Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
Where can carcinoid tumor cells arise?
Can arise anywhere along the gut; small bowel is the most common site
What does carcinoid tumor grow as?
It grows as a submucosal polyp-like nodule
What is the relation between carcinoid tumor and serotonin?
The neurosecretory granules often secrete serotonin
What is serotonin released into?
the portal circulation
Where is serotonin metabolized?
Its metabolized by liver monoamine oxidase (MAO) into 5-HIAA (5-hydroxyindoleacetic acid)
What happens to 5-HIAA?
it is excreted in the urine.
What does metastasis of carcinoid tumor to the liver result in?
it allows serotonin to bypass liver metabolism.
What is carcinoid syndrome / heart disease?
Serotonin is released into the hepatic vein and leaks into systemic circulation via hepato-systemic shunts, resulting in carcinoid syndrome and carcinoid heart disease.
What is carcinoid syndrome characterized by?
bronchospasm, diarrhea, and Hushing of skin;
What might trigger symptoms of carcinoid syndrome?
it can be triggered by alcohol or emotional stress, which stimulate serotonin release from the tumor,
What characterizes carcinoid heart disease?
It is characterized by right-sided valvular fibrosis
In carcinoid heart disease why is there right sided valvular fibrosis?
What does the right sided valvular fibrosis seen in carcinoid heart disease lead to?
tricuspid regurgitation and pulmonary valve stenosis
In carcinoid heart diseae are there left-sided valvular lesions?
No, they are not seen due to presence of monoamine oxidase which metabolizes serotonin in the lung,
What is acute appendicitis?
Acute inflammation of the appendix; most common cause of acute abdomen
What is the most common cause of acute abdomen?
What is acute appendicitis related to?
obstruction of the appendix by lymphoid hyperplasia (children) or a tecalith (adults)
What is McBurney point?
It is where the pain for acute appendicitis localizes to lower right quadrant
What are the clinical features in acute appendicitis?
1. Periumbilical pain, fever, and nausea; pain eventually localizes to right lower quadrant (McBurney point). 2. Rupture results in peritonitis that presents with guarding and rebound tenderness.
What is a common complication for acute appendicitis?
Periappendiceal abscess is a common complication
What is inflammatory bowel disease?
Chronic, relapsing inflammation of bowel
What is inflammatory bowel disease possibly due to?
abnormal immune response to enteric flora
How does inflammatory bowel disease classically present?
in young women (teens to 30s) as recurrent bouts of bloody diarrhea and abdominal pain
Where is inflammatory bowel disease more prevalent?
in the West, particularly in Caucasians and Eastern European Jews
How do you diagnose inflammatory bowel disease?
It?s a diagnosis of exclusion whose symptoms mimic other causes of bowel inflammation
What is inflammatory bowel disease subclassified as?
ulcerative colitis or Crohn?s disease
What is the wall involvement for ulcerative colitis?
Mucosal or submucosal ulcers
Where does ulcerative colitis begin?
In the rectum
What does ulcerative colitis involve after the rectum?
It can extend proximally up to the cecum, the remainder of the GI tract is unaffected