Gastro Flashcards

Question

What is absorbed in Proximal 100-200cm of small intestine

Answer 1

carbohydrates, protein, water soluble vitamins.

Answer 2

monoglycerides and fatty acids as miceller complexes, medium chain triglycerides directly into portal circulation.

Answer 3

vit B12, bile salts.

Answer 4

water, electrolytes.

Answer 5

``` "non oedematous malnutrition" Severe energy and protein malnutrition Weight loss - severe muscle wasting, hypotonia, visible intestinal pattern, emaciation, wrinkled skin, shrunken wizened face Listlessness Subnormal temperature Slow pulse ```

Answer 6

``` Severe protein malnutrition "Oedematous malnutrition" Loss of muscle tissue oedema Hepatomegaly Increased susceptibility to infections vomiting and diarrhoea ``` Anorexia Lethargy, apathy, irritability Patchy hyper and hypopigmentation Sparse and thin hair, streaky red or grey in dark skin kids

Answer 7

(B6) classically associated with isoniazid Breast fed by Vit B6 deficent mother Homocystinuria Microcytic anaemia Refractory seizures in infancy Sensory neuropathy Dermatitis

Answer 8

Echinococcosis "tapeworm" Treatment - if cyst is simple and accessible, percutaneous injection of hypertonic saline can be done. Medical treatment is with albendazole, response occurs in 40-60%, can cause mild GIT upset, elevated transaminases. Liver – many cysts never become symptomatic and regress spontaneously or produce non-specific symptoms; symptoms can include increased abdo girth, hepatomegaly, vomiting, abdominal pain. Lung – chest pain, cough, haemoptysis. Diagnosis is via USS; serological tests can be done but there is a false negative rate of 50%

Answer 9

Glycogen and triglycerides are both stored in the liver, for later release during periods of fasting.

Answer 10

for biliary atresia aims to restore bile flow from the liver to the proximal small bowel by creating a roux-en-Y loop of bowel directly anastomosed to the liver. Even if successful, most patients develop slowly progressive liver disease and almost all patients with biliary atresia require liver transplant. Portal hypertension Ascending cholangitis is a common complication, particularly in patients following successful Kasai procedure with an incidence between 40-90%. Most patients have at least one episode by two years of age. Patients following Kasai procedure are at risk of ascending cholangitis due to the nature of the anatomy and bacterial stasis in the roux limb.

Answer 11

Wilson disease which usually presents with hepatic dysfunction in children. In teenagers and adults, neurological and psychiatric problems are the more common presenting complaint. Kaiser-fleischer rings are seen in 50% of patients with liver disease and nearly 100% of patients with neurological involvement. A less well known clinical feature of Wilson disease is that is can lead to distal renal tubular acidosis which results in kidney stones.

Answer 12

80% of autosomal dominant hereditary pancreatitis serine protease 1 Toggle navigation CLOSEnavigation Search Home Health Conditions Genes Chromosomes & mtDNA Classroom Help Me Understand Genetics PRSS1 gene serine protease 1 Normal Function The PRSS1 gene provides instructions for making an enzyme called cationic trypsinogen. This enzyme is a serine peptidase, which is a type of enzyme that cuts (cleaves) other proteins into smaller pieces. Cationic trypsinogen is produced in the pancreas and helps with the digestion of food. Cationic trypsinogen is secreted by the pancreas and transported to the small intestine, where it is cleaved to form trypsinogen. When the enzyme is needed, trypsinogen is cleaved again into its working (active) form called trypsin. Trypsin aids in digestion by cutting protein chains at the protein building blocks (amino acids) arginine or lysine, which breaks down the protein. Trypsin also turns on (activates) other digestive enzymes that are produced in the pancreas to further facilitate digestion. A particular region of trypsin is attached (bound) to a calcium molecule. As long as trypsin is bound to calcium, the enzyme is protected from being broken down. When digestion is complete and trypsin is no longer needed, the calcium molecule is removed from the enzyme, which allows trypsin to be broken down. Related Information What is DNA? What is a gene? How do genes direct the production of proteins? More about How Genes Work Health Conditions Related to Genetic Changes Hereditary pancreatitis More than 40 mutations in the PRSS1 gene have been found to cause hereditary pancreatitis, a condition characterized by recurrent episodes of inflammation of the pancreas (pancreatitis), which can lead to a loss of pancreatic function. Most of these mutations change single protein building blocks (amino acids) in cationic trypsinogen. Some PRSS1 gene mutations result in the production of a cationic trypsinogen enzyme that is prematurely converted to trypsin while it is still in the pancreas. Other mutations prevent trypsin from being broken down. The most common PRSS1 gene mutation that causes hereditary pancreatitis replaces the amino acid arginine with the amino acid histidine at position 122 in the enzyme (written Arg122His or R122H). As a result of this mutation, the enzyme is not able to be broken down, even when it is no longer bound to calcium. Trypsin activity in the pancreas can damage pancreatic tissue and can also trigger an immune response, causing inflammation in the pancreas and leading to episodes of pancreatitis.

Answer 13

Autosomal recessive hereditary pancreatitis Heterozygotes have 12 fold risk of chronic pancreatitis but majority are asymptomatic serine peptidase inhibitor Kazal type 1 The protein encoded by this gene is a trypsin inhibitor, which is secreted from pancreatic acinar cells into pancreatic juice. It is thought to function in the prevention of trypsin-catalyzed premature activation of zymogens within the pancreas and the pancreatic duct. Mutations in this gene are associated with hereditary pancreatitis and tropical calcific pancreatitis.

Answer 14

Sclerosing cholangitis is a common hepatobiliary disease associated with IBD. It is usually diagnosed in the second decade in paediatric patients. There is progressive inflammation and fibrosis of segments of intra and extrahepatic bile ducts, and this can progress to complete obliteration. Most patients are asymptomatic, and SC is found on routine LFT’s: elevated ALP, GGT, antinuclear or smooth-muscle antibodies can be present. 10-15% of adult patients present with: anorexia, wt loss, fatigue, RUQ pain, jaundice, intermittent acute cholangitis with fevers.

Answer 15

M - normal S - moderately low Z - very low Null ``` ZZ = neonatal cholestasis and emphysema Null = no liver disease but severe lung disease ```

Answer 16

Helicobacter pylori is a gram-negative bacillus associated closely with antral gastritis. Epidemiology studies have shown that individuals infected with H. pylori have an increased risk of gastric adenocarcinoma. Studies have also shown that individuals infected with H. pylori have an increased risk of gastric mucosa-associated lymphoid tissue (MALT) lymphoma, a rare cancer of the stomach. Gastric MALT lymphoma is frequently associated (72-98%) with chronic inflammation as a result of the presence of H.pylori. Conversely, risk of oesophageal adenocarcinoma may be reduced in H. pylori-infected individuals.

Answer 17

Thoracic inlet

Answer 18

PFIC 1 &2 low GGT - impaired bile salt secretion, present with intrahepatic cholestasis in infancy - PFIC 2 more severe with higher bile salts, more puritis, earli liver failure and risk of hepatocellular carcinoma PFIC 3 high GGT - reduced biliary phospholipid secretion - late infancy to early adulthood

Gastro Flashcards

(42 cards)