CH10 - Gastrointestinal Pathology Flashcards Preview

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Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
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211

Where can carcinoid tumor cells arise?

Can arise anywhere along the gut; small bowel is the most common site

212

What does carcinoid tumor grow as?

It grows as a submucosal polyp-like nodule

213

What is the relation between carcinoid tumor and serotonin?

The neurosecretory granules often secrete serotonin

214

What is serotonin released into?

the portal circulation

215

Where is serotonin metabolized?

Its metabolized by liver monoamine oxidase (MAO) into 5-HIAA (5-hydroxyindoleacetic acid)

216

What happens to 5-HIAA?

it is excreted in the urine.

217

What does metastasis of carcinoid tumor to the liver result in?

it allows serotonin to bypass liver metabolism.

218

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.

219

What is carcinoid syndrome characterized by?

bronchospasm, diarrhea, and Hushing of skin;

220

What might trigger symptoms of carcinoid syndrome?

it can be triggered by alcohol or emotional stress, which stimulate serotonin release from the tumor,

221

What characterizes carcinoid heart disease?

It is characterized by right-sided valvular fibrosis

222

In carcinoid heart disease why is there right sided valvular fibrosis?

increased collagen

223

What does the right sided valvular fibrosis seen in carcinoid heart disease lead to?

tricuspid regurgitation and pulmonary valve stenosis

224

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,

225

What is acute appendicitis?

Acute inflammation of the appendix; most common cause of acute abdomen

226

What is the most common cause of acute abdomen?

Acute appendicitis

227

What is acute appendicitis related to?

obstruction of the appendix by lymphoid hyperplasia (children) or a tecalith (adults)

228

What is McBurney point?

It is where the pain for acute appendicitis localizes to lower right quadrant

229

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.

230

What is a common complication for acute appendicitis?

Periappendiceal abscess is a common complication

231

What is inflammatory bowel disease?

Chronic, relapsing inflammation of bowel

232

What is inflammatory bowel disease possibly due to?

abnormal immune response to enteric flora

233

How does inflammatory bowel disease classically present?

in young women (teens to 30s) as recurrent bouts of bloody diarrhea and abdominal pain

234

Where is inflammatory bowel disease more prevalent?

in the West, particularly in Caucasians and Eastern European Jews

235

How do you diagnose inflammatory bowel disease?

It?s a diagnosis of exclusion whose symptoms mimic other causes of bowel inflammation

236

What is inflammatory bowel disease subclassified as?

ulcerative colitis or Crohn?s disease

237

What is the wall involvement for ulcerative colitis?

Mucosal or submucosal ulcers

238

Where does ulcerative colitis begin?

In the rectum

239

What does ulcerative colitis involve after the rectum?

It can extend proximally up to the cecum, the remainder of the GI tract is unaffected

240

What are the symptoms of ulcerative colitis?

Left lower quadrant pain (rectum) with bloody diarrhea