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Systemic Pathology > Diseases Of The Stomach And Ileum > Flashcards

Diseases Of The Stomach And Ileum Flashcards

1
Q

What are some diseases of the stomach and duodenum

A

Peptic ulcer disease
Acute gastritis
IBD
Colonic diverticula
Hirschprung’s disease
Malabsorption syndrome (MAS)

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2
Q

What causes peptic ulcer disease

A

H. pylori or chronic NSAID use
(And also in Zollinger-Ellison syndrome - gastrinoma, or Crohn’s disease)

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3
Q

What is PUD characterized by

A

One or more ulcerative lesions in the duodenum (most common) or stomach

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4
Q

What are the RFs (risk factors) of PUD

A

Smoking/Heavy alcohol use (delay healing as well)
Glucocorticoids
Caffeine
Stress

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5
Q

What are the presentations of PUD

A

Usually asymptomatic but presents as:
Epigastric pain (gnawing/burning)
Dyspepsia
N/V
Bloating

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6
Q

How does acute gastritis come about

A

It results from acidic damage due to imbalance between damaging and protective factors of the stomach

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7
Q

What are the RFs of acute gastritis

A

H. pylori
Smoking/heavy alcohol consumption
NSAID overdose
Severe burn (Curling ulcer) or increase ICP (Cushing ulcer)

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8
Q

What are the presentations of acute gastritis

A

Hematemesis
Melena
Iron deficiency anaemia (IDA)
Epigastric pain
Dyspepsia and early satiety
Microscopy (redness and hyperemia indicating a superficial inflammation)

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9
Q

What are the types of acute gastritis

A

Type A atrophic gastritis
Autoimmune gastritis
Type B atrophic gastritis
H. pylori gastritis

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10
Q

What is IBD

A

It is the chronic inflammation of the bowel. It has an unknown etiology

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11
Q

What are the two types of IBD

A

Crohn’s disease and ulcerative colitis

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12
Q

What is a colonic diverticula

A

It is the outpouring of only the mucosa and submucosa through the muscularis propria due to intramural pressure (Eg. Constipation due to low fiber or uncontrollable peristalsis) or areas where the muscle is transversed by vessels. It is mostly a false diverticulum

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13
Q

What is the most common location of a colonic diverticulum

A

Sigmoid colon (narrowest part of the colon)

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14
Q

What are some complications of colonic diverticulum

A

Usually asymptomatic or with abdominal discomfort and painless hematochezia
Diverticulitis presents with LLQ pain, fever, leukocytosis but no bleeding

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15
Q

What are some complications of a colonic diverticulum

A

Hemorrhage (most common cause of lower GI bleeding in adults due to session of the surface which causes painless hematochezia
Fistula (most common is a colovesical fistula). Presents with dysuria, air/feces in urine and recurrent UTIs
-Inflammation (diverticulitis) and abscess (persistent fever and abdominal pain despite antibiotic treatment)
Perforation (presents with acite abdomen due to fecal peritonitis)

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16
Q

What are some positional disorders

A

Volvulus
Intussusception
Ileus
Hurschprung’s disease
Malabsorption syndrome

17
Q

What is volvulus

A

Twisting of the bowel along its mesentery

18
Q

What is the most common site of a volvulus

A

Sigmoid colon in adults and caecum in children

19
Q

What is the presentation of positional disorders

A

Abdominal pain
Distention
Bilous vomiting
Hematochezia or ischaemia

20
Q

What is intussusception

A

Telescoping of the proximal segment of the bowel into a distal segment

21
Q

How do adults mostly get intussusception

A

Due to tumor

22
Q

What are some effects of intussusception

A

Obstruction and ischemia (currant-jelly stool)

23
Q

What is an ileus

A

Disruption of the normal propulsive ability of the intestine

24
Q

What are some causes of an ileus

A

Drugs (opiates)
Hypokalemia
IBD
Acute pancreatitis

25
Q

What are some presentations of ileus

A

Constipation
Pain
Distention (decreased bowel sounds)
Nausea and vomiting

26
Q

What is Hirschprung’s disease

A

A birth defect from the neural crest fail to migrate resulting in the absence of myenteric and submucosal plexus

27
Q

What are some presentations of Hirschprung’s disease

A

Defective relaxation and peristalsis of rectum and distal sigmoid colon
Affected segment cannot relax and pass stool resulting in localized ileus and megacolon proximally
Bilious vomiting and failure to pass meconium

28
Q

What is malabsorption syndrome

A

An impaired intestinal absorption of all types of nutrients

29
Q

What causes MAS

A

Insufficient absorption (malfunction of the intestinal wall) or improper digestion of nutrients (insufficient secretion of pancreatic enzymes or bile)

30
Q

What are the presentations of MAS

A

Chronic diarrhea (mass and frequency)
Steatorrhea (hallmark of malabsorption)
Anorexia and weight loss
Hypoalbuminemia (edema/ascites)
Dehydration
Vitamin deficiency (B12, folate, K)
Bloating and flatulence

31
Q

What are the types of MAS

A

Primary and secondary MAS

32
Q

What are the examples of the primary MAS

A

Celiac disease
Topical sprue
Lactose intolerance

33
Q

What are some examples of secondary MAS

A

Whipple disease
Crohn’s disease
Gastroenteritis

34
Q

What are some examples of extra-intestinal MAS

A

Pancreatic insufficiency
Bile deficiency
Gastritis

Systemic Pathology (17 decks)

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