6. GIT path - Small Intestine Flashcards
A 29 year old man comes to the doctor with complaints of joint pain. He has also been having consistent steatorrhea. A biopsy is taken with histology yield abundant macrophages in the lamina propria that are PAS positive. What is the infection organism?
A. Giardia B. Tropheryma whippelii C. H. Pylori D.Cryptosporidium E. Clonorchis Sinensis
RFA
Ans. B. Tropheryma whippellii- the patient has Whipple disease
A. Giardia- acquired in drinking water, in immunosuppressed
C. H. Pylori- cause gastric colitis and ulcers
D. Cryptosporidium -chronic diarrhea in AIDS patients, is intracellular
E. Clonorchis Sinensis-chinese liver fluke would get it from eating raw fish, increases of cholecystitis or adenocarcinoma of the bile duct
A 14 year old boy is brought to the doctor by his parents with complaints of periumbilical pain that has spread to his right lower quadrant. He has been vomiting as well as having a low fever. What is a possible complication of his condition.
A. Liver abscess B. Gastric Ulcer C. Hirschsprung Disease D. Diverticular Disease E.Esophageal Webs
RFA
Ans. A. Liver abscess is complication of appendicitis so is: Peritonitis, Periappendiceal abscess and bacteremia
B. Gastric Ulcer- is a related to H. Pylori
C. Hirschsprung’s congenital but is related to Down syndrome
D. Diverticular Disease- is related to a low fiber diet
E. Esophageal Webs- Plummer Vinson Syndrome (iron deficiency anemia)
A 22 year old female presents with complaints of diarrhea multiple times a week. She suspects that it could be due to her diet. Biopsy of the small intestine shows villous atrophy, elongated and hyperplastic crypts, and increased intraepithelial lymphocytes. What cell types will be increase din the the lamina propria? (MG)
A. Lymphocytes, macrophages, plasma cells
B. Macrophages, plasma cells, neutrophils
C. Plasma cells, eosinophils, lymphocytes
D. Eosinophils, neutrophils, lymphocytes
E. Neutrophils, macrophages, lymphocytes
A. Lymphocytes, macrophages, plasma cells
Dx is Celiac sprue
A 50 year old male presents with a history of joint pain, diffuse abdominal pain, and loose stools that are pale and greasy. A biopsy of the small intestine lamina propria has granules that stain PAS positive. What is the causative organism? (MG)
A. Cryptosporidium B. Giardia C. Mycobacterium tuberculosis D. Tropheryma whippelii E. Vibrio cholerae
D. Tropheryma whippelii
Dx is Whipple’s Disease
TB also stains PAS positive but would not cause the sx described.
Whipple’s disease can also cause CNS issues.
A 35 y/o male with HIV presents with diarrhea following a hiking trip in the Smoky Mountains. The protