Wk3 Small intestine/Colon pt1 Flashcards Preview

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Flashcards in Wk3 Small intestine/Colon pt1 Deck (41):
1

List complications of Meckel's diverticulum

1. ulceration dt ectopic gastric mucosa

2. perforation

3. hemorrhage

4. fistula w/bladder

5. intussusception

2

List four kinds of diarrhea:

1. Secretory -- isotonic stools

2. Osmotic -- lactase deficiency

3. Malabsorptive -- steatorrhea

4. Exudative -- inflammatory, neutrophils, bloody stool

3

How is Whipple disease diagnosed?

-PCR on tissue biopsy

4

Most common (80%) cause of intestinal obstruction:

mechanical:

-hernia
-adhesion
-intussusception
-volvulus
-tumor

5

loss of normal propulsive function of bowel in absence of mechanical obstruction:

ileus

6

Defect in the wall of peritoneal cavity:

hernia

7

fibrous band of scar tissue between bowel segments:

Adhesions

8

Twisting of bowel loop around its mesenteric base:

Volvulus

9

Segment of bowel telescopes into immediate distal segment of bowel:

Intussesception

10

Common cause of intussusception in infants?

anatomical defect

11

Common cause of intussusception in older children and adults?

intraluminal tumor or mass

12

Rule of 2's?

Meckel's diverticulum

13

Failed involution of which structure causes Meckel's diverticulum?

vitelline duct

14

premature arrest of neural crest cell migration

premature death of ganglion cells

Hirschsprung's disease

15

Most common location of Hirschsprung's disease:

distal sigmoid colon and rectum

16

Two nerve plexuses affected by Hirschsprung's:

submucosal (Meissner)

myenteric (Auerbach)

17

Pathophys of Hirschsprung's disease:

absent peristaltic contractions and proximal dialation

18

Global malabsorption?

diffuse mucosal involvement

or

reduced absorptive surface (ie. Celiac)

19

Partial or segmental malabsorption?

interference with absorption of specific nutrients

ie. vit B12

20

3 common causes of malabsorption in the USA?

1. chronic pancreatitis

2. celiac disease

3. Crohn's

21

Clinical definition of diarrhea:

greater than 3 loose stools per day

22

Acute diarrhea:

less than 14 days

23

Chronic diarrhea:

greater than 4 weeks

24

intraepithilial lymphocytes with vilious atrophy

celiac

25

alleles associated with Celiac:

HLA-DQ2

HLA-DQ8

26

Immune cells responsible for reaction in Celiac:

T-cells

27

Gluten by product that becomes antigen on APC's in celiac:

deamidated gliadin

28

enzyme that converts gliadin to deamidated gliadin:

tTG

tissue transglutaminase

29

Ab's that may be dx for celiac?

Anti-tTG

30

Histologic appearance of Celiac:

flattened vili

enlarged crypts

intraepithilial lymphocytes

31

Celiac location?

duodenum

32

Tropical sprue cause?

enteric bacteria

Tx: broad spec abx

33

Location for Tropical sprue:

distal ileum

34

Common deficiency in Tropical sprue?

B12

35

mutation of MTP?

Abetalipoproteinemia

36

Pathophys of abetalipoproteinemia?

Enterocyte can't package TGs into chylomicrons

TG's accumulate in cells

vit deficiencies

37

burr cells

(acanthocytes)

Abetalipoproteinemia

(lipid membrane defects)

38

Tropheryma whippelii

Gram ?

gram +

actinomycete

39

Pathophys of Whipple disease?

Organisms accumulate in Mac's --> clog up lamina propria --> lymphatic obstruction --> chylomicrons can't get to blood

can affect other organs:

synovium

right heart valves

brain

40

Definitive dx for Whipple disease:

PCR on tissue biopsy

41

Most common type of disaccharidase deficiency:

lactase