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DIT Primers 21-30 > 25 > Flashcards

25 Flashcards

1
Q 
On what type of immune cell is each of the following cell surface proteins found? 
CD4 
CD14 
CD16
CD19 
CD3
CD8
A 
CD4 - TH cells
CD14 - MQs 
CD16 - NK cells
CD19 - B cells 
CD3 - ALL T cells
CD8 - Cytotoxic T cells
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2
Q

Child with immune disorder suffers from repeated staph accesses. It is found that neutrophils fail to respond because the chemotactic stimuli are deficient.
Most likely dx?

A 
Hyper IgE (Job) Syndrome 
- Low IFN-Y
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3
Q

What are the contents, blood supply, and innervation of the foregut?

A

Esophagus, stomach, 1st part of duodenum, liver + gallbladder, pancreas
Blood = celiac trunk
Para = vagus
symp = splanchnic nerves

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4
Q

What are the contents, blood supply, and innervation of the midgut?

A

3rd and 4th duodenum, ileum, appendix, proximal 2/3 colon (to splenic flexure)
Blood = sma
para = vagus
simp = splanchnic nerves

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5
Q

What are the contents, blood supply, and innervation of the hindgut?

A

Distal 1/3 colon (sigmoid, rectum) to pectinate line
Blood = IMA
para = pelvic splanchnic nerves
simp = lumbar splanchnic nerves

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6
Q

Describe hypertrophic pyloric stenosis:

A
  • congenital thickened pylori muscularis
  • projectile vomiting
  • palpable knot (olive) in pyloric region
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7
Q

Describe extra hepatic biliary atresia:

A
  • congenital incomplete recanalization of bile duct during development
  • presents shortly after birth
  • dark urine, clay colored stools, jaundice
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8
Q

Describe annular pancreas:

A
  • congenitally abnormal ventral/ dorsal pancreatic bud fusion–> constriction around duodenum
  • duodenal obstruction–> biliary vomiting
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9
Q

Mekel’s Diverticulum: What is the rule of 2’s?

A

This is a persistent remnant of the vitelline duct

  • 2 in long
  • 2 ft from ileocecal valve
  • 2% population
  • 2 years (presents by 2 yoa)
  • 2 types of epithelium possible: gastric + pancreatic
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10
Q

Describe congenital malrotation of the midgut:

A
  • failure to accomplish normal 270 degree rotation during 6th week gestation
  • cecum and appendix are in upper abdomen
  • asstd. with volvulus (twisting and obstruction of intestine)
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11
Q

Describe congenital intestinal stenosis:

A
  • failure of normal lumen recanalization

- failure to thrive

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12
Q

What is hirshspring disease?

A

neural crest cells fail to migrate into colon–> NO peristalsis

  • constipation/ abdominal distention
  • bowel movement will follow digital rectal exam (no meconium stool)
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13
Q

Describe anal agenesis:

A

Improper formation of urorectal septum–> no anal opening

  • rectovesical fistula
  • rectovaginal fistula
  • rectourethral fistula
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14
Q

Esophageal adenocarcinoma:

  • associated risks and precipitation factors
  • population
  • prevalence
A
  • Associated with Barrett’s esophagus (GERD, smoking, obesity, nitrosamines)
  • mostly whites
  • # 1 esophageal cancer in US
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15
Q

Esophageal adenocarcinoma:

  • associated risks and precipitation factors
  • population
  • prevalence
A
  • Associated with ETOH and tobacco
  • mostly blacks
  • # 1 esophageal cancer ww
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16
Q

What are esophageal varicies?

Common cause and clinical findings

A

Commonly due to portal HTN–> varicosities in the esophagus

  • Hematemesis
  • Caput medusa
  • Ascites
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17
Q

What is Boerhaave Syndrome?

A

Severe retching–> complete rupture of esophagus

- Can cause pneumothorax or even death

18
Q

What is esophageal Achalasia?

