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Flashcards in GIT: Small Intestine Deck (25)
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1

Meckel diverticulum is caused by incomplete _____

Meckel diverticulum is caused by incomplete involution of vitelline duct

2

describe how Meckel diverticulum is an example of heterotopia

Meckel diverticulum contains gastric mucosa and pancreatic tissue

3

describe complications of Meckel diverticulum

  • complications:
    • hemorrhage and peptic ulcer
    • intestinal obstruction
    • diverticulitis
    • perforation
    • fistula

4

describe intestinal changes that occur in celiac sprue

  • typical: villous atrophy (reduced area for absorption)
  • increased intraepithelial lymphocytes
  • elongated and hyperplastic crypts
  • increased lymphocytes, macrophages, plasma cells in lamina propria

5

describe the pathogenesis of celiac sprue

6

describe the image 

7

describe serologic tests done in celiac sprue

  • serologic tests:
    • anti-gliadin and anti-endomysial antibodies
    • anti-tissue transglutaminase (tTG) antibodies

8

name the HLA genotypes associated with celiac sprue

HLA-DQ2 (majority) and HLA-DQ8

9

in patients with celiac sprue, there is a long-term risk of ____

in patients with celiac sprue, there is a long-term risk of intestinal T-cell lymphomas

10

describe tropical sprue (post-infectious sprue)

  • pathogenesis related to bacterial infection superimposed on pre-existing small intestine injury
  • as opposed to celiac sprue, all parts of small intestine equally involved
  • responds to antibiotics

11

as opposed to celiac sprue, in tropical sprue, ____

as opposed to celiac sprue, in tropical sprue,  all parts of small intestine are equally involved

12

describe Whipple disease

  • mainly involves intestine, joints and CNS
  • G+ve sickle-shaped bacteria
  • mucosa laden with distended macrophages in lamina propria; contain PAS positive granules
  • may have granulomatous inflammation
  • treated with antibiotics

13

Whipple disease is caused by _____

Whipple disease is caused by G+ve sickle-shaped bacteria (Tropheryma whippelii)

14

describe the image

Whipple disease

15

describe Giardia

  • protozoan gut pathogen with flagellum
    • trophozoites and cysts are shed
  • usually acquired from drinking water contaminated with cysts
    • poor sanitation and crowded living conditions predispose to infection
  • immunosuppression increases risk

16

describe predisposing factors for luminal obstruction

  • predisposing factors:
    • false teeth
    • gastrectomy
    • intestinal adhesions
    • inadequate mastication and large amounts of food

17

list therapeutic agents that can lead to luminal obstruction

barium sulphate and antacid gels

18

___, or ingested hairs, can cause luminal obstruction

bezoars, or ingested hairs, can cause luminal obstruction

19

roundworms, such as _____, can cause luminal obstruction

roundworms, such as Ascaris lumbricoides, can cause luminal obstruction

20

list 2 endogenous origins of luminal obstruction

  • meconium ileus in infants with CF
    • thick mucus at mid-terminal ileum
  • gallstone ileus
    • usually a stone >2.5 cm in diameter lodges in terminal ileum
    • usually through cholecystoduodenal fistula
    • rarely small stone grows in biliary tree

21

list the 3 conditions of the small intestine that lead to ischemia

  • volvulus
  • strangulated hernia
  • gangrene

22

describe acute appendicitis

  • inflammation of the appendix
  • underlying obstruction of the lumen in 50-80% of cases

23

list the complications of acute appendicitis

  • complications:
    • perforation 
    • peritonitis
    • periappendiceal abscess
    • liver abscess
    • bacteremia

24

describe an adenoma, a low-grade appendiceal mucinous neoplasm (LAMN), and a mucinous adenocarcinoma

  • adenoma:
    • confined to lumen, wall normal
  • LAMN: 
    • mucin, epithelium in wall; non-destructive
    • can metastasize to ovary and peritoneum
  • mucinous adenocarcinoma:
    • high-grade, destructive invasion

25

describe a pseduomyxoma peritonei

  • peritoneal involvement by mucinous implants
  • most: appendix
  • low-grade tumors (LAMN)
    • abundant mucin
    • scant low-grade neoplastic epithelium
  • high-grade tumors (mucinous adenocarcinoma)
    • abundant malignant epithelial cells
    • signet ring cells can be present