Small intestine pathology Flashcards
(113 cards)
1
Q
This is protrusion of tissue through an abnormal opening or weakness
A
Hernia
2
Q
In this type of hernia, contents are trapped
A
Incarcerated hernia
3
Q
In this type of hernia, contents become ischemic/necrotic
A
Strangulated hernia
4
Q
This occurs when fibrous bands entrap or constrict GI segment
A
Adhesions
5
Q
This occurs when a loop of bowel extends through a space created by adhesions
A
Internal herniation
6
Q
Internal herniation occurs when a loop of bowel extends through a space created by this
A
Adhesions
7
Q
This occurs when bowel segment telescopes into the immediately distal segment
A
Intussusception
8
Q
Intussusception most commonly occurs in this age group
A
Young children (<2 years)
9
Q
This occurs when bowel loop twists around vascular supply
A
Volvulus
10
Q
Volvulus occurs when bowel loop twists around this
A
Vascular supply
11
Q
This type of Volvulus occurs in older patients
A
Sigmoid Volvulus
12
Q
Sigmoid Volvulus occurs in this age population
A
Older
13
Q
Coffee bean sign on abdomen x-ray indicates this condition
A
Sigmoid Volvulus
14
Q
Type type of Volvulus will show coffee bean sign on abdominal x-ray
A
Sigmoid Volvulus
15
Q
This type of Volvulus occurs in adults and is less common
A
Cecal Volvulus
16
Q
LLQ abdominal distention indicates this type of Volvulus
A
Sigmoid Volvulus
17
Q
Central/right abdominal distention indicates this type of Volvulus
A
Cecal Volvulus
18
Q
Embryo sign on abdominal x-ray indicates this condition
A
Cecal Volvulus
19
Q
Embryo sign on abdominal x-ray occurs with this type of Volvulus
A
Cecal
20
Q
Sigmoid Volvulus has this key finding on abdomen x-ray
A
Coffee bean sign
21
Q
Cecal Volvulus has this key finding on abdomen x-ray
A
Embryo sign
22
Q
This type of Volvulus is seen in infants with malrotation
A
Midgut volvulus
23
Q
During development, intestines normally rotate around the axis of this
A
Superior mesenteric artery
24
Q
Intestinal malrotation leads to a high risk of this type of volvulus
A
Midgut volvulus
25
Intestinal malrotation results in high risk of midgut volvulus, as well as obstruction by these
Ladd bands
26
Midgut Volvulus occurs in this age population
Infants
seen with malrotation
27
Will intestinal malrotation result in bilious or non-bilious emesis?
Bilious
28
This is failed recanalization of duodenum during gestation
Duodenal atresia
29
Duodenal atresia is associated with this syndromic condition
Trisomy 21
also increased rate of annular pancreas, cardiac, and other anomalies
30
In duodenal atresia, if vomiting occurs, is it usually bilious or non-bilious?
Bilious
31
Double bubble sign and polyhydramnios often occur in this condition with increased rate of annular pancreas and cardiac anomalies
Duodenal atresia
32
Jejunal/ileal atresia is due to this
Intrauterine vascular accident and ischemia
33
Does this describe duodenal or jejunoileal atresia:
Polyhydramnios often
Both
34
Does this describe duodenal or jejunoileal atresia:
Bilious vomiting on day 1
Both
35
Does this describe duodenal or jejunoileal atresia:
No distention
Duodenal atresia
36
Does this describe duodenal or jejunoileal atresia:
Abdominal distention after feeding
Jejunoileal
37
Does this describe duodenal or jejunoileal atresia:
Peristaltic waves often
Both
38
Does this describe duodenal or jejunoileal atresia:
Double bubble sign
Duodenal
39
Does this describe duodenal or jejunoileal atresia:
Multiple air-fluid levels usually
Jejunoileal
40
This is an ileal diverticulum at the site of vitelline duct
Meckels diverticulum
41
Meckels diverticulum occurs in this part of the small intestine
Ileum
42
Meckels diverticulum occurs at the site of this duct
Vitelline duct
43
This condition has the rule to Twos:
2% of population
~2ft from ileocecal valve
2 in long
Presents in first 2 years of life
2 types of ectopic tissue (gastric and pancreatic)
Meckels diverticulum
44
Meckels diverticulum is usually asymptomatic, but would present at this age
In first 2 years of life
(rule of Twos)
45
Meckels diverticulum has these 2 types of ectopic tissue
Gastric and pancreatic
46
How long is a Meckels diverticulum usually?
