknown
      • Inflammation is limited to the mucosa and submucosa (except in severe cases).
      • Gross appearance includes continuous lesions throughout the affected colon, congested velvety mucosa, shallow ulcers, and pseudopolyps (intact mucosa).
      • Microscopic features include severe mucosal congestion during acute phase, presence of crypt abscesses and giant mucosal ulcers, and destruction of glandular epithelium during chronic phase, infiltration by mainly plasma cells, and epithelial hyperplasia and dysplasia in late stages.
      • Clinical features include diarrhea with mucus and blood in the stool, lasting from days to months, that subsides and recurs at varying intervals. Age peak is typically around 20-30.
      • Complications include rectal hemorrhage, anemia, diarrhea, weight loss, perforation, malignant change(after 10 years of pancolitis), secondary amyloidosis, and toxic megacolon (massive colon dilatation due to loss of motility.

    Appendicitis

    • The most frequent cause of acute abdomen in younger adults and children of both sexes.
    • Cause: usually due to obstruction of the appendix lumen, leading to ischemia and secondary bacterial infection (E. coli).
    • Gross appearance: swollen, congested appendix; fibrin may be visible on the serosal surface.
    • Microscopic appearance: inflammatory exudate in the lumen, infiltration of the wall by acute inflammatory cells (especially in the muscle layer), ulceration and necrosis of mucosa, congestion of blood vessels, and edema of the wall, potentially gangrenous necrosis in severe cases.
    • Clinical features include periumbilical pain migrating to the right lower quadrant, anorexia, vomiting, mild fever, and leukocytosis (WBC count >15000/cmm).
    • Complications include perforation with peritonitis; toxemia, and death (2%), and portal pyemia, chronic appendicitis.

    Diverticula of the Intestine

    • Outpouching of the intestinal wall.
    • Can be congenital (e.g., Meckel's diverticulum) or acquired (e.g., colonic diverticulosis).
    • Meckel's diverticulum: Remnant of the vitelline duct. Occurs in 2% of the population, usually identified at 2 years of age. Typically located 2 feet from the ileocecal valve and 2 cm in length. Carcinoid tumors occur in 2% of cases.
    • Colonic diverticula: Arise in the sigmoid colon due to chronic constipation. Characterized by multiple pouches formed of mucosa and submucosa protruding through weak spots in the colon wall at the mesenteric attachment points.
    • Complications include inflammation (diverticulitis), peptic ulcers (if gastric mucosa is present), carcinoid tumors, and intestinal obstruction.

    Congenital Megacolon (Hirschsprung's Disease)

    • Genetic disorder leading to the absence of ganglion cells in a segment of the colon.
    • Gross appearance includes dilation above the affected segment, with the affected segment or portion (e.g., rectum or sigmoid colon) being narrow.
    • Microscopic: Absence of ganglion cells in the Auerbach's and Meissner's plexuses in the submucosa.
    • Clinical features typically appear in infancy, are more common in females (4:1 ratio), and are characterized by constipation, abdominal distention, and vomiting.
    • Complications include enterocolitis (life-threatening) and perforations (rare).

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    Description

    Test your knowledge on gastrointestinal disorders, focusing primarily on Crohn's disease and its distinguishing features. This quiz covers gross appearances, clinical manifestations, complications, and related conditions, allowing you to explore the subject in depth.

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