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Pathoma - Small Bowel Flashcards

(44 cards)

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1
Q

Duodenal atresia

A

duodenum ends in blind loop

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2
Q

Duodenal atresia - cause

A

congenital: failure to canalize

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3
Q

Duodenal atresia - association

A

Down’s Syndrome

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4
Q

Duodenal atresia - clinical presentation

A
  • polyhydramnios
  • “double-bubble sign” (distension of stomach and duodenumw/ tight pyloric sphincter between)
  • Bilious vomiting
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5
Q

Meckel diverticulum

A

outpouching of ALL 3 layers of bowel wall

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6
Q

Meckel diverticulum - cause

A

failure of vitelline duct to involute

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7
Q

Meckel diverticulum - Rule of 2’s

A

2% of population
2 inches long
w/in 2 ft of ileocecal valve
presents w/in first 2 years of life (though usually asymptomatic)

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8
Q

Volvulus

A

twisting of bowel along mesentary

obstruction and infarction

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9
Q

Volvulus - common sites

A

elderly: sigmoid colon

young adults: cecum

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10
Q

Intussusception

A

telescoping of bowel (leads to infarction/obstruction)

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11
Q

Intussusception - clinical signs

A

currant jelly stool

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12
Q

Intussusception - causes

A

children: lymphoid hyperplasia (peyer’s patches stimulated by viral infection)
adults: tumor (“leading edge”)

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13
Q

Small bowel ischemia

A

highly susceptible to ischemic injury (lots of digestion=lots of blood needed)

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14
Q

Small bowel ischemia: types and causes

A

Transmural- thrombus/embolism of SMA

Mucosal - marked hypotension

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15
Q

Lactose intolerance

A

decreased function of lactase enzyme

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16
Q

Lactase enzyme found where?

A

brush border of enterocytes

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17
Q

Celiac disease

A

immune-mediated damage to small bowel due to gluten exposure

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18
Q

Celiac disease: histocompatibility

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A

HLA DQ2 + DQ8

19
Q

Celiac disease: clinical presentation

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A

diarrhea + bloating (+ failure to thrive in infants)

20
Q

Celiac disease: pathoimmunology

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A

gliadin deaminated by tissue transglutamase (tTG)

  • > deaminated gliadin presented by APCs to MHC-II
  • > Helper T cells (T4) mediated damage
21
Q

Dermatitis herpetiformis

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A

complication of celiac disease- vesicular lesions

22
Q

Dermatitis herpetiformis: immunopathology

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A

IgA deposition at tips of dermal papillae

23
Q

Celiac disease: lab findings

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A

IgA antibodies against: endomysium, tTG or gliadin

IgG ab’s also possible if IgA deficient pt

24
Q

Celiac disease: location

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A

primarily duodenum (less jejunum/ileum)

25
Celiac disease: diagnosis
duodenal biopsy
26
Celiac disease: findings on biopsy
flattened villi + hyperplasia of crypts
27
Celiac disease: refractory disease despite good diet
small bowel carcinoma or T cell lymphoma
28
Tropical sprue
damage to small bowel villi due to unknown organism (->malabsorption)
29
Tropical sprue - clinical presentation
similar to celiac disease, except: occurs in tropical regions responds to antibiotics jejunum/ileum most affected
30
Whipple disease
systemic destruction of tissue due to T. whippeli infection
31
Whipple disease: characteristic findings
macrophages filled with Tropheryma whippeli
32
Whipple disease: location
lamina propria of small bowel
33
Whipple disease: clinical presentation
steatorrhea/fat malabsoprtion | arthritis, lymph nodes, cardiac valves, CNS
34
Whipple disease: key histological finding
foamy macrophages in lamina propria
35
Abetalipoproteinema
autosomal recessive deficiency of B-48 and B100
36
Abetalipoproteinemia: clinical presentation
B-48 (chylomicrons)->malabsorption | B-100 (VLDL/LDL)-> absent serum VLDL/LDL
37
Carcinoid tumor
malignant neuroendocrine cell proliferation
38
Carcinoid tumor: lab findings
chromogranin (+) (not specific for bowel tumor) | 5-HIAA in urine (carcinoid tumors often secrete seratonin)
39
Carcinoid tumor: location
can appear anywhere along gut, small bowel most common
40
Carcinoid syndrome and carcinoid tumor of gut
won't present as syndrome unless it metastasizes to liver (liver destroys seratonin from tumor before it can reach systemic circulation if tumor limited to gut->only get urine metabolites)
41
Carcinoid syndrome: classic presentation
bronchospasm, diarrhea, flushing of skin | worsened by EtOH or emotional stress
42
Carcinoid heart disease and bowel
also doesn't occur w/ gut carcinoid tumor unless metastasis
43
Carcinoid heart disease: presentation
Right sided valvular fibrosis (COLLAGEN deposition) | ->tricuspid regurgitation and pulmonary valve stenosis
44
Why is left side of heart protected in carcinoid heart disease?
lungs have MOA- breaks down seratonin into 5-HIAA before it returns to heart

GI (9 decks)

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