Small and Large Bowel Flashcards

1
Q

Loss of propulsive function in the bowel in the absence of mechanical obstruction is called a…

A

Ileus

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2
Q

A defect in the wall of the peritoneal cavity leading to a protrusion is called a…

A

Hernia

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3
Q

Where are the most common sites for a hernia?

A

Inguinal or femoral canal, umbilicus, or surgical scars

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4
Q

Fibrous bands of scar tissue between bowel segments, the abdominal wall, or operative sites is called a…

A

Bowel adhesions

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5
Q

A complete twisting of loop of bowel at its mesenteric base is called a…

A

Volvulus

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6
Q

When a segment of bowel telescopes into an immediately distal segment, it’s called a…

A

intussusception

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7
Q

What is the difference between stenosis and atresia?

A

Stenosis: lumen decreased in caliber
Atresia: Complete block of lumen

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8
Q

An incomplete closure of ventral abdominal musculature leading to a sac protrusion is called a…

A

Omphalocele

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9
Q

A defect involving all layers of abdominal wall leading to a visceral herniation is called a…

A

Gastroschisis

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10
Q

How many patients with Meckel’s diverticulum have symptoms?

A

4%

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11
Q

What are the 5 rules of 2?

A
Meckels Diverticulum
2% of population
2 feet of ileocecal valve
2 inches long
2x as common in males as females
Occurs by age of 2
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12
Q

How does Hirchsprung’s disease present?

A

Failure to pass meconium in neonatal period
Obstructive constipation
Abnormal distention
Vomiting

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13
Q

What is the pathological abnormality in Hirschsprung disease?

A

Abnormal migration of neural crest cells from cecum to rectum, or when the ganglion cells prematurely die

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14
Q

Which plexi lack ganglion cells in Hirschsprung disease?

A

Submucosal and myenteric

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15
Q

What are some causes of ischemic bowel disease?

A

Arterial thrombosis/obstruction
Mesenteric venous thrombosis
Hypoperfusion

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16
Q

Which bowel segments are most likely to be affected by ischemia?

A
Splenic flexure (SMA and IMA watershed)
Sigmoid and rectum (IMA, pudenda, aliac artery watershed)
17
Q

What is a watershed zone?

A

Initial intestinal segments located at the end of the arterial supply

18
Q

What are some complications to transmural bowel necrosis?

A

Sepsis due to breakdown of mucosal barrier. SUDDEN

19
Q

A lesion of malformed submucosal and mucosal blood vessels in the cecum and right colon is called…

A

Angiodysplasia

20
Q

How does angiodysplasia present?

A

Acute and massive GI bleed or chronic intermittent GI bleed

21
Q

What is the difference between global and isolated diarrhea?

A

Global: Disease associated with reduced absorptive surface (celiac disease)
Isolated: Reduced absorption of specific nutrients

22
Q

What are the four kinds of diarrhea?

A

Secretory diarrhea
Osmotic diarrhea
Malabsorptive diarrhea
Exudative diarrhea

23
Q

What immune mediated disease is associated with moderate to marked villous atrophy of the small bowel?

A

Celiac disease

24
Q

What skin problem is associated with celiac disease?

A

Dermatitis herpetiformis

25
Q

What lab tests help for diagnosis of celiac sprue?

A

Serology IgA deficiency or TTGA

Small bowel Bx

26
Q

What is abetalipoproteinemia?

A

Mutation in the microsomal triglyceride transfer protein leading to an accumulation of triglycerides in the cytoplasm

27
Q

What are not formed in abetalipoproteinemia?

A

Chylomicrons

28
Q

What is the inheritance pattern of abetalipoproteinemia?

A

Autosomal recessive

29
Q

What cells are seen in the peripheral blood smear in abetalipoproteinemia?

A

Burr cells

30
Q

What is whipple disease caused by?

A

Gram positive actinomycete, Tropheryma whippelii

31
Q

What do you see on H&E stain for Whipple disease?

A

Effacement of normal lamina propria by a sheet of swollen macrophages

32
Q

What is the most common cause of acute diarrhea?

A

Infectious diarrhea

33
Q

What is the key diagnostic test for C. dif?

A

Toxin producing strain detection of C. difficile typically with PCR assay