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MSII: Pathology Unit 6 > Rubin's Small Intestine > Flashcards

Rubin's Small Intestine Flashcards

1
Q

The duodenum extends to the…

A

Ligament of Treitz

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2
Q

The mucosal epithelium is replaced every….

A

4-7 days

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3
Q

What are the 4 types of cells in the small intestinal crypts?

A

Paneth cells, goblet cells, endocrine cells, undifferentiated cells

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4
Q

“congenital failure of duodenum to canalize”

A

duodenal atresia

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5
Q

What is duodenal atresia associated with?

A

Down Syndrome

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6
Q

“spherical tubular structures attached to the alimentary tract that have smooth muscular walls and GI type epithelium”

A

Duplications

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7
Q

“outpouching of all 3 layers of the bowel wall”

A

Meckel Diverticulum

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8
Q

Why does meckel diverticulum occur?

A

failure of the vitelline duct to involute

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9
Q

What is the most common and clinically significant congenital anomaly of the small intestine?

A

Meckel Diverticulum

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10
Q

What is meconium ileus?

A

an early complication of CF, the thick stool of a newborn

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11
Q

“twisting of the bowel along its mesentary”

A

Volvulus

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12
Q

Where are volvulus’ located in elderly and young adults?

A

Elderly–> sigmoid

young adults–> cecum

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13
Q

“Transverse circular ulcers, circumferential “napkin ring” fibrosis strictures, caseous necrosis”

A

Intestinal tuberculosis

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14
Q

3 most common intestinal fungal infections?

A

Candida, histoplasma, mucor

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15
Q

“telescoping of proximal segment of bowel for forward into distal segment”

A

Intussusception

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16
Q

Most common cause of intussusception in children and in adults?

A

Children–> terminal ileum

Adults–> tumor

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17
Q

Most common cause of acute intestinal ischemia?

A

SMA occlusion

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18
Q

T/F: the small intestine is highly susceptible to ischemic injury

A

True

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19
Q

What are the 3 causes of acute intestinal ischemia?

A

Arterial occlusion, nonocclusive intestinal ischemia, mesenteric vein thrombosis

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20
Q

Most common cause of chronic intestinal ischemia?

A

Atherosclerotic narrowing

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21
Q

Mucosal infarction is due to…

A

marked HTN

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22
Q

Transmural infarction is due to…

A

thrombosis/ embolism of SMA or mesenteric vein

23
Q

What are the clinical features of small bowel infarction?

A

Pain, bloody diarrhea, hypoactive bowel sounds

24
Q

What two substances are preferentially absorbed by the distal small intestine?

A

bile salts and vit B12

25
Q

What does supply of bile require?

A

normal liver function

Unobstructed bile flow
intact enterohepatic bile salt circulation

26
Q

What causes luminal phase malabsorption?

A

insufficient bile acids

27
Q

What cause insufficient bile acids?

A

Impaired excretion of bile

Bacterial overgrowth

Deficient bile salts

28
Q

What causes intestinal phase malabsorption?

A

specific enzyme defects or impaired transport

29
Q

“decreased function of lactose enzyme in brush border of enterocytes”

A

lactose intolerance

30
Q

How does lactose intolerance present?

A

Abdominal distention

Diarrhea (because undigested lactose is osmotically active)

31
Q

“Immune mediated damage of small bowel villi due to gluten exposure”

A

Celiac disease

32
Q

Celiac disease is associated with which HLA types?

A

HLA- DQ2

HLA- DQ8

33
Q

ANtibodies seen in celiac disease?

A

IgG anti- endomysial and anti- tisse transglutaminase antibodies

34
Q

Which parts of the small intestine are most affected by celiac disease?

A

duodenum and proximal jejunum

35
Q

Most pathogenic part of gluten?

A

Gliadin–> antibodies against it are generated

36
Q

Which immune cells are predominant in celiac disease?

A

Increased CD8 T cells

37
Q

Pathologic findings in celiac disease?

A

destruction of villi and brush border but increased depth of intestinal crypts

38
Q

Differences in tropical sprue?

A

1- tropical region

2- seen after infectious diarrhea and responds to Abx

3- damage to jejunum and ileum

39
Q

“antibodies to the gut epithelium, especially to enterocytes”

A

Autoimmune enteropathy

40
Q

“systemic tissue damage characterized by macrophages loaded with tropheryma whippelii”

A

Whipple disease

41
Q

What are the symptoms of Whipple disease?

A

arthritis, fatty stools, increased skin pigmentation, CNS problems, endocarditis

42
Q

“AR deficiency of APO B-48 and B-100 that causes malabsorption”

A

abetalipoproteinemia

43
Q

What is Milroy disease?

A

intestinal lypnagiectasia + peripheral lymphedema

44
Q

“generalized malformation that causes malabsorption”

A

Congenital lymphangiectasia

45
Q

Name the 3 benign tumors of the small intestin?

A

Adenomas

Peutz- Jeghers Syndrome

GIST

46
Q

“AD inherited disorder, intestinal hamartomatous polyps and mucocutaenous melanin pigmentation”

A

Peutz- jeghers Syndrome

47
Q

Mutation seen in Peutz- jeghers Syndrome?

A

inactivating mutation of LKB1 protein kinase

48
Q

Where do adenocarcinomas mainly occur?

A

duodenum or jejunum

49
Q

Where does adenocarcinoma begin?

A

In crypt epithelium

50
Q

What is MALT?

A

Primary intestinal lymphoma

51
Q

carcinoid tumors are associated with?

A

MEN1

52
Q

“malignant prolferation of neuroendocrine cells with neurosecretory granules that are chromogranin (+)”

A

carcinoid tumor

53
Q

What hormone do carciod tumors usually secrete?

A

Serotonin–> 5- HIAA is in the urine (it is a metabolite)

54
Q

What are the symptoms of carcinoid syndrome?

A

bronchospasm, diarrhea, flushing skin, right sided valvular dibrosis

MSII: Pathology Unit 6 (12 decks)

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