Pathophysiology Flashcards
(101 cards)
1
Q
congenital absence or closure of a body orifice or tubular organ
A
atresia
2
Q
[atresia] Type A (I)
A
lower esophagus closed
3
Q
[atresia] Type B (II)
A
upper esophagus connects with trachea
4
Q
[atresia] Type C (III)
A
lower esophagus connects with trachea
5
Q
[atresia] Type D
A
both upper and lower esophagus connect to trachea
6
Q
[atresia] Type E (H-type)
A
w/o esophageal atresia, upper and lower esophagus connect to trachea
7
Q
[atresia] s/s
A
choking, dyspnea (shortness of breath), cyanosis, gagging, excessive salivation
8
Q
[atresia] dx
A
radiography - ngt cannot pass thru
esophagography
9
Q
[atresia] Cx
A
aspiration (accidental breathing in of food or fluid into the lungs)
10
Q
[atresia] Tx
A
Surgery
11
Q
abnormal tube-like passage from one structure to another
A
fistula
12
Q
[fistula] pathogenesis
A
malformation during organo. caused by lack of cell differentiation of trachea, during 4th-6th wk
13
Q
[fistula] Tx
A
surgery
14
Q
most common type of bowel atresia, blockage ion ileum (final, longest section of SI)
A
Ileal Atresia
15
Q
[ileal atresia] pathogenesis
A
unknown, caused by vascular accident during fetal dev’t
16
Q
[ileal atresia] s/s
A
abdominal distention, inability to pass stool
17
Q
[ileal atresia] Tx
A
resection-anastomosis (connection created)
ileostomy
18
Q
second most common type of bowel atresia (1:20,000)
A
duodenal atresia
19
Q
[duodenal atresia] s/s
A
vomiting, distended epigastrum
20
Q
[duodenal atresia] Dx
A
sonography- dilated stomach w/o other fluid collections in the abdo
rad’phy - “double bubble”
21
Q
[duodenal atresia] Cx
A
aspiration
22
Q
[duodenal atresia] Tx
A
resection-anastomosis
23
Q
congenital disorder of dev’t of distal rectum and anus may lead to complete bowel obstruction
A
colonic atresia
24
Q
[colonic atresia] pathophy
A
gas and stool cannot pass thru a narrow area
25
[colonic atresia] s/s
bloating/swelling, passing no stool, vomiting
26
[colonic atresia] Dx
rad'phy
27
[colonic atresia]Cx
perforation, infection, sepsis
28
[colonic atresia] Tx
surgery
29
anal opening to the exterior is absent
anal agenesis (imperforate anus)
30
[anal agenesis] s/s
stool from the vagina
urine from the anus
constipation
31
[anal agenesis] Dx
crosstable lateral rectum proj. (prone)
fistulogram -use cm
32
[anal agenesis] Cx
fistula formation w/ the genitourinary system, perineum vagina
33
[anal agenesis] Tx
surgery
34
enlargement of sphincter, greatly narrowed pyloric canal, commonly confused with pylorospasm
hypertophic pyloric/pylorus
pyloric stenosis
35
[pyloric stenosis] pathophy
idiopathic; assoc. with TGF-a, nerve dysfunction
hypertrophy and hyperplasia of pyloric spincter
36
[pyloric stenosis] s/s
projectile bile free-emesis, vomiting, inability to gain wt., immed. hungry in b/w feedings, dehydration
37
[pyloric stenosis] Dx
physical ex. -olive sign
sonography - highly accurate-standard
conv
ugis
38
[pyloric stenosis] Dx (sonography)
1. thickness of pylorus >5cm
2. target sign
39
[pyloric stenosis] Dx (conventional)
1. caterpillar sign - peristaltic waves
40
[pyloric stenosis] Dx (ugis)
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
41
inappropriate rotation, anomalous position fixation of S and L bowel; incidence for m and f are the same
malrotation
42
[malrotation] s/s
bilious vomiting, bloody stool, constipation
43
[malrotation] Dx
Ugis - golden standard
BaE
Sonography
44
[malrotation] dx deviations from the normal route of the contrast in the duodenum , may show gastric torsion
ugis (gold standard)
45
[malrotation] dx - BaE
evaluate location of cecum
46
[malrotation] dx- sonography
if ugis and enema is contraindicated -complementary- 3rd part of duodenum is b/w aorta and SMA
47
[malrotation] dx- sonography
if ugis and enema is contraindicated -complementary- 3rd part of duodenum is b/w aorta and SMA
48
[malrotation] dx- sonography
if ugis and enema is contraindicated -complementary- 3rd part of duodenum is b/w aorta and SMA
49
[malrotation] Cx
volvulus- twisting of intestine on itself,
incarceration of bowel (internal hernia),
50
[malrotation] Rx
resection anastomosis for complications
51
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 [..]
