Path II Flashcards by Amanda Beach

What is the most common atresia and fistula in the GI tract

blind upper esophagus and fistula between lower esophagus and trachea

How well did you know this?

Not at all

Perfectly

first signs of esophageal atresia and tacheoesophageal fistula

polyhydramnios

How well did you know this?

Not at all

Perfectly

Sx pyloric stenosis

projectile non-bilious vomiting, 2-8 wks of age

How well did you know this?

Not at all

Perfectly

how common is a pyloric stenosis

US 1 in 600

M4:1F

How well did you know this?

Not at all

Perfectly

Tx for pyloric stenosis

NOT gastrectomy

simple muscle sectioning

How well did you know this?

Not at all

Perfectly

duodenal atresia is associated with what?

first sign?

30% have trisomy 21

polyhydramnios

How well did you know this?

Not at all

Perfectly

where do most duodenal atresias occur

ampulla of vater

How well did you know this?

Not at all

Perfectly

double bubble sign

annular pancreas

duodenal atresia

How well did you know this?

Not at all

Perfectly

most common form of congenital intestinal atresia? what causes it?

imperforate anus

failure of cloacal diaphragm to involute

How well did you know this?

Not at all

Perfectly

what is omphalocele

failure midgut to return to abdominal cavity, incomplete umbilicus, covered by amnion

How well did you know this?

Not at all

Perfectly

risk factors for having a child with omphalocele

advanced maternal age

How well did you know this?

Not at all

Perfectly

what is a diaphragmatic hernia and associated with?

incomplete formation of diaphragm

associated with pulmonary hypoplasia

How well did you know this?

Not at all

Perfectly

what is gastroschisis

defect in abdominal wall so that gut is lateral to umbilicus and not covered by amnion

How well did you know this?

Not at all

Perfectly

what are ectopic tissue rests

gastric or pancreatic tissue that can lead to inflammation, bleeding, scarring and obstruction

How well did you know this?

Not at all

Perfectly

what is an “inlet patch”

heterotopic gastric mucosa in upper 1/3 esophagus

How well did you know this?

Not at all

Perfectly

What is the most common malformation of the small bowel

meckel diverticulum from failure involution of the vitelline duct

How well did you know this?

Not at all

Perfectly

where are meckel diverticulums

otehr side of mesentery “antimesenteric”

in distal ileum within 1 m of ileocecal valve

How well did you know this?

Not at all

Perfectly

what is a true meckel diverticulum

contains all three layers of the bowel wall (mucosa, submucosa and muscularis)

How well did you know this?

Not at all

Perfectly

Tx for vitelline duct abnormalities

normally close by 10 weeks

How well did you know this?

Not at all

Perfectly

Sx meckel diverticulum (96% asymptomatic)

obstruciton )intussusception), bleeding from peptic ulceration of adjacent mucosa, pain/inflammation

rule of 2s is what and applies to what?

meckel diverticulum
2% popn
within 2 ft ICV
approx 2in long
2M:1F
usually Sx by 2 y.o

Dx meckel diverticulum in children

99mTc Nuclear Medicine Scan

concentrates in gastric mucosa and urine

What causes Hirschsprung Disease

part of the colon lacks Meissner and Auerbach plexuses and ganglion cells
no migration of neural crest cells from cecum to rectum during embryogenesis- ganglion cells undergo premature death

What genes have been identified in hirschsprung disease

8, especially Rtk RET

what part is always affected in megacolon

rectum

population affected by megacolon

1/5,000 live birth 4M:1F | up to 10% in trisomy 21

imagin for hrischprungs

barium enema

what is the in the mucosa layer of esophagus

epithelium- squamous non-keratinizing Lamina Propria- Intm zone of loose CT and capillaries that connects epithelium with supporting framework of the muscularis mucosae

what is found in the submucosa of esophagus

smooth muscle, blood vessels, lymph, nerves and submucosal glands

describe the muscularis propria of esophagus

external starts as skeletal muscle and gradually transitions into smooth muscle internal layer has circular transverse smooth muscle

what is oropharyngeal dysphagia

difficulty transferring food to the esophagus or in intitiating swallowing

what is esophageal dysphagia

difficulty transporting down esophagus (food gets stuck) "nutcracker esophagus"

what are the types of pain assoc with esophagus

pyrosis (heartburn) odynophagia (pain while swalloing) atypical chest pain ("atypical" for coronary artery disease)

what is pummer vinson syndrome

upper esophageal webs, Fe deficiency anemia, glossitis, cheilosis

esophageal webs are most common where

upper esophagus

what is a schatzki ring in esophagus

circumferential A is above GEJ B is below GEJ

schatzki rings common in what sex

W >40

95% of hiatal hernias are what type

sliding (above fundus where esophagus connects)

what lesions are related to motility dysfunction in esophagus

hiatal hernia, diverticula, mallory-weiss tear and achalasia

what is triad of esophageal achalasia

incomplete LES relaxation, increased LES tone, aperistalsis of the esophagus

causes of achalasia

primary is idiopathic | secondary to chagas disease, DM, polio

signs of achalasia

dysphagia regurig and pain behind sternum weight loss

achalasia increases risk for?

SCC

Dx achlasia

barium swallow and manometry

CREST syndrome

``` calcinosis raynauds esophageal dysfunction (fibrous replacement of lower 2/3 esophagus and loss of LES) sclerodactyly telangiectasias ```

anti-Scl 70 topoisomerases

CREST syndrome

presentation of mallory weiss laceration

alcoholic severe retchin or violent vomiting UGI bleeds that heal promptly- mucosal longitudinal tears)

Signs boerhaave syndrome

``` vomiting thoracic crepitus increased esophageal intraluminal pressure hematemesis and chest pain perforation of esophagus on L side ```

imaging booerhave syndrome

CXR- pneumomediastinum, L pleural effusin, L pneumothorax | esophagram- extravastaion of contrast material