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Year2 GI Exam I > PATH V > Flashcards

PATH V Flashcards

1
Q

brunners glands are where

A

duodenum

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2
Q

where are peyers patches

A

ileum

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3
Q

majority of GI obstructions are caused by

A

adhesions, hernias
volvulus
intussusception

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4
Q

what are causes of pseudo obstructions

A

paralytic ileus
vascular- bowel infarction
myopathies and neuropathies (hirschsprung)

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5
Q

signs of bowel obstruction

A

pain, distention, vomiting, constipation

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6
Q

what will bowel obstruction show on XR

A

intestinal obstruction

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7
Q

most common cause intestinal obstruction in US

A

adhesion between 2 loops of intestin

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8
Q

most common cause intestinal obstruction in children <2 y.o

A

intussusception

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9
Q

main cause of intussusception in adults

A

meckels

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10
Q

most frequent cause intestinal obstruction worldwide

A

hernia (inguinal)

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11
Q

what side are hernias moe likely

A

right side

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12
Q

what does reducing a hernia mean

A

it can be manually pushed back into abdominal cavity

if cannot be reduced- incarcerated

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13
Q

bent inner tube or coffee bean sign on abdominal XR could be what

A

sigmoid volvulus

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14
Q

most likely places for volvulus

A

sigmoid colon, cecum, small bowel, stomach, large bowel

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15
Q

reason for abdominal adhesions

A

post operative scar tissue, inflammation, endometriosis

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16
Q

what intestinal vascular disorders can lead to GI bleeds

A

ischemic bowel disease
angiodysplasia
hemorrhoids

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17
Q

what can cause lower intestinal bleeding

A

angiodysplasia, colonic carcinoma, IBD, rectosigmoid carcinoma, hemorrhoids, anal fissure

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18
Q

what can cause SI bleeding

A

IBD, intussusception, meckel diverticulum

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19
Q

how does the small intestine not suffer from chronic blood loss in a small artery

A

so many collaterals

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20
Q

causes of Ischemic bowel disease

A

arterial embolism
aterial thrombosis
venous thrombosis
non-occlusive ischemia

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21
Q

causes of arterial emboli

A

cardiac vegetation, angiography procedure, aortic atheroembolism, superior mesenteric most common

22
Q

where do arterial thrombosis take place in GI

A

superior mesenteric from atherosclerosis or systemic vasculitis, dissecting aneurysms

23
Q

what are causes of non occlusive ischemia in bowel

A

cardiac failure, shock, dehydration, vasoconstrictive drugs like cocaine, CMV infection

24
Q

what is a mural infarction? transmural?

A

mural is through muscularis mucosa and submucosa

transmural is where everything can leak across wall

25
Q

if there is full thickness infarction and necrosis of bowel wall how many days till perforation

A

1-4 days

26
Q

Sx of infarcted bowel

A

severe periumbilical pain

nausea and vomiting

27
Q

what does SMA supply

A

middle colon right colon, ileocolic aa

28
Q

IMA supplies

A

left colon, sigmoid and superior rectal artery

29
Q

what is the watershed zone of colon that is susceptible to ischemia

A

splenic flexure

30
Q

what is angiodysplasia

A

non neoplastic vascular lesion usually in cecum or proximal right colon
tortuous dilation of malformed submucosal and mucosal blood vessels

31
Q

how common is angiodysplasia

A

20% significant lower intestinal bleeding

32
Q

what causes hemorrhoids

A

persistent elevation in venous pressure

33
Q

population with hemorrhoids

A

pregnant females
unusual under 30 y.o common after 50 y.o
cirrhosis assoc (portal HTN)

34
Q

most common cause hemorrhoids

A

straining at stool

35
Q

what is definition diarrhea

A

increase in stool mass, frequency and or fluifity

>200 gm/day

36
Q

what is dysentery

A

low volume, painful bloody diarrhea

37
Q

what is secretory diarrhea

A

> 500mL isotonic fluid stoool
persists during fasting
infectious, viral or enterotoxin

38
Q

osmotic diarrhea

A

> 500mL hypertonic fluid in stool
stops with fasting
lactase deficiency

39
Q

exudative diarrhea

A

mucosal damage causing purulent bloody stools
persists during fasting
bacterial or IBD

40
Q

derange motility diarrhea

A

improper neuromuscular fucntion
variable during fasting
neural hormonal or surgical

41
Q

what is the 72 hr stool fat test

A

patient on diet of 100 gm fat/day then stool collected for 3 days, if >18-21 gm fat then malabsorption

42
Q

malabsorption diarrhea

A

bulky with steatorrhea
stops with fasting
pale smelly floats
celiac, giardia, CF, chronic pancreatitis

43
Q

what viruses cause secretory diarrhea

A

rotavirus, norovirus, enteric adenoviruses

astroviruses

44
Q

what infections that are enterotoxin mediated cause secretory diarrhea

A

vibrio cholerae
E coli
Bacillus cereus
clostridium perfringens

45
Q

infectious causes of exudative diarrhea

A

shigella, salmonella, campylobacter, entamoeba histolytica

46
Q

infectious causes of malabsorptive diarrhea

A

giardia

47
Q

Sx infectious enterocolitis

A

diarrhea, abdominal pain, urgency, perianal discomfort, incontinence and hemorrhage

48
Q

what GI virus attack infants 6 mo-2 y.o

A

rotavirus group A

49
Q

what is second most common GI virus in US

A

norovirus

50
Q

histo features viral enteritis

A

increased intraepithelial, lamina propria lymphocytes and crypt hypertrophy

51
Q

Mech of bacterial enterocolitis

A
  • ingestion of preformed toxin: staph, vibrio, C perfringens, C botulinum
  • infection by toxigenic organisms: e coli, v cholerae, campylobacter
  • infection by enteroinvasive organisms: shigella, salmonella, campylobacter, enteroinvasive E coli
52
Q

complications of campylobacter enterocolitis

A

arthritis, guillain barre syndrome

Year2 GI Exam I (18 decks)

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