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Year2 GI Exam I > Path II > Flashcards

Path II Flashcards

1
Q

What is the most common atresia and fistula in the GI tract

A

blind upper esophagus and fistula between lower esophagus and trachea

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2
Q

first signs of esophageal atresia and tacheoesophageal fistula

A

polyhydramnios

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3
Q

Sx pyloric stenosis

A

projectile non-bilious vomiting, 2-8 wks of age

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4
Q

how common is a pyloric stenosis

A

US 1 in 600

M4:1F

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5
Q

Tx for pyloric stenosis

A

NOT gastrectomy

simple muscle sectioning

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6
Q

duodenal atresia is associated with what?

first sign?

A

30% have trisomy 21

polyhydramnios

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7
Q

where do most duodenal atresias occur

A

ampulla of vater

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8
Q

double bubble sign

A

annular pancreas

duodenal atresia

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9
Q

most common form of congenital intestinal atresia? what causes it?

A

imperforate anus

failure of cloacal diaphragm to involute

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10
Q

what is omphalocele

A

failure midgut to return to abdominal cavity, incomplete umbilicus, covered by amnion

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11
Q

risk factors for having a child with omphalocele

A

advanced maternal age

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12
Q

what is a diaphragmatic hernia and associated with?

A

incomplete formation of diaphragm

associated with pulmonary hypoplasia

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13
Q

what is gastroschisis

A

defect in abdominal wall so that gut is lateral to umbilicus and not covered by amnion

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14
Q

what are ectopic tissue rests

A

gastric or pancreatic tissue that can lead to inflammation, bleeding, scarring and obstruction

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15
Q

what is an “inlet patch”

A

heterotopic gastric mucosa in upper 1/3 esophagus

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16
Q

What is the most common malformation of the small bowel

A

meckel diverticulum from failure involution of the vitelline duct

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17
Q

where are meckel diverticulums

A

otehr side of mesentery “antimesenteric”

in distal ileum within 1 m of ileocecal valve

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18
Q

what is a true meckel diverticulum

A

contains all three layers of the bowel wall (mucosa, submucosa and muscularis)

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19
Q

Tx for vitelline duct abnormalities

A

normally close by 10 weeks

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20
Q

Sx meckel diverticulum (96% asymptomatic)

A

obstruciton )intussusception), bleeding from peptic ulceration of adjacent mucosa, pain/inflammation

21
Q

rule of 2s is what and applies to what?

A 
meckel diverticulum
2% popn
within 2 ft ICV
approx 2in long
2M:1F
usually Sx by 2 y.o
22
Q

Dx meckel diverticulum in children

A

99mTc Nuclear Medicine Scan

concentrates in gastric mucosa and urine

23
Q

What causes Hirschsprung Disease

A

part of the colon lacks Meissner and Auerbach plexuses and ganglion cells
no migration of neural crest cells from cecum to rectum during embryogenesis- ganglion cells undergo premature death

24
Q

What genes have been identified in hirschsprung disease

A

8, especially Rtk RET

25
Q

what part is always affected in megacolon

A

rectum

26
Q

population affected by megacolon

A

1/5,000 live birth 4M:1F

up to 10% in trisomy 21

27
Q

imagin for hrischprungs

A

barium enema

28
Q

what is the in the mucosa layer of esophagus

A

epithelium- squamous non-keratinizing
Lamina Propria- Intm zone of loose CT and capillaries that connects epithelium with supporting framework of the muscularis mucosae

29
Q

what is found in the submucosa of esophagus

A

smooth muscle, blood vessels, lymph, nerves and submucosal glands

30
Q

describe the muscularis propria of esophagus

A

external starts as skeletal muscle and gradually transitions into smooth muscle
internal layer has circular transverse smooth muscle

31
Q

what is oropharyngeal dysphagia

A

difficulty transferring food to the esophagus or in intitiating swallowing

32
Q

what is esophageal dysphagia

A

difficulty transporting down esophagus (food gets stuck) “nutcracker esophagus”

33
Q

what are the types of pain assoc with esophagus

A

pyrosis (heartburn)
odynophagia (pain while swalloing)
atypical chest pain (“atypical” for coronary artery disease)

34
Q

what is pummer vinson syndrome

A

upper esophageal webs, Fe deficiency anemia, glossitis, cheilosis

35
Q

esophageal webs are most common where

A

upper esophagus

36
Q

what is a schatzki ring in esophagus

A

circumferential
A is above GEJ
B is below GEJ

37
Q

schatzki rings common in what sex

A

W >40

38
Q

95% of hiatal hernias are what type

A

sliding (above fundus where esophagus connects)

39
Q

what lesions are related to motility dysfunction in esophagus

A

hiatal hernia, diverticula, mallory-weiss tear and achalasia

40
Q

what is triad of esophageal achalasia

A

incomplete LES relaxation, increased LES tone, aperistalsis of the esophagus

41
Q

causes of achalasia

A

primary is idiopathic

secondary to chagas disease, DM, polio

42
Q

signs of achalasia

A

dysphagia
regurig and pain behind sternum
weight loss

43
Q

achalasia increases risk for?

A

SCC

44
Q

Dx achlasia

A

barium swallow and manometry

45
Q

CREST syndrome

A 
calcinosis
raynauds
esophageal dysfunction (fibrous replacement of lower 2/3 esophagus and loss of LES)
 sclerodactyly
telangiectasias
46
Q

anti-Scl 70 topoisomerases

A

CREST syndrome

47
Q

presentation of mallory weiss laceration

A

alcoholic
severe retchin or violent vomiting
UGI bleeds that heal promptly- mucosal longitudinal tears)

48
Q

Signs boerhaave syndrome

A 
vomiting
thoracic crepitus
increased esophageal intraluminal pressure
hematemesis and chest pain
perforation of esophagus on L side
49
Q

imaging booerhave syndrome

A

CXR- pneumomediastinum, L pleural effusin, L pneumothorax

esophagram- extravastaion of contrast material

Year2 GI Exam I (18 decks)

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