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GENPATH > GIT 2 Doc Villaroya > Flashcards

GIT 2 Doc Villaroya Flashcards

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1
Q

Serosa-lined pouch of peritoneum

A

Hernial sac

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2
Q

Acquired hernias typically occurs ____ via the ___ (enumerate the 3)

A

Anteriorly, via the:
1. Inguinal and Femoral canals
2. Umbilicus
3. Site of surgical defects

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3
Q

It is the most frequent cause of intestinal obstruction

A

Hernias

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4
Q

Pressure at the __ of the pouch may impair the venous drainage of the entrapped viscus

A

Neck

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5
Q

Caused by surgical procedures, infection, or other causes of peritoneal inflammation

A

Adhesions

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6
Q

Where do adhesions usually occur?

A
  1. Between bowel segments
  2. Abdominal wall
  3. Operative sites
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7
Q

Sequelae, including obstruction and strangulation, are similar to _____

A

External hernias

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8
Q

This occurs when a loop of bowel twists about its mesenteric point of attachment and results in both luminal and vascular compromise

A

Volvulus

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9
Q

Volvulus presents with features of both ___ and ____

A

Obstruction and Infarction

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10
Q

Volvulus occurs most often in the ___

A

Large redundant Loops of the sigmoid colon

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11
Q

This occurs when a segment of the intestine, constricted by a wave of peristalsis, telescopes into the immediately distal segment

A

Intussusception

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12
Q

Untreated intussusception may progress to __, ___, and ___

A
  1. Intestinal obstruction
  2. Compression of mesenteric vessels
  3. Infarction
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13
Q

It is the most common cause of intestinal obstruction in children younger than 2 years of age

A

Intussusception

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14
Q

Intussusception is generally caused by an ____, that serves as the initiating point of traction.

A

Intraluminal mass or tumor

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15
Q

It can be used both diagnostically and therapeutically for idiopathic intussusception in infants and young children

A

Contrast enemas

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16
Q

Majority of the GI tract is supplied by the (enumerate 3)

A
  1. Celiac
  2. Superior mesenteric
  3. Inferior mesenteric arteries
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17
Q

In a large majority of cases, acute obstruction is caused by ___

A

Thrombosis or embolism

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18
Q

Most important risk factor for thrombosis

A

Severe atherosclerosis

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19
Q

Less common cause of thrombosis

A

Systemic vasculitides

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20
Q

Obstructive emboli most commonly originate from __

A

Aortic atheromas or Cardiac mural thrombi

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21
Q

Two phases of intestinal response to ischemia

A
  1. Hypoxic injury
  2. Reperfusion injury
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22
Q

What are the 3 major variables that determine the severity of ischemic bowel disease

A
  1. Severity of vascular compromise
  2. Time frame during which it develops
  3. Vessels affected
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23
Q

Watershed zones include:

A
  1. Splenic flexure
  2. Sigmoid colon and rectum
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24
Q

What terminates at the splenic flexure?

