CH10 - Gastrointestinal Pathology Flashcards Preview

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Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
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151

What might gastric carcinoma spread to?

lymph nodes can involve the left supraclavicular node (Virchow node).

152

For gastric carcinoma what does distant metastasis most commonly involve?

Liver

153

For the intestinal type of gastric carcinoma what does distant metastasis involve?

Periumbilical region (Sister Mary Joseph nodule)

154

For the diffuse type of gastric carcinoma what does distant metastasis involve?

Bilateral ovaries (Krukenberg tumor)

155

What is duodenal atresia?

Congenital failure of duodenum to canalize;

156

What is duodenal atresia associated with?

Down syndrome

157

What are the clinical features for duodenal atresia?

1. Polyhydramnios 2. Distension of stomach and blind loop of duodenum (double bubble) 3. Bilious vomiting

158

What is meckel diverticulum?

Outpouching of all three layers of the bowel wall (true diverticulum)

159

Why does meckel diverticulum arise?

due to failure of the vitelline duct to involute

160

For meckel diverticulum what is the rule of 2s?

1) Seen in 2% of the population 2) 2 inches long and located in the small bowel within 2 feet of the ileocecal valve 3) during the first 2 years of life with bleeding, volvulus, intussusception, or obstruction (mimics appendicitis); however, most cases are asymptomatic

161

What is the most common congenital anomaly of the GI tract?

Meckel diverticulum

162

How long is the meckel diverticulum?

2 inches long

163

Where is the meckel diverticulum located?

in the small bowel within 2 feet of the ileocecal valve

164

How can meckel diverticulum present?

during the first 2 years of life with bleeding, volvulus, intussusception, or obstruction (mimics appendicitis); however, most cases are asymptomatic

165

Why is there bleeding during the presentation of meckel diverticulum?

Its due to heterotopic gastric mucosa

166

What is volvulus?

Twisting of bowel along its mesentery

167

What does volvulus result in?

obstruction and disruption of the blood supply with infarction

168

What are the most common locations for a volvulus?

sigmoid colon in the elderly and cecum in young adults

169

What is intussusception?

Telescoping of proximal segment of bowel forward into distal segment

170

How does intussusception work?

Telescoped segment is pulled forward by peristalsis, resulting in obstruction and disruption of blood supply with infarction.

171

What is intussusception associated with?

a leading edge (focus of traction)

172

What is the most common cause of intussusception in children?

lymphoid hyperplasia (e.g., due to rotavirus) which usually arises in the terminal ileum, leading to intussusception into the cecum

173

What is the most common cause of intussusception in adults?

tumor.

174

What is small bowel infarction?

Small bowel is highly susceptible to ischemic injury.

175

When does transmural infarction occur?

with thrombosis/embolism of the superior mesenteric artery or thrombosis of the mesenteric vein.

176

When does mucosal infarction occur?

with marked hypotension

177

What are the clinical features for small bowel infarction?

they include abdominal pain, bloody diarrhea, and decreased bowel sounds,

178

What is lactose intolerance?

Decreased function of the lactase enzyme found in the brush border of enterocytes

179

What is the normal function of lactase?

It normally breaks down lactose into glucose and galactose.

180

How does lactose intolerance present?

with abdominal distension and diarrhea upon consumption of milk products; undigested lactose is osmotically active.