2 inches
(remember rule of Twos)
47
Ischemic bowel disease due to non-occlusive vascular narrowing
Chronic mesenteric ischemia
48
Most Chronic mesenteric ischemia is due to this
Atherosclerotic narrowing
49
Is Chronic mesenteric ischemia more common in males or females?
Females
50
An older patient with atherosclerotic risk factors has progressive postprandial abdominal pain, likely due to this condition
Chronic mesenteric ischemia
51
What is the location of the pain in Chronic mesenteric ischemia?
Epigastric
52
This is transient ischemia usually due to hypoperfusion
Ischemic colitis
53
Ischemic colitis is transient ischemia usually due to this
Hypoperfusion
(due to hemodynamic instability)
54
These are the two classic locations of Ischemic colitis
Splenic flexure
Rectosigmoid area
55
This should be done to assess the severity of Ischemic colitis
Colonoscopy
56
This is intestinal ischemia due to sudden arterial occlusion
Acute mesenteric ischemia
57
This is the most common cause of Acute mesenteric ischemia
Embolism or thrombosis of large artery
58
A patient with acute, severe, unremitting abdominal pain, diarrhea, hematochezia, that eventually develops peritonitis and septic shock, with a history of A-fib, likely has this condition
Acute mesenteric ischemia
59
Mesenteric venous thrombosis most commonly occurs in this vessel
Superior mesenteric vein
60
Will early/mild ischemic bowel disease morphology show preservation of surface epithelium?
No - surface epithelial loss
61
Will early/mild ischemic bowel disease morphology show inflammation?
Mild
62
Will early/mild ischemic bowel disease morphology show preservation of crypt bases?
Yes
63
Necrotizing enterocolitis most frequently occurs in this age group
Premature, low birth weight neonates
64
When does Necrotizing enterocolitis occur?
In neonates, with onset of oral feedings
higher incidence with formula feedings
65
Necrotizing enterocolitis affects these three portions of the GI tract
Terminal ileum, cecum, ascending colon
66
This occurs when improper bacterial colonization causes ischemic injury
Will show pneumatosis intestinalis, dilated "stacked" loops of bowel
Necrotizing enterocolitis
67
Severe form of this condition will have portal venous air, free air, significant blood, leukocytosis, neutropenia, thrombocytopenia, gangrene and perforation in a neonate
Necrotizing enterocolitis
68
Malabsorption due to intraluminal digestion may occur with this condition
Chronic pancreatitis
69
Malabsorption due to defective post-mucosal transport may occur with this condition
Whipple disease
70
Stool osmotic gap is elevated in this
Malabsorption
71
What produces osmotic force in Disaccharidase deficiency?
Persistence of lactose in lumen
produces watery diarrhea
72
What causes cloating and flatulence in Disaccharidase deficiency?
Bacterial fermentation of lactose
73
This form of Disaccharidase deficiency is very rare
Congenital
74
This form of Disaccharidase deficiency is normal adult loss of lactase enzyme
Age-related
75
This form of Disaccharidase deficiency is post-inflammatory state, may resolve
Transient
76
Will Disaccharidase deficiency have a low or high stool pH?
Low
(due to bacterial fermentation)
77
Abetalipoproteinemia is an autosomal recessive deficiency of this
Apolipoprotein B
78
What is the inheritance pattern of Abetalipoproteinemia?
Autosomal recessive
79
Abetalipoproteinemia causes failure to package triglycerides into these
Chylomicrons
80
What causes vacuolated cytoplasm in enterocytes in Abetalipoproteinemia?
