1/19/15 Flashcards
What mnemonic can be used to remember all the retroperitoneal structures?
SADPUCKER Suprarenal glands (adrenal glands) Aorta and IVC Duodenum (2nd and 4th parts) Pancreas (except tail) Ureter Colon (ascending and descending) Kidney Esophagus Rectum (partially)
What are the manifestations of tuberculosis in the GI system?
mass lesions, adhesions and strictures
What are the three parasites that infect the GI tract and cause diarrhea? What type of diarrhea do they cause? How do you treat each parasite?
Giardia - fatty diarrhea; metronidazole
Entamoeba histolytica - bloody diarrhea; metronidazole or iodoquinol for asymptomatic carriers
Cryptosporidium - watery diarrhea (mild in immunocompetent but severe in AIDS); prevent by water filtration or nitazoxanide in immunocompetent patients
What are the manifestations of diffuse scleroderma on the GI tract?
A lack of peristalsis -> dysphagia to solids and liquids
Decreased LES tone -> GERD
What is the differential diagnosis for white plaques on the oral mucosa? What are the major differences between these etiologies?
Hairy leukoplakia - manifestation of EBV in immunocompromised; cannot be scraped off
Leukoplakia - precancerous; cannot be scraped off
oral thrush - able to be scraped off
squamous papilloma - due to a benign HPV infection
What are the three main branches of the celiac artery and what organs do they supply?
Left gastric artery - lesser curvature of the stomach
Splenic artery - body and tail of pancreas, spleen, fundus of the stomach, greater curvature of stomach
Common hepatic artery - liver, gallbladder, head and neck of pancreas, proximal duodenum, lesser and greater curvature of stomach (anastomoses with splenic and left gastric)
Pernicious anemia predisposes to what disease?
Pernicious anemia -> loss of parietal cells -> achlorhydria -> increased gastrin -> proliferation of ECL cells -> carcinoid tumors
Pernicious anemia -> chronic gastritis -> intestinal type gastric adenocarcinoma
What part of the body is most affected in Hirschsprung’s disease? How do patients with Hirschsprung’s disease present?
affects the rectum with varying progression proximally.
Patients present with failure to pass stool, increased tone of the anal sphincter and proximal dilation of the colon
What is colicky pain in the RUQ caused by?
contraction of the gallbladder against an obstruction
What are the histological findings in Reye’s syndrome? How does Reye’s syndrome manifest clinically?
Characterized by enlarged, dysfunctional mitochondria that leads to extensive steatosis/fatty change in the liver (hepatomegaly) and edema in the brain/encephalopathy (lethargy that progresses to coma and neurological deficits)
What infections are associated with Reye’s syndrome?
chickenpox and influenza B
What organism causes severe, water diarrhea, hypotension and fluid filled blisters mostly on the lower limbs and can be acquired through eating shellfish?
vibrio vulnificus
What disease are anti-smooth muscle antibodies associated with? antimitochondrial antibodies? anti-endomysial antibodies?
anti-smooth muscle - autoimmune hepatitis
antimitochondrial - primary biliary cirrhosis
anti-endomysial - celiac disease
Why can patients with polycythemia vera develop ascites and hepatomegaly?
Polycythemia vera predisposes to vascular sludging and thrombosis. Thrombosis of the hepatic vein (Budd-Chiari syndrome) leads to ascites and hepatomegaly
How does cryptosporidium cause severe diarrhea in AIDS patients?
It invades the brush border epithelial cells and lyses the cells
