Small And Large Intestines

Question 1

Numerate the developmental anomalies of small intestine!

Answer 1

1) Atresia or stenosis
2) Duplication
3) Meckel diverticulum
4) Omphalocele

Question 2

In case of atresia it involve many segments of small intestine True/False?

Answer 2

False .The correct is

Involve only one segment

Question 3

Duplication ,takes the form of persistent blind ended tubular protrusion up to 5 to 6 cm long True/False?

Answer 3

False .The correct is

Meckel diverticulum

Question 4

Duplication ,usually take form of tubular to saccular cystic structure ?

Answer 4

True

Question 5

Meckel diverticulum is resultant of failure involution of omphalomesenteric duct ?

Answer 5

True

Question 6

Define Omphalocele !

Answer 6

Is a congenital defect in periumbilical abdominal wall leaves behind a membranous sac ,into which the small intestine herniate

Question 7

Major anomalies of large intestine include….&….

Answer 7

Malrotation and Hirschsprung disease

Question 8

In malrotation , the developing bowel prevent the intestines from take their normal appearance ?

Answer 8

False .The correct is

Prevent them from assume their normal intra-abdominal position

Question 9

Define Hirschsprung disease !

Answer 9

Leading to congenital megacolon

1) The caudate migrating of neural crest driving cell along the alimentary tract arrests at some point before reaching the anus
2) Leading to functional obstruction and aggressive distention of the colon proximal to the affected part

Question 10

Numerate the vascular disorder of intestine !

Answer 10

1) Ischemic Bowel disease
2) Angiodysplasia
3) Haemorrhoids

Question 11

Ischemic lesions affect the small intestine True/False?

Answer 11

True

Question 12

Ischemic bowel disease affect the large intestine only True/False?

Answer 12

True

Question 13

What is the main cause of Ischemic lesion?

Answer 13

Occlusion of one of the three major supply trunks of the intestine -celiac ,superior and inferior mesenteric arteries.

Question 14

Why the loss of one vessels in Ischemic disease may be not affect?

Answer 14

Due to rich anastomotic interconnection between the vascular beds

Question 15

Explain what happen if the lesions forming within end-arteries the penetrate the gut wall!

Answer 15

Producing small focal ischemic lesions ranges from transmural infarction ,affect all visceral layers of wall, to mural infarction ,affect mucosa and submucosa ,sparing the muscular layer of wall ,and
mucosal infarction ,if the lesions extend on deeper than the muscularis mucosa

Question 16

The predisposing factor of ischemic lesions are ….. , …. , …. , non-occlusive ischemia and Miscellaneous

Answer 16

Arterial thrombosis ,Arterial embolism and Venous thrombosis

Question 17

Describe the appearance of Ischemic lesions.

Answer 17

Whether the occlusions are arterial or venous ,the infarction always take appearance of dark red haemorrhagic appearance because of the reflow of blood into the damaged area

Question 18

Transmural infarction , the onset of pian tends to be more sudden with…. than the ….

Answer 18

Mesenteric embolism ,arterial and venous thrombosis.

Question 19

Why the diagnosis must be made promptly ?

Answer 19

Because this condition may progress to shock and vascular collapse

Question 20

Why the mortality rate of Ischemic Bowel disease approach 90% ?

Answer 20

Because the time between the onset of symptoms and the perforation caused by gangrene is so small

Question 21

What is the cause of angiodysplasia ?

Answer 21

This case is result from tortuous dilations of submucosal and mucosal blood vessels which is most often occur in cecum or right colon ,usually after sixth decade of life

Question 22

In Angiodysplasia ,the haemorrhage may be acute and massive and only cause pernicious anaemia True/False?

Answer 22

False .The correct is

Ut may be chronic and intermittent and only cause severe anaemia

Question 23

Give example about systemic disorders !

Answer 23

Hereditary Haemorrhagic Telangiectasia

Question 24

Give example of variceal dilations !

Answer 24

1) Varices of Oesophagus

2) Haemorrhoids

Question 25

What is the main cause of Haemorrhoids ?

Answer 25

Persistently elevated venous blood pressure within haemorrhoidal plexus

Question 26

Numerate the predisposing factor of haemorrhoids !

Answer 26

1) Straining at stool in the setting of chronic constipation
2) Venous stasis of pregnancy in younger women
3) Resulting from cirrhosis of the liver

Question 27

Haemorrhoids include ….&….

Answer 27

External haemorrhoids (dilations of the inferior haemorrhoidal plexus)
Internal haemorrhoids (dilations of the superior and middle haemorrhoidal plexus)

Question 28

Explain the complications of haemorrhoids !

Answer 28

1) Thin walled ,dilated vessels that commonly bleed, sometimes masking bleeding from far than serious proximal lesions
2) They may become thrombosed,particularly when subject to trauma from passage of stool
3) Internal haemorrhoids may prolapse during straining at stool and then become trapped by the compressive anal sphincter leading to sudden extremely painful ,oedematous haemorrhagic enlargement or strangulation

Question 29

IBD include….&….

Answer 29

Crohn disease & Ulcerative colitis

Question 30

Why IBD consider as individual disease ?

Answer 30

Because they have many difference

Question 31

How IBD is initiated ?

Answer 31

By diverse genetic and immunologic pathways that are modified by environmental influences , including microbes and their products

Question 32

Crohn’s disease affect the respiratory system from mouth to the lung True/False?

Answer 32

False .The correct is

The alimentary tract from mouth to the anus

Question 33

Crohn’s disease is it including systemic disorders?

Answer 33

Yes such as iritis migratory polyarthritis, hepatic pericholangitis and obstructive uropathy with attendant nephrolithiasis

Question 34

What is the features of CD ?

Answer 34

1) Sharply delimited and typically transmural involvement of bowel by an inflammatory process and mucosal damage
2) The presence of noncaseating granulomas in 40%-60% of cases
3) Fissuring by formation of fistulae
4) Making bowel wall rubbery and thick the result of oedema ,inflammation ,fibrosis , and hypertrophy of muscularis propria ,as a result the lumen is almost always narrowed
5) The classic feature of CD is (skippy lesions)

Question 35

Early disease exhibit focal mucosal ulcers resembling Aphthus Ulcer ?

Answer 35

True

Question 36

Describe the progressive disease !

Answer 36

Ulcers coalesce into long ,serpentine linear ulcers , which tend to be oriented along the axis of the bowel

Question 37

Explain the dominant manifestations of CD?

Answer 37

1) Recurrent episodes of diarrhoea
2) Crampy abdominal pain
3) Fever lasting from days to months

Question 38

How the manifestation of CD initiated ?

Answer 38

Begin insidiously , but in some instances , particularly in young persons ,the onset of pain so abrupt and the diarrhoea so mild that abdominal exploration is performed with a diagnosis of appendicitis