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Flashcards in GI: Small and Large Intestine Deck (55)
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1

True or false: the small intestine has goblet cells

true

2

Brunner's glands are specific to which part of the small intestine?

duodenum

3

_________ ______ are specific to the ileum

Peyer's patches

4

What is the big function of the large intestine?

water absorption

5

True or false: there are goblet cells in the large intestine

TRUE

6

What are the general layers of the GI tract?

epithelium
lamina propria
muscularis mucosa
submucosa
muscularis propria (circular muscle --> myenteric plexus --> longitudinal)
serosa/adventitia

7

What is gastroschisis?

extrusion of abdominal contents thru abdonimal folds (NO peritoneum)

8

What is omphalocele?

persistence of herniation of abdominal contents into umbilical cord - sealed by peritoneum

9

Define intussusception

bowel telescopes into distal segment (usually at ileocecal junction)

10

What are symptoms of intussusception?

abdominal pain with current jelly stools (usually in kids)

11

What is the name of the condition when the bowel twists around the mesentery?

volvulus

12

What is the most common acquired GI emergency in premature or low birth weight babies?

necrotizing enterocolitis

(in small and large intestines, terminal ileum and ascending colon)

13

What is Meckel's Diverticulum?

persistence of omphalomesenteric duct (disease of 2s)

14

What is Hirschprung Disease?

absence of ganglion cells (premature arrest of neural crest cells migrating from the cecum to rectum

MISSING ENTERIC NEURONS (do biopsy to look for these - need to get to muscularis propria)

15

What are some signs of malabsorption?

chronic diarrhea
steatorrhea
weigh loss
abdominal pain

16

Define steatorrhea

72 hour fecal fat (>7 grams/24 hours), voluminous, malodorous

17

What symptoms can malabsorption lead to?

anemia (not enough B12, folate)
bleeding (not enough vit. K)
osteopenia and tetany (not enough Ca, Mg, Vit. D)
peripheral neuropathy (not enough vit. A and vit. D)

18

What is the most common disaccharidase deficiency?

lactase deficiency (leads to osmotic diarrhea)

19

What makes a lactose tolerance test positive?

administration of lactase producing symtoms
glucose rises to

20

What is abetaliporproteinemia?

decreased synthesis of apolipoprotein B (decreased ability to generate chylomicrons, decreased secretion of cholesterol)

21

What is the main physiological problem in celiacs?

damage to small intestine when gluten is consumed

22

What are some symptoms of celiacs?

diarrhea, weight loss, abrominal pain
dermatitis herpeformis

23

What is a main giveaway symptom of celiacs that presents on the skin?

dermatitis herpetiformis (skin blistering due to Ig deposition)

24

What does celiacs look like on endoscopy?

atrophic mucosa (atrophied folds)

25

Which disease is associated with flattening of the villi?

celiacs

26

What is a big finding on biospy/histology of celiacs?

increased number of intraepithelial T lymphocytes (CD8)

27

What is another disease that looks similar to celiacs but can be treated with antibiotics

tropical sprue (unknown cause)

28

What are signs of acute colitis?

neutrophils in epithelium and lamina propria

29

What are some bacteria that can cause acute colitis?

cholera
campylobacter
shigella
salmonella
typhid
yersinia
e coli

30

What are 2 viral causes of acute colitis?

norovirus
rotavirus (mostly kids - severe diarrhea)

31

What are 3 parasites/protozoa that cause GI problems?

nematodes (ascaris)
flatworms
protozoa (giardia, entamoeba histolytica)

32

What GI condition commonly follows a course of broad spectrum antibiotics?

pseudomembranous colitis

33

What does pseudomembranous colitis look like on histology?

mushroom shaped protrusion over the normal mucosa

34

What is a common GI problem that occurs in middle aged females but looks normal on endoscopy?

collagenous colitis

35

How does collagenous colitis present?

chronic watery diarrhea (3-20 non bloody stools per day)

36

How do you diagnose collagenous colitis?

histology (trichrome stain - look for collagen and look for lymphocytes in epithelium)

37

Which form of colitis has a strong association with autoimmune diseases?

lymphocytic colitis

38

If both feature symptoms of chronic diarrhea and passage of non bloody stool, what is the difference between lymphocytic and collagenous colitis?

lymphocytic: males and females equally

collagenous: females more (stains on trichrome)

39

What is Whipple's Disease?

gram positive rod shaped actinomycete (tropheryma whippleli) engulfed by macs

leads to malabsorption, lymphadenopathy, arthritis

40

What is the pathogenesis of Whipples?

foamy macs distend the villi so vessels and lymphatics become congested --> poor absorption and function of villi)

41

What is a potential cause of IBD

reduced enteric infections leading to inadequate development of gut immune response

42

What are some symptoms of Crohns?

intermittent attacks of mild diarrhea, fever, abdominal pain, recurrent attacks or flare ups of diarrhea (can present abruptly with RLQ pain)

NON BLOODY

43

True or False: Crohn's can occur at any point along the GI tract

true (but usually ileum or ileocecal valve)

segmented involvement which spares some areas

44

What does crohn's look like on gross?

ulcerated mucosa and fistula formation

45

What does Crohn's look like on histology?

transmural inflammation, cryptitis, crypt abscesses, ulceration, non-caseating granulomas

46

What is ulcerative colitis?

relapsing attacks of mucoid diarrhea WITH pain (can have an explosive initial attack with serious bleeding)

47

What are 2 complications of ulcerative colitis?

- primary sclerosing cholangitis
- cancer

48

How does the inflammation of UC differ from Crohn's?

inflammation of mucosa that is continuous (diffuse - begins at rectum and progresses proximally)

49

What does the early phase of UC look like?

neutrophils and crypt abscesses

50

What does the later phase of UC look like?

mucosa ulcerates and pseudo polyps form

51

What does the LATE phase of UC look like?

atrophy and possible dysplasia

52

True or false: UC is transmural

FALSE (only in mucosa/submucosa)

53

What are the main differences between UC and Crohn's?

Crohn's is transmural
UC is only mucosa/submucosa

Crohn's is non bloody
UC is bloody

Crohn's is any part of GI (skipped areas)
UC is diffuse

54

What are some extraintestinal complications with Crohn's?

migratory polyarthritis

kidney stones

55

What are some extraintestinal complications with UC?

primary sclerosing cholangitis