Term
| What's the histopathology in sprue? |
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Definition
| flat mucosa due to surface lymphocytes and damage. Secondary crypt hyperplasia and loss of absorptive surface. |
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Term
| Def of Ulcerative colitis |
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Definition
| A chronic inflammation of unknown etiology that mostly involves colonic mucosa, destroying it to various degrees mainly by damaging crypt epithelium |
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Term
| Types of cells/histopath seen in UC? |
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Definition
plasma cells, neutrophilic cryptitis, abscesses, multiple foci of cryptitis
Distortion: no 2 crypts are the same size, shape or are going in the same direction. |
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Term
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Definition
| the worse the disease, the more bleeding and deficiency in water/electrolyte abs, uncontrollable bleeding/diarrhea |
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Term
| “inflammatory pseudopolyps” |
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Definition
Ulcers isolating islands of inflamed mucosa make polyps
Segments of nonfunctioning colon…risk of perforation and paralyze the colon |
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Term
| 3 complications of UC and ulcers |
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Definition
Many large ulcers
uncontrollable hemorrhage/diarrhea
Undermining ulcers
inflammatory pseudopolyps
Broad deep ulcers
Megacolon: a big colon |
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Term
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Definition
| granularity, loss of transverse folds, and atrophy of crypts, ulcerative pancolitis |
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Term
| Complication of long-standing UC? |
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Definition
| Carcinoma if 10+ yrs, but rare and high-grade dysplasia |
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Term
| Definition of Crohn’s Disease |
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Definition
| a chronic ulcerating disease of unknown etiology that involves any part of the gut, but mostly small intestine, and that, in the full blown case, involves the entire gut wall (transmural) |
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Term
| Key features of Crohn's disease |
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Definition
segmental distribution, targets Terminal ileum, apthous lesions (ulcers), linear ulcers, and fissures/fistula diving into the wall (penetrating ulcers!)
mesenteric Fat wrapping that can cause strictures
irregular distribution/linear ulcers |
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Term
| histopath features of crohn's |
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Definition
Ulcers, distortion, transmural lymphocytic nodules, stromal hyperplasia
muscularis mucosa proliferation, subserosal inflammation
granulomas |
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Term
| Ischemic Bowel Disease Causes |
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Definition
Arterial hypoperfusion
1. Low flow states
marginal cardiovascular status, such as
shock: heart failure, sepsis
2. Arterial blockage
atherosclerosis
emboli and thrombi
arteritis
Venous outflow obstruction
congestion and hemorrhage dominate |
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Term
| Histopath of acute ischemic bowel |
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Definition
| necrosis of superficial mucosa, regenerating crypts at the base, plasma cells diminished, even ischemic ulcers that penetrate into the muscularis propria, ischemic submucosal edema, |
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Term
| Infectious causes of bowel inflammation (acute infectious colitides) (3) |
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Definition
1. Clostridium difficile associated pseudomembranous colitis
2. Acute self-limited colitis (bacterial)
3. Verotoxin-producing E coli associated acute hemorrhagic colitis |
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Term
| Pseudomembranous Colitis Histopath |
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Definition
| Membranous exudates: Coems from superficial crypts, necrotic debris pouring out in explosive fashion! |
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Term
| Cause of PMC and downstream consequence? |
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Definition
Due to Clostridium difficile
Precursor:
broad spectrum antibiotics
Result:
overgrowth of C difficile
and toxin production
Treated by other antibiotics
You can get Megacolon! |
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Term
| Causes of acute self-limited (infectious colitis) |
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Definition
most important: campylobacter fetus ssp jejuni
Others:
Salmonella
Shigella
Enterbacteriaceae
Clostridia
Gonococcus
Staphylococcus aureus
Yersinia enterocolitica
Reovirus
Cryptosporidia
E. histolytica |
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Term
| What does the colon infected with verotoxin producing E coli look like? |
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Definition
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Term
| Causes of Chronic watery diarrhea and endoscopically normal colon |
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Definition
1. Small bowel disease: not so much
2. Secretory diarrhea (VIPoma)
3. Microscopic colonic disease
4. Irritable bowel syndrome |
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Term
| Histopath of Collagenous colitis |
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Definition
| Thick trichome stained collagen layer beneath the surface epithelium plus surface and lamina propria inflammation |
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Term
| Malabsorption and diarrhea causes (review) |
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Definition
Mucosal defects: sprues, infiltrative diseases,
Crohn’s of TI, Ulcerative colitis
Enzyme deficiencies: chronic pancreatitis
cystic fibrosis |
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Term
| Secretion/exudation causes of diarrhea |
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Definition
acute colonic infections:
acute self-limited, C difficile PMC, cholera
chronic colonic inflammations: ulcerative colitis
lymphocytic and collagenous colitis |
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