Pathophysiology Flashcards

1
Q

congenital absence or closure of a body orifice or tubular organ

A

atresia

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2
Q

[atresia] Type A (I)

A

lower esophagus closed

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3
Q

[atresia] Type B (II)

A

upper esophagus connects with trachea

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4
Q

[atresia] Type C (III)

A

lower esophagus connects with trachea

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5
Q

[atresia] Type D

A

both upper and lower esophagus connect to trachea

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6
Q

[atresia] Type E (H-type)

A

w/o esophageal atresia, upper and lower esophagus connect to trachea

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7
Q

[atresia] s/s

A

choking, dyspnea (shortness of breath), cyanosis, gagging, excessive salivation

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8
Q

[atresia] dx

A

radiography - ngt cannot pass thru
esophagography

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9
Q

[atresia] Cx

A

aspiration (accidental breathing in of food or fluid into the lungs)

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10
Q

[atresia] Tx

A

Surgery

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11
Q

abnormal tube-like passage from one structure to another

A

fistula

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12
Q

[fistula] pathogenesis

A

malformation during organo. caused by lack of cell differentiation of trachea, during 4th-6th wk

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13
Q

[fistula] Tx

A

surgery

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14
Q

most common type of bowel atresia, blockage ion ileum (final, longest section of SI)

A

Ileal Atresia

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15
Q

[ileal atresia] pathogenesis

A

unknown, caused by vascular accident during fetal dev’t

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16
Q

[ileal atresia] s/s

A

abdominal distention, inability to pass stool

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17
Q

[ileal atresia] Tx

A

resection-anastomosis (connection created)
ileostomy

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18
Q

second most common type of bowel atresia (1:20,000)

A

duodenal atresia

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19
Q

[duodenal atresia] s/s

A

vomiting, distended epigastrum

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20
Q

[duodenal atresia] Dx

A

sonography- dilated stomach w/o other fluid collections in the abdo
rad’phy - “double bubble”

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21
Q

[duodenal atresia] Cx

A

aspiration

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22
Q

[duodenal atresia] Tx

A

resection-anastomosis

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23
Q

congenital disorder of dev’t of distal rectum and anus may lead to complete bowel obstruction

A

colonic atresia

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24
Q

[colonic atresia] pathophy

A

gas and stool cannot pass thru a narrow area

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25
Q

[colonic atresia] s/s

A

bloating/swelling, passing no stool, vomiting

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26
Q

[colonic atresia] Dx

A

rad’phy

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27
Q

[colonic atresia]Cx

A

perforation, infection, sepsis

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28
Q

[colonic atresia] Tx

A

surgery

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29
Q

anal opening to the exterior is absent

A

anal agenesis (imperforate anus)

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30
Q

[anal agenesis] s/s

A

stool from the vagina
urine from the anus
constipation

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31
Q

[anal agenesis] Dx

A

crosstable lateral rectum proj. (prone)
fistulogram -use cm

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32
Q

[anal agenesis] Cx

A

fistula formation w/ the genitourinary system, perineum vagina

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33
Q

[anal agenesis] Tx

A

surgery

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34
Q

enlargement of sphincter, greatly narrowed pyloric canal, commonly confused with pylorospasm

A

hypertophic pyloric/pylorus
pyloric stenosis

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35
Q

[pyloric stenosis] pathophy

A

idiopathic; assoc. with TGF-a, nerve dysfunction

hypertrophy and hyperplasia of pyloric spincter

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36
Q

[pyloric stenosis] s/s

A

projectile bile free-emesis, vomiting, inability to gain wt., immed. hungry in b/w feedings, dehydration

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37
Q

[pyloric stenosis] Dx

A

physical ex. -olive sign
sonography - highly accurate-standard
conv
ugis

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38
Q

[pyloric stenosis] Dx (sonography)

A
  1. thickness of pylorus >5cm
  2. target sign
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39
Q

[pyloric stenosis] Dx (conventional)

A
  1. caterpillar sign - peristaltic waves
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40
Q

[pyloric stenosis] Dx (ugis)

