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USMLE-Pathology-(Pathoma+ FA+UWorld) > Small Bowel Diseases > Flashcards

Small Bowel Diseases Flashcards

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1
Q

Duodenal Atresia ?

A

Congenital failure of deuodenum to canalize

Pathoma-106

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2
Q

Double bubble sign in which disease ?

A

Duodenal atresia

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2
Q

Clinical features of duodenal atresia ?

A
  1. Poly hyramnios
  2. Bilious vomiting
  3. Double bubble sign - Dsitension of stomach & Blind loop of duodenum
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3
Q

Mekels diverticulum type ?

A

True diverticulum

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3
Q

Duodenal atresia assosiation ?

A

Down syndrome

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3
Q

Presentation of mekels diverticulum ?

A
  1. Bleeding-Heterotopic gastric mucosa
  2. Volvulus
  3. Intussusception
  4. Obstruction-Mimics appendicits
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4
Q

Cause of MD ?

A

Failure of viteline duct to involute

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4
Q

Meckel diverticum ?

A

Outpouching of all three layers of bowel wall

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5
Q

Volvulus ?

A

Twisting of bowel along the mesentry

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5
Q

Rules of 2 ?

A
  1. Population - 2%
  2. Long - 2inch
  3. 2 feet away from ileocecal valve
  4. Present first 2 year of life
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6
Q

Volvulus features ?

A
  1. Obstruction
  2. Disruption blood supply
  3. Infarction
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7
Q

Volvulus site ?

A
  1. Adult-Sigmoid colon
  2. Young-Cecum
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8
Q

Intussusception means ?

A

Telescoping of proximal segement of bowel forward into distal segement

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9
Q

Featuresn of intussusception ?

same as volvulus

A
  1. Obstruction
  2. Disruption blood supply
  3. Infarction
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10
Q

Association with leading edeg-Focus of traction ?

A
  1. Children-Lymphoid hyperplasia=Rotavirus =Terminal ileum = I into cecum
  2. Adults=Tumor most common
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11
Q

Small bowel infracy
small bowel highly susceptible to —-

A

Ischemic injury

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12
Q

Clinical features of small bowel infarction ?

A
  1. Ab pain
  2. Bloody diarrhea
  3. dec bowel sounds

Pathoma-107

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13
Q

Mucosal infarction occurs in —

A

HTN

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14
Q

Transmural inarction occurs in —

A
  1. Sup mesenteric artery
  2. Mesenteric vein

Thrombosis/Embolism

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15
Q

Lactase enzymes site >?

A

Brush border of enterocytes

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16
Q

Lactase enzymes function –

A

Lactose—Glucose + Galactose

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17
Q

Lactose intolerance ?

A

Dec function of lastase enzymes

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18
Q

Presentation of LI ?

A
  1. Abdominal distension
  2. Diarrhea

upon consumption of milk products

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19
Q

Cause of lactose intolerance ?

A
  1. Congenital-rare autosomal recessive disorder
  2. Acquired - late childhood development
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20
Lactase is highly susceptible to ----
Injury
21
Gluten source ?
1. Wheat 2. Grains 3. GLIADIN
22
Celiac disease ?
Immune mediated damage of small bowel villi- Gluten exposure
23
Celiac disease by Gluten ?
Helper T cell mediate tissue damage
24
Gliadin process ?
Gliadin = Deaminated by Tissue transglutaminase (tTG) = Deamidated Gliadin is presented to Helper T cell by MHC-II
25
Clinical presentation of adults ?
1. Chronic diarrhea 2. Bloating
25
Clinical presentation in children ?
1. Ab distension 2. Diarrhea 3. Failure to thrive
26
Antigen presentation of celiac disease ?
1. HLA-DQ2 2. DQ8
27
Dermatitis herpetiformis cause ?
IgA deposition at the tips of dermal papillae
27
Skin presentation in celiac disease ?
Small herpes like vesicles
28
Small herpes liek vesicles are called ?
Dermatitis herpetiformis
29
Dermatitis herpetiformis Tx ?
Gluten free diet
30
Lab findings of celiac disease ?
IgA antibodies against endomysium ,tTG or gliadin
31
Other lab finidngs ?
IgG antibodies + IgA deficiency ( Inc incidence of IgA deficiency in Celiac disease )
32
Most prominent damage in celiac disease ?
Duodenum | Less in ileum & jejunum
33
Late complications of celiac disease ?
1. Small bowel Ca 2. T-cell lymphoma
34
Duodenal biopsy result ?
1. Flattening of villi 2. Hyperplasia of crypts 3. inc Intraepithelial lymphocytes
35
Tropical sprue ?
Damage to small bowel villi resulting in malabsorption | Pathoma-108
36
Tropical sprue occurs after --
1. Infectious diarrhea 2. Responds to antibiotics
37
Tropical sprue common site ?
Jejunum & ileum
38
Jejunum & ileum manifestation in Tropical sprue ?
1. Secondary vitamin-B12 2. Folate deficiency
39
Other sites of WD >?
1. Synovium of joints-Arthirits 2. Cardiac valves 3. Lymph nodes 4. CNS
40
Whipple disease ?
Systemic tissue damage by macrophage
41
which organism in whipple disease ?
Tropheryma whippelii
42
Positive stain >????
PAS stain
43
Common site involvement in whipple disease ?
Small bowel lamina propria
44
Process of tissue damage in Whipple disease ?
1. Macrophage compress lacteals 2. Chylomicrons cannot be transferred from enterocytes to lymphatics 3. Fat malabsoption & steatorrhea
45
AbetalipoProteinemia ?
Autosomal recessive deficiency of ApoLipoProtein= B48 & B100 | PATHOMA-108
46
AbetalipoProteinemia Clinical features ?
1. Malabsorption-Defective chylomicron formation- B48 2. Absent VLDL & LDL- B100
47
Carcinoid tumor ?
Maliganant proliferation of neuroendocrine cells-Low grade malignancy | Pathoma-108
48
Histo of carcinoid tumor ?
Submucosal polyp like nodules
48
Carcinoid tumor characteristics ?
Tumor cells contains neurosecretory granules that are + for chromogranin
49
Common site of carcinoid tumor ?
Small bowel
49
Carcinoid tumor secretes ?
Serotonin
50
Serotonin fate ?
Serotonin = 5-HIAA by MAO
50
Serotonin is metabolized by ?
1. Liver monoamine oxidase -MAO
50
5-HIAA excreted into --
Urine | 108
51
Metastasis of carcinoid tumor allows serotonin to bypass--
liver metabolism
52
Seratonin is release in which vein ?
Hepatic vein
53
Seratonin manisfestation ?
1. Carcinoid syndrome 2. Carcinoid heart disease
54
Carcinoid tumor clinical features ?
1. Bronchospasm 2. Diarrhea 3. Flushing of skin
55
Carcinoid heart disease manifestation?
1. Right sided valvular fibrosis 2. Increased collagen
56
Carcinoid tumor symptoms triggered by ?
Alchohol \that stimulate serotonin release
57
Right sided valvular disease feature ?
1. tricuspid regurgitation 2. pulmonary valve stenosis
58
Left sided valvular fibrosis present ???????
NO due to MAO | 109-Pathoma

USMLE-Pathology-(Pathoma+ FA+UWorld) (75 decks)

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