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Year2 GI Exam I > Path II > Flashcards

Flashcards in Path II Deck (49)
1

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

blind upper esophagus and fistula between lower esophagus and trachea

2

first signs of esophageal atresia and tacheoesophageal fistula

polyhydramnios

3

Sx pyloric stenosis

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

4

how common is a pyloric stenosis

US 1 in 600
M4:1F

5

Tx for pyloric stenosis

NOT gastrectomy
simple muscle sectioning

6

duodenal atresia is associated with what?
first sign?

30% have trisomy 21
polyhydramnios

7

where do most duodenal atresias occur

ampulla of vater

8

double bubble sign

annular pancreas
duodenal atresia

9

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

imperforate anus
failure of cloacal diaphragm to involute

10

what is omphalocele

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

11

risk factors for having a child with omphalocele

advanced maternal age

12

what is a diaphragmatic hernia and associated with?

incomplete formation of diaphragm
associated with pulmonary hypoplasia

13

what is gastroschisis

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

14

what are ectopic tissue rests

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

15

what is an "inlet patch"

heterotopic gastric mucosa in upper 1/3 esophagus

16

What is the most common malformation of the small bowel

meckel diverticulum from failure involution of the vitelline duct

17

where are meckel diverticulums

otehr side of mesentery "antimesenteric"
in distal ileum within 1 m of ileocecal valve

18

what is a true meckel diverticulum

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

19

Tx for vitelline duct abnormalities

normally close by 10 weeks

20

Sx meckel diverticulum (96% asymptomatic)

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

21

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

22

Dx meckel diverticulum in children

99mTc Nuclear Medicine Scan
concentrates in gastric mucosa and urine

23

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

24

What genes have been identified in hirschsprung disease

8, especially Rtk RET

25

what part is always affected in megacolon

rectum

26

population affected by megacolon

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

27

imagin for hrischprungs

barium enema

28

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

29

what is found in the submucosa of esophagus

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

30

describe the muscularis propria of esophagus

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

31

what is oropharyngeal dysphagia

difficulty transferring food to the esophagus or in intitiating swallowing

32

what is esophageal dysphagia

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

33

what are the types of pain assoc with esophagus

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

34

what is pummer vinson syndrome

upper esophageal webs, Fe deficiency anemia, glossitis, cheilosis

35

esophageal webs are most common where

upper esophagus

36

what is a schatzki ring in esophagus

circumferential
A is above GEJ
B is below GEJ

37

schatzki rings common in what sex

W >40

38

95% of hiatal hernias are what type

sliding (above fundus where esophagus connects)

39

what lesions are related to motility dysfunction in esophagus

hiatal hernia, diverticula, mallory-weiss tear and achalasia

40

what is triad of esophageal achalasia

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

41

causes of achalasia

primary is idiopathic
secondary to chagas disease, DM, polio

42

signs of achalasia

dysphagia
regurig and pain behind sternum
weight loss

43

achalasia increases risk for?

SCC

44

Dx achlasia

barium swallow and manometry

45

CREST syndrome

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

46

anti-Scl 70 topoisomerases

CREST syndrome

47

presentation of mallory weiss laceration

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

48

Signs boerhaave syndrome

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

49

imaging booerhave syndrome

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