A

Inferior and Superior Mesenteric Arterial Circulations

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25
What terminates at the sigmoid colon and rectum?
Inferior mesenteric, pudendal, and iliac arterial circulations
26
It can cause localized injury at watershed zones
Generalised hypotension or hypoxemia
27
These are cells found within the crypts and are necessary for recovery from epithelial injury
Epithelial stem cells
28
What is the morphologic signature of ischemic intestinal disease
Surface epithelial atrophy with normal or hyperproliferative crypts
29
Most common site of GI ischemia
Colon
30
Chronic ischemia is accompanied by fibrous scarring of the ____
Lamina propria
31
8n both acute and chronic ischemia, bacterial superinfection and enterotoxin release may induce ____, that resembles ____
1. Pseudomembrane formation 2. Clostridioides difficile - associated pseudomembranous colitis
32
It typically presents with sudden onset of cramping, left lower abdominal pain, desire to defecate, and passage of blood or blo9dy diarrhea
Acute colonic ischemia
33
What supplies theright side of the colon?
Superior mesenteric artery
34
It may be the initial presentation of more widespread compromise of intestinal perfusion
Right-sided colonic ischemia
35
This may progress to more extensive and transmural infarction if the vascular supply is not restored by correction of the insult
Limited zones of mucosal and mural infarctions
36
It may masquerade inflammatory bowel disease with episodes of bloody diarrhea interspersed with periods of healing
Chronic ischemia
37
It causes ischemic GI disease due to viral tropism for endothelial cells and resulting localized vascular obstruction
CMV infection
38
It occurs when the GI tract irradiated and is due to a combination of epithelial and endothelial injury
Radiation enterocolitis
39
Its presence within the stroma may provide an important clue to the etiology of radiation enterocolitis
Radiation fibroblasts
40
This manifests as anorexia, abdominal cramps, and malabsorptive diarrhea
Acute radiation enteritis
41
This type of radiation enterocolitis is often more indolent and may present as an inflammatory enterocolitis
Chronic radiation enteritis
42
It is an acute disorder of the small and large intestines that can result in transmural necrosis. It is also the most common acquired GI emergency of neonates
Necrotizing enterocolitis
43
It is characterized by malformed submucosal and mucosal blood vessels that are dilated and thin walled
Angiodysplasia
44
It has the largest diameter of any colonic segment, thus it develops the greatest wall tension
Cecum
45
It is characterized by defective absorption of fats, fat-and water soluble vitamins, proteins, carbohydrates, electrolytes and minerals, and water.
Malabsorption
46
Hallmark of malabsorption
Steatorrhea
47
It is defined as an increase in stool mass, frequency, or fluidity, typically greater than 200g per day
Diarrhea
48
Painful, bloody, small stool diarrhea
Dysentery
49
It is a diarrhea that is characterized by isotonic stool and persists during fasting
Secretory diarrhea
50
It is a diarrhea caused by excessive osmotic force by unabsorbed luminal solutes. It abates with fasting
Osmotic diarrhea
51
It is a diarrhea that follows generalised failure of nutrient absorption, associated with steatorrhea and is relieved with fasting
Malabsorptive diarrhea
52
It is a diarrhea due to inflammatory disease and is characterized by purulent, often bloody stools that continue during fasting
Exudative diarrhea
53
Cystic fibrosis primarily affects the ___
Lungs
54
It is an immune-mediated disorder triggered by the ingestion of gluten-containing foods in genetically predisposed individuals
Celiac disease
55
It is the alcohol-soluble fraction of gluten that contains most of the disease-producing components
Gliadin
56
It triggers the activation of CD8+ intraepithelial lymphocytes
Il-15
57
These cells are expressed by the lymphocytes and is defined as a natural Killer cell marker and receptor for MIC-A
NKG2D
58
It is a disorder prevalent in areas and populations with poor sanitation and hygiene
Environmental Enteric Dysfunction
59
It is an x-linked disorder characterized by severe persistent diarrhea and autoimmune disease that occurs most often in young children
Autoimmune enteropathy
60
It is an autosomal recessive disorder caused by a mutation in the gene encoding lactase
Congenital lactase deficiency
61
It is a disorder caused by downregulation of lactase gene expression
Acquired lactase deficiency
62
It is an autosomal recessive disorder of vesicular transport that leads to deficient brush-border assembly, it is sometimes referred as "Davidson disease"
Microvillus Inclusion Disease
63
Microvillus Inclusion Disease is caused by mutations in the ____
MYO5B gene
64
It is a rare autosomal recessive disease characterized by an inability to assemble triglyceride-rich lipoproteins
Abetalipoproteinemia
65
Abetalipoproteinemia is caused by a mutation in ___
Microsomal Triglyceride Transfer Protein (MTP)
66
It is the most common cause of lower intestinal bleeding in those older than 60 years old
Angiodysplasia
67
It is the fourth most common cause of death worldwide
Diarrheal disease
68
It is the most common bacterial enteric pathogen in high income countries and is an important cause of traveler's diarrhea and food poisoning
Campylobacter jejuni
69
What are the 4 major properties that contribute to virulence
1. Motility 2. Adherence 3. Toxin production 4. Invasion
70
Campylobacter infection can result in reactive arthritis primarily in patients with ____
HLA-B27 genotype
71
It is one of the most common causes of bloody diarrhea
Shigellosis/Shigella spp
72
Most common cause of salmonellosis
Salmonella enteritidis
73
Infections are most frequently linked to ingestion of pork, raw milk, and contaminated water and tend to cluster in the winter
Yersinia
74
Fatal complication of psedomembranous colitis
Toxic megacolon
75
Most common cause of non bacterial gastroenteritis
Norovirus
76
Common cause of pediatric diarrhea
Adenovirus
77
Cause decreased expression of brush-border enzymes, microvillus damage, and apoptosis of small intestinal epithelial cells
Giardia lamblia
78
It is characterized by chronic, relapsing abdominal pain, bloating, and changes in bowel habits
Irritable Bowel Syndrome
79
It is a chronic condition resulting from complex interactions between intestinal microbiota and host immunity in genetically predisposed individuals
Inflammatory Bowel Disease
80
Cases where features of both Crohn disease and ulcerative colitis overlap
Indeterminate colitis
81
This occurs following allogeneic hematopoietic stem cell transplantation
Graft-Versus-Host Disease

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