A
  1. String sign - elongated pylorus
  2. Double track sign - caused by redundant mucosa in the narrowed pyloric lumen
  3. Mushroom sign (umbrella sign) - thickened muscle
  4. Shoulder sign - hypertrophied pyloric muscle on Ba filled antrum
  5. Beak Sign - filling of the proximal pylorus
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41
Q

inappropriate rotation, anomalous position fixation of S and L bowel; incidence for m and f are the same

A

malrotation

42
Q

[malrotation] s/s

A

bilious vomiting, bloody stool, constipation

43
Q

[malrotation] Dx

A

Ugis - golden standard
BaE
Sonography

44
Q

[malrotation] dx deviations from the normal route of the contrast in the duodenum , may show gastric torsion

A

ugis (gold standard)

45
Q

[malrotation] dx - BaE

A

evaluate location of cecum

46
Q

[malrotation] dx- sonography

A

if ugis and enema is contraindicated -complementary- 3rd part of duodenum is b/w aorta and SMA

47
Q

[malrotation] dx- sonography

A

if ugis and enema is contraindicated -complementary- 3rd part of duodenum is b/w aorta and SMA

48
Q

[malrotation] dx- sonography

A

if ugis and enema is contraindicated -complementary- 3rd part of duodenum is b/w aorta and SMA

49
Q

[malrotation] Cx

A

volvulus- twisting of intestine on itself,
incarceration of bowel (internal hernia),

50
Q

[malrotation] Rx

A

resection anastomosis for complications

51
Q

contain nerve cell are missing from the muscle layer of a part of the LI - prevent normal relaxation (1:5000-male predominance)

absence of [..] and [..] in bowel wall typically in [..]

A

Hirschsprung disease

Meissner and Auerbach plexus

sigmoid colon

52
Q

Hirschsprung disease other name

A

congenital aganglionic megacolon

53
Q

[Hirschsprung disease] pathophy

A

unknown, linked to manifestation of parasympathetic nervous system

inheritance of RET protooncogene in chromosome 10

54
Q

[Hirschsprung disease] s/s

A

distended/dilated sigmoid
narrow rectum
severe constipation
recurrent fecal impaction

55
Q

[Hirschsprung disease] Dx

A

BaE
UTS, CT, MRI

56
Q

[Hirschsprung disease] Cx

A

distended abdomen, constipation,
fecal impaction (toxic megacolon) - BaE contraindication

57
Q

congenital diverticulum of distal ileum, abnormal pouch or pocket of distal ileum (w/in 6 ft of ileocecal valve)

A

Meckel Diverticulum

58
Q

[Meckel Diverticulum] pathophy

A

remnant of a duct connecting the SB to umbilicus failure to remove the vitelline duct

58
Q

[Meckel Diverticulum] rule of 2s

A

-2% gen pop
-located on antimesenteric border of ileum 2 ft from ileocecal valve
-2in length-diverticulum

59
Q

[Meckel Diverticulum] s/s

A

rectal bleeding, cramping, vomiting, bowel obstruction

60
Q

[Meckel Diverticulum] Dx

A

SPECT- Tc99m with pertechnetate - Meckel Scans
BaE

61
Q

[Meckel Diverticulum] Cx

A

bleeding due to ulceration, abdominal camping, vomiting, bowel obstruction

62
Q

[Meckel Diverticulum] Tx

A

Surgery-resection

63
Q

abnormal digestion and absorption of gluten in SB

A

gluten-sensitive enteropathy

64
Q

[gluten-sensitive enteropathy] other name

A

non tropical sprue
celiac sprue/disease

65
Q

[gluten-sensitive enteropathy] s/s

A

diarrhea, fatigue, wt. loss, bloating and gas, abdo pain, vomiting, constipation

66
Q

[gluten-sensitive enteropathy] Dx

A

SIS - appear as stack of coins
biopsy of SB

67
Q

[gluten-sensitive enteropathy] Dx

A

SIS - appear as stack of coins

68
Q

[gluten-sensitive enteropathy] Tx

A

Rec. avoid food containing gluten, vitamin therapy

69
Q

[gluten-sensitive enteropathy] Tx

A

Rec. avoid food containing gluten, vitamin therapy

70
Q

inability to digest certain carbohydrates (including lactose bc of an acquired lactase deficiency) - 60% non white popu