Hirschsprung disease
Meissner and Auerbach plexus
sigmoid colon
52
Hirschsprung disease other name
congenital aganglionic megacolon
53
[Hirschsprung disease] pathophy
unknown, linked to manifestation of parasympathetic nervous system
inheritance of RET protooncogene in chromosome 10
54
[Hirschsprung disease] s/s
distended/dilated sigmoid
narrow rectum
severe constipation
recurrent fecal impaction
55
[Hirschsprung disease] Dx
BaE
UTS, CT, MRI
56
[Hirschsprung disease] Cx
distended abdomen, constipation,
fecal impaction (toxic megacolon) - BaE contraindication
57
congenital diverticulum of distal ileum, abnormal pouch or pocket of distal ileum (w/in 6 ft of ileocecal valve)
Meckel Diverticulum
58
[Meckel Diverticulum] pathophy
remnant of a duct connecting the SB to umbilicus failure to remove the vitelline duct
58
[Meckel Diverticulum] rule of 2s
-2% gen pop
-located on antimesenteric border of ileum 2 ft from ileocecal valve
-2in length-diverticulum
59
[Meckel Diverticulum] s/s
rectal bleeding, cramping, vomiting, bowel obstruction
60
[Meckel Diverticulum] Dx
SPECT- Tc99m with pertechnetate - Meckel Scans
BaE
61
[Meckel Diverticulum] Cx
bleeding due to ulceration, abdominal camping, vomiting, bowel obstruction
62
[Meckel Diverticulum] Tx
Surgery-resection
63
abnormal digestion and absorption of gluten in SB
gluten-sensitive enteropathy
64
[gluten-sensitive enteropathy] other name
non tropical sprue
celiac sprue/disease
65
[gluten-sensitive enteropathy] s/s
diarrhea, fatigue, wt. loss, bloating and gas, abdo pain, vomiting, constipation
66
[gluten-sensitive enteropathy] Dx
SIS - appear as stack of coins
biopsy of SB
67
[gluten-sensitive enteropathy] Dx
SIS - appear as stack of coins
68
[gluten-sensitive enteropathy] Tx
Rec. avoid food containing gluten, vitamin therapy
69
[gluten-sensitive enteropathy] Tx
Rec. avoid food containing gluten, vitamin therapy
70
inability to digest certain carbohydrates (including lactose bc of an acquired lactase deficiency) - 60% non white popu
carbohydrate intolerance
71
[carbohydrate intolerance] s/s
cramping and diarrhea
72
[carbohydrate intolerance] Dx
SIS - Ba + lactose - increased transit time, dilution in the distal ileum and colon
stack of coins appearance - dilated LS
73
[carbohydrate intolerance] Cx
nutritional deficiencies
74
[carbohydrate intolerance] Tx
abstain from consumption of dairy products
75
narrowing of esophagus
esophageal stricture
76
[esophageal stricture] pathophy
inflammation of the mucosa
77
[esophageal stricture] s/s
edema, swelling, scarring or perforation
78
[esophageal stricture] dx
esophagography
benign stricture - smooth
malignant tumor - ragged
endoscopy
79
[esophageal stricture] tx
surgery, corticosteroids (anti-inflammatory), repeated dilation using tubes
80
due to backward flow of gastric acid and contents into the esophagus due to an incompetent cardiac sphincter
GERD
81
[GERD] pathophy
no definitive pathologic cause, not necessarily always abnormal
82
[GERD] s/s
heart burn, backwash, upper abdo pain, chest pain, dysphagia
83
[GERD] dx not useful test
UGIS - variable sensitivity and specificity, used to identify patho assoc. w/ gerd
84
[GERD] dx provides functional and morphologic
sonography- too sensitive, less specific
85
[pyloric stenosis] Tx
pyloromyotomy
86
[Hirschsprung disease] Tx
Resection + Colostomy
87
[GERD] dx gold standard
Ph Probe Test - place catheter inside nasogastric to assess acid level for 24 hrs up to 96 hrs
88
[GERD] dx
ph probe test
ugis
sono
Reflux Scintigraphy - Tc-99m DTPA w/ H20
89
[GERD] Cx
esophagitis, ulceration of esophagus
90
[GERD] Tx
truncal elevation, avoid coffee, alcohol, chocolate, smoking
antacids,
H2 blockers
surgery -last resort
91
errossion of mucous membrane of the lower end of the esophagus, stomach or duodenum
peptic ulcer
92
[peptic ulcer] pathophy
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
[peptic ulcer] acute
last up to 3 wks
multiple
pinhead-inch size
MC- pylorus
rarely involve muscular coat
94
[peptic ulcer] subacute
fewer in no. maybe single
involve muscular coat
95
[peptic ulcer] chronic
if still persist in 2 mos
MC: lesser curvature
96
[peptic ulcer] s/s
duodenal ulcer - midmorning pain relieved by food but returns after 2-3 hrs
gastric ulcers - epigastric pain (relieved or aggravated by food)
97
[peptic ulcer] Dx
endoscopy -primary modality
double contrast ugis
ct or upright abdo radiograph
98
[peptic ulcer] double cont ugis rad app
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
[peptic ulcer] Cx
bowel obstruction, infection, peritonitis
100
[peptic ulcer] Tx
antibiotic, surgery for hemorrhage or perforation
