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Year2 GI Exam I > PATH V > Flashcards

Flashcards in PATH V Deck (52)
1

brunners glands are where

duodenum

2

where are peyers patches

ileum

3

majority of GI obstructions are caused by

adhesions, hernias
volvulus
intussusception

4

what are causes of pseudo obstructions

paralytic ileus
vascular- bowel infarction
myopathies and neuropathies (hirschsprung)

5

signs of bowel obstruction

pain, distention, vomiting, constipation

6

what will bowel obstruction show on XR

intestinal obstruction

7

most common cause intestinal obstruction in US

adhesion between 2 loops of intestin

8

most common cause intestinal obstruction in children <2 y.o

intussusception

9

main cause of intussusception in adults

meckels

10

most frequent cause intestinal obstruction worldwide

hernia (inguinal)

11

what side are hernias moe likely

right side

12

what does reducing a hernia mean

it can be manually pushed back into abdominal cavity
if cannot be reduced- incarcerated

13

bent inner tube or coffee bean sign on abdominal XR could be what

sigmoid volvulus

14

most likely places for volvulus

sigmoid colon, cecum, small bowel, stomach, large bowel

15

reason for abdominal adhesions

post operative scar tissue, inflammation, endometriosis

16

what intestinal vascular disorders can lead to GI bleeds

ischemic bowel disease
angiodysplasia
hemorrhoids

17

what can cause lower intestinal bleeding

angiodysplasia, colonic carcinoma, IBD, rectosigmoid carcinoma, hemorrhoids, anal fissure

18

what can cause SI bleeding

IBD, intussusception, meckel diverticulum

19

how does the small intestine not suffer from chronic blood loss in a small artery

so many collaterals

20

causes of Ischemic bowel disease

arterial embolism
aterial thrombosis
venous thrombosis
non-occlusive ischemia

21

causes of arterial emboli

cardiac vegetation, angiography procedure, aortic atheroembolism, superior mesenteric most common

22

where do arterial thrombosis take place in GI

superior mesenteric from atherosclerosis or systemic vasculitis, dissecting aneurysms

23

what are causes of non occlusive ischemia in bowel

cardiac failure, shock, dehydration, vasoconstrictive drugs like cocaine, CMV infection

24

what is a mural infarction? transmural?

mural is through muscularis mucosa and submucosa
transmural is where everything can leak across wall

25

if there is full thickness infarction and necrosis of bowel wall how many days till perforation

1-4 days

26

Sx of infarcted bowel

severe periumbilical pain
nausea and vomiting

27

what does SMA supply

middle colon right colon, ileocolic aa

28

IMA supplies

left colon, sigmoid and superior rectal artery

29

what is the watershed zone of colon that is susceptible to ischemia

splenic flexure

30

what is angiodysplasia

non neoplastic vascular lesion usually in cecum or proximal right colon
tortuous dilation of malformed submucosal and mucosal blood vessels

31

how common is angiodysplasia

20% significant lower intestinal bleeding

32

what causes hemorrhoids

persistent elevation in venous pressure

33

population with hemorrhoids

pregnant females
unusual under 30 y.o common after 50 y.o
cirrhosis assoc (portal HTN)

34

most common cause hemorrhoids

straining at stool

35

what is definition diarrhea

increase in stool mass, frequency and or fluifity
>200 gm/day

36

what is dysentery

low volume, painful bloody diarrhea

37

what is secretory diarrhea

>500mL isotonic fluid stoool
persists during fasting
infectious, viral or enterotoxin

38

osmotic diarrhea

>500mL hypertonic fluid in stool
stops with fasting
lactase deficiency

39

exudative diarrhea

mucosal damage causing purulent bloody stools
persists during fasting
bacterial or IBD

40

derange motility diarrhea

improper neuromuscular fucntion
variable during fasting
neural hormonal or surgical

41

what is the 72 hr stool fat test

patient on diet of 100 gm fat/day then stool collected for 3 days, if >18-21 gm fat then malabsorption

42

malabsorption diarrhea

bulky with steatorrhea
stops with fasting
pale smelly floats
celiac, giardia, CF, chronic pancreatitis

43

what viruses cause secretory diarrhea

rotavirus, norovirus, enteric adenoviruses
astroviruses

44

what infections that are enterotoxin mediated cause secretory diarrhea

vibrio cholerae
E coli
Bacillus cereus
clostridium perfringens

45

infectious causes of exudative diarrhea

shigella, salmonella, campylobacter, entamoeba histolytica

46

infectious causes of malabsorptive diarrhea

giardia

47

Sx infectious enterocolitis

diarrhea, abdominal pain, urgency, perianal discomfort, incontinence and hemorrhage

48

what GI virus attack infants 6 mo-2 y.o

rotavirus group A

49

what is second most common GI virus in US

norovirus

50

histo features viral enteritis

increased intraepithelial, lamina propria lymphocytes and crypt hypertrophy

51

Mech of bacterial enterocolitis

- ingestion of preformed toxin: staph, vibrio, C perfringens, C botulinum
- infection by toxigenic organisms: e coli, v cholerae, campylobacter
- infection by enteroinvasive organisms: shigella, salmonella, campylobacter, enteroinvasive E coli

52

complications of campylobacter enterocolitis

arthritis, guillain barre syndrome