A

carbohydrate intolerance

71
Q

[carbohydrate intolerance] s/s

A

cramping and diarrhea

72
Q

[carbohydrate intolerance] Dx

A

SIS - Ba + lactose - increased transit time, dilution in the distal ileum and colon

stack of coins appearance - dilated LS

73
Q

[carbohydrate intolerance] Cx

A

nutritional deficiencies

74
Q

[carbohydrate intolerance] Tx

A

abstain from consumption of dairy products

75
Q

narrowing of esophagus

A

esophageal stricture

76
Q

[esophageal stricture] pathophy

A

inflammation of the mucosa

77
Q

[esophageal stricture] s/s

A

edema, swelling, scarring or perforation

78
Q

[esophageal stricture] dx

A

esophagography
benign stricture - smooth
malignant tumor - ragged
endoscopy

79
Q

[esophageal stricture] tx

A

surgery, corticosteroids (anti-inflammatory), repeated dilation using tubes

80
Q

due to backward flow of gastric acid and contents into the esophagus due to an incompetent cardiac sphincter

A

GERD

81
Q

[GERD] pathophy

A

no definitive pathologic cause, not necessarily always abnormal

82
Q

[GERD] s/s

A

heart burn, backwash, upper abdo pain, chest pain, dysphagia

83
Q

[GERD] dx not useful test

A

UGIS - variable sensitivity and specificity, used to identify patho assoc. w/ gerd

84
Q

[GERD] dx provides functional and morphologic

A

sonography- too sensitive, less specific

85
Q

[pyloric stenosis] Tx

A

pyloromyotomy

86
Q

[Hirschsprung disease] Tx

A

Resection + Colostomy

87
Q

[GERD] dx gold standard

A

Ph Probe Test - place catheter inside nasogastric to assess acid level for 24 hrs up to 96 hrs

88
Q

[GERD] dx

A

ph probe test
ugis
sono
Reflux Scintigraphy - Tc-99m DTPA w/ H20

89
Q

[GERD] Cx

A

esophagitis, ulceration of esophagus

90
Q

[GERD] Tx

A

truncal elevation, avoid coffee, alcohol, chocolate, smoking
antacids,
H2 blockers
surgery -last resort

91
Q

errossion of mucous membrane of the lower end of the esophagus, stomach or duodenum

A

peptic ulcer

92
Q

[peptic ulcer] pathophy

A

duodenal ulcers - all ages, usually benign, duodenal bulb
gastric ulcers - >40 yrs, lesser curvature and antrum , can lead to malignancy

H-pylori- increased gastrin production

NSAIDS - damage epithelial cells

93
Q

[peptic ulcer] acute

A

last up to 3 wks
multiple
pinhead-inch size
MC- pylorus
rarely involve muscular coat

94
Q

[peptic ulcer] subacute

A

fewer in no. maybe single
involve muscular coat

95
Q

[peptic ulcer] chronic

A

if still persist in 2 mos
MC: lesser curvature

96
Q

[peptic ulcer] s/s

A

duodenal ulcer - midmorning pain relieved by food but returns after 2-3 hrs

gastric ulcers - epigastric pain (relieved or aggravated by food)

97
Q

[peptic ulcer] Dx

A

endoscopy -primary modality
double contrast ugis
ct or upright abdo radiograph

98
Q

[peptic ulcer] double cont ugis rad app

A

radiating spikelike wheels of mucosal folds that run into the edge of the crater, round and irregular edges

for malignancy, Carman Meniscus Sign - lenticular shape of Ba under gastric ulcer

99
Q

[peptic ulcer] Cx

A

bowel obstruction, infection, peritonitis

100
Q

[peptic ulcer] Tx

A

antibiotic, surgery for hemorrhage or perforation