Fat accumulation
81
Lipid vacuoles in surface enterocytes, and RBC acanthocytes (spiky appearance due to membrane defects) are seen morphologically in this condition
Abetalipoproteinemia
82
Steatorrhea, diarrhea, fatty liver, failure to thrive, low cholesterol, near absent LDL, and vitamin E deficiency are seen in this condition
Abetalipoproteinemia
83
Is cholesterol low or high in Abetalipoproteinemia?
Low
84
What causes peripheral neuropathy, absent DTRs, slow intellectual development, and ataxia in Abetalipoproteinemia?
Vitamin E deficiency
85
Whipple disease affects this part of the GI tract
Small intestine
(rare to affect colon)
86
In whipple disease, accumulations of bacteria occur in this alimentary canal layer of the small bowel
Lamina propria
also accumulate in mesenteric lymph nodes
87
This condition caused by a bacteria affects the small intestine, but can also have lymphadenopathy, arthritis, CNS affects
Whipple disease
88
This condition is proliferation of colonic-type bacteria within small intestine
Small intestinal bacterial overgrowth
89
Small bowel normally has low bacteria concentration due to these three factors
Gastric acid, transit, ileocecal valve
90
Hypoproteinemia, deficiencies in vitamin B12, thiamine and nicotinimide can occur in this condition in which bacterial metabolism produces ethanol and fat malabsorption
Small intestinal bacterial overgrowth
91
Are levels of protein low or high in Small intestinal bacterial overgrowth?
Low (due to competition with bacteria)
92
How can diabetic autonomic neuropathy result in Small intestinal bacterial overgrowth?
Neuropathy results in disrupted GI transit, promoting bacterial growth
93
H2/Methane breath test can be used to diagnose this condition
Small intestinal bacterial overgrowth
94
Celiac disease is strongly associated with these genes
HLA-DQ2 and HLA-DQ8
95
This immune mediated enteropathy is associated with IgA deficiency
Celiac disease
96
This enzyme usually deamidates gliadin
Tissue transglutaminase
97
Celiac disease is mediated by this type of immune cell
T cells
(T-cell mediated reaction activates antibody and cytokine production)
98
This is the best diagnostic test for Celiac disease
Total IgA and tissue transglutaminase IgA and IgG (TTG)
99
Are anti-gliadin antibodies specific for Celiac disease?
Not specific - not useful for diagnosis
100
This is the gold standard for diagnosis of Celiac disease
Duodenal biopsy
101
Enterocyte damage and villous atrophy occurs in this condition that can present with diarrhea, malabsorption, weight loss, anemia, failure to thrive, infertility, osteoporosis, rash, edema, night blindness
Celiac disease
102
Does this describe a small bowel carcinoid in the duodenum or ileum/jejunum:
Mostly small
Duodenum
103
Does this describe a small bowel carcinoid in the duodenum or ileum/jejunum:
Almost never get carcinoid syndrome
Duodenal
104
Does this describe a small bowel carcinoid in the duodenum or ileum/jejunum:
Small, submucosal polypoid masses
Duodenum
105
Does this describe a small bowel carcinoid in the duodenum or ileum/jejunum:
Most secrete serotonin
Ileum > jejunum
106
Does this describe a small bowel carcinoid in the duodenum or ileum/jejunum:
Larger tumors with obstruction, intussusception
Ileum > jejunum
107
Does this describe a small bowel carcinoid in the duodenum or ileum/jejunum:
Larger submucosal mass, produces fibrosis with kinking often
Ileum > jejunum
108
This tumor of the small intestine will show nests of cohesive epithelioid cells, salt and pepper chromatin, and are chromagrainin and synpatophysin positive
Small bowel carcinoid
109
Small bowel carcinoid is positive for these two markers since it is from neuroendocrine cells
Chromogranin
Synaptophysin
110
Serotonin is typically metabolized by this enzyme in liver and lung
Monoamine oxidase
111
These are the two early symptoms of acute appendicitis
Anorexia (decreased appetite)
Periumbilical pain
112
This is the most common appendix neoplasm
Carcinoid
113
This neoplasm of the appendix produces appendiceal distention and may perforate, resulting in Pseudomyxoma peritonei (mucin accumulation in abdominal cavity)
May also produce invasive carcinoma
Mucinous adenomas (LAMN/HAMN)