What does biopsy reveal? How does it present? What are radiological findings?

A

Failure of lower esophageal sphincter to relax due to loss of aurbach’s plexus (loss of ganglion cells between inner and outer muscular layers) –>

  • uncoordinated peristalsis
  • solid and LIQUID dysphasia
  • dilated distal esophagus followed by stenosis (Bird’s beak) on XR
19
Q

Two common causes of esophaglea achalasia?

A

Chugs Disease
-Trypanosoma cruzi –> cardiomegaly, megaesophagus

CREST Syndromes

  • calcinosis
  • raynauds
  • esophageal dysmotility
  • telangiectasia
20
Q

What is an omphalocele?

A

OOOOOOh so much worse than gastroschisisis…

  • Extruding viscera covered by sac (peritoneum + amnion)
  • liver often involved
  • additional GI/ GU/ CV/ CNS/ MS anomalies frequently involved
21
Q

What is gastroschisisis?

A
  • extruding viscera not covered by sac
  • liver NOT involved
  • less common to find additional anomalies
  • LATERAL to umbilicus (right»>lt)
22
Q

Zener Diverticulum location:

A

Above UES

23
Q

Traction diverticulum location:

A

midpoint of esophagus

24
Q

Epiphrenic diverticulum location:

A

above the LES

25
Q

There are two types of hiatal hernia; which is more common?

A

sliding&raquo_space;» paraesophageal

26
Q

What is the most common type of tracheoseophageal fistula?

A

1 = blind end esophagus (all the foods go into a lil’ sac that gets filled up)

27
Q

What is a Mallory weiss tear? With what is it associated?

A
  • laceration of gastroesophageal junction
  • less serious than boerhaave
  • associated with ETOH and bulimia
28
Q

Specialized columnar epithelium seen in a biopsy from distal esophagus

A

barretts esophagus

29
Q

Biopsy of a patient with esophagitis reveals large, pink, intranuclear inclusions and host cell chromatin that is pushed to the edge of the nucleus

A

CMV esophagitis

30
Q

Biopsy of a patient with esophagitis reveals enlarged cells, intranuclear and cytoplasmic inclusions, and a clear perinuclear halo

A

HSV esophagitis

31
Q

An esophageal biopsy reveals a lack of ganglion cells between the inner and outer muscular layers

A

Achalasia

32
Q

Protrusion of the mucosa in the upper esophagus

A

Esophageal webbing

Associated with “Plummer Vinson”

33
Q

Plummer Vinson Triad***

A
  • Dysphasia (due to esophageal webbing)
  • Glossitis
  • Fe Deficiency anemia
34
Q

Outpouching of the esophagus found just above the LES

A

Epiphrenic diverticulum

35
Q

Goblet cells seen in the distal esophagus

A

Barretts esophagus

36
Q

A PAS stain on a biopsy obtained from a patient with esophagitis reveals hyphate organisms

A

esophageal candidiasis

37
Q

Esophageal pouch found in the upper esophagus

A

Zener diverticulum

38
Q

Describe the histo change associated with Barretts esophagus?

A

simple squamous–> simple columnar

*Typically due to chronic GERD

39
Q

60 yom with chronic reflux presents with esophageal cancer. What is the most likely histo subtype?

A

chronic reflux–> barrett esophagus–> esophageal adenocarcinoma

40
Q

4 potential causes of esophagitis?

A
  • GERD
  • candidiasis in immunocompromised patients
  • CMV
  • HSV
41
Q

What are esophageal strictures? How are they diagnosis?

What should you look for in patient history?

A

narrowing of the esophagus–look for patient swallowing “lye”

42
Q

6 Layers of the gut lining innermost–> outermost

A

Mucosa (lamina propria–> muscularis externa)
Submucosa
Meissner’s plexus
Muscular externa (circular–> longitudinal)
Auerbach’s/ Myenteric plexus
Serosa

DIT Primers 21-30 (10 decks)

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