Midterm Ch. 14 Part 3

Question 1

Malabsorption manifests with

Answer 1

Chronic diarrhea

Question 2

Celiac disease is

Answer 2

B and T cell immediated.

Familial HLA-DQ2 or DQ8

Reaction to gliadin

Whites 30-60. Yrs

Iron deficiency anemia, fatigue, pallor

Question 3

What is celiac disease manifesting on the skin

Answer 3

Dermatitis herpetiformis

Blisters on arms, elbows

Itchy (pruritic)

Question 4

What is environmental enteropathy

Answer 4

Tropical sprue

Cycles of mucosal injury, malnutrition

Affects young children 2-3yr

Question 5

When is lactose intolerance MC acquired

Answer 5

During young adulthood

Rarely congenital

Autosomal recessive, life threatening

DX. Via breath hydrogen test

Question 6

Cholera is

Answer 6

Gram negative

Contaminated H2O

Cholera toxin

MC in India/Africa

Opens CFTR-massive chloride ion secretion

Question 7

“Rice water” diarrhea is associated with

Answer 7

Cholera

Hypovolemic shock

Question 8

Cholera is an acute onset

Answer 8

70% of cases are lethal MC in 24hrs

Question 9

What is travelers diarrhea

Answer 9

> 3 unformed or “loose” stools within 24 hours

Acute onset

Question 10

What is the MC bacterial enteric pathogen in US

Answer 10

Campylobacter jejuni

Enterotoxins

May initiate reactive arthritis (+HLA-B27) or GBS (rare)

Question 11

What is antibiotic intestinal colitis

Answer 11

Pseudomembranous coliti

Allows clostridium difficile to overgrow

Mc during hospitalization

Tx. Vancomycin

Question 12

What is half of all gastroenteritis cases

Answer 12

Viral gastroenteritis

Rotavirus- children

Norovirus- adults aka Norwalk-like virus

Question 13

What is Giardiasis lamblia

Answer 13

Flagellated Protozoa, resists cold and chlorine

Fecal contamination

Alters S.I. Enzymes

Giardiasis

Question 14

What is known as beaver fever

Answer 14

Giardiasis lamblia

Giardiasis

Question 15

What is the MC diverticulitis

Answer 15

Sigmoid 95%

MC to have multiple

Risks: age, straining, refined foods

Question 16

What is Tenesmus

Answer 16

Sensation of inadequate bowel movement

Sign of sigmoid diverticulitis

May become larger and more numerous

Question 17

What age is at risk for diverticulitis

Answer 17

50% of people over age 60

Question 18

What is irritable bowel syndrome

Answer 18

Altered bowel habits WITHOUT inflammation

MC develops between 20-40 yrs, females, psychological stress

Tx. Fiber, decrease carbs and stress management

Question 19

What is inflammatory bowel disease

Answer 19

Abnormal G.I. Immune response

Autoimmune, hypersensitive, idiopathic

Females, adolescence, whites, hygiene

Question 20

Crown disease affects

Answer 20

Entire G.I. Tract, MC in ileum. Transmural

Question 21

Ulcerative Colitis affects

Answer 21

Rectum/distant colon

Mucosa and Submucosa

Question 22

What is crohn disease

Answer 22

Regional inflammation (transmural) with fissures

T-cell mediated reaction

Melena occurs in 50%

1:500

Tx. Probiotics, immunosuppressive meds

Risk for G.I. Adenocarcinoma 8-10 yrs after Dx

Question 23

What is ulcerative colitis

Answer 23

Superficial inflammation= mucosal ulceration

Always begins in rectum to proximal

Pseudopolyps

1:5000

Smoking is inhibitory

Associated with toxic megacolon

Question 24

Relapsing episodes, insidious onset of tenesmus, fever, abdominal pain, stool is “stringy”

Answer 24

Ulcerative colitis

Possible prophylactic colectomy

Question 25

What is a harmatomas

Answer 25

Mature cell types minimal risk colon polyp

Question 26

What is a hyperpllastic colon polyp/tumor

Answer 26

Resemble dysplasia Well differentiated, pulled up epithelial MC dx. In elderly 50-60 yrs old

Question 27

What is adenomatous polyp/tumor

Answer 27

Benign neoplasm MC colon polyp

Question 28

A colonic adenoma is

Answer 28

Age related, onset around 40 1/2 of U. S. Adults >50yrs old Familial 4x risk Occult blood (FOB) possible anemia Considered malignant

Question 29

Adenoma in colon risk of cancer if

Answer 29

Cancer is rare if <1cm Cancer in 1/2 if >4cm

Question 30

Familial adenomatous polyposis is

Answer 30

Autosomal dominant cancer syndrome, APC gene on chromosome 5 Teenage onset of numerous adenomas 100% develop colon cancer MC before 30 yrs old

Question 31

How many adenomas to be familial adenomatous polyposis

Answer 31

100> Normallly MC 500-2500 polyps

Question 32

What is lynch syndrome

Answer 32

Hereditary cancer syndrome Inherited mutations alter DNA mismatch repair Risk for various cancers, younger onset

Question 33

Adenocarcinoma or carcinoid tumor which is MC

Answer 33

Adenocarcinoma

Question 34

Colorectal adenocarcinoma MC affects ppl ages

Answer 34

50-70 MC malignancy of G.I. tract

Question 35

WHat increases the risk of colorectal adenocarcinoma

Answer 35

Highly processed diet U.S.A. Has highest rates

Question 36

What part of colon has the most cancer

Answer 36

Ascending 30% Sigmoid colon 25% Rectum 20% Descending 15% Transverse 10%

Question 37

Colorectal adenocarcinoma MC moves to

Answer 37

Liver, regional lymphatics and hematopoietic Increase with a meat diet

Question 38

Where is the MC small intestine tumors

Answer 38

Duodenum Only 3-6% of all G.I. Tumors Asymptomatic early Abdominal pain/cramping. Nausea, vomiting, weight loss

Question 39

What is the MC tumor of the appendix

Answer 39

Carcinoid Rarely adenocarcinoma Possible cite for mucocele

Question 40

Baby acne occurs when

Answer 40

MC around 2 months, 20% of babies Idiopathic, possibly from maternal hormones

Question 41

What is a milium

Answer 41

A keratin filled cysts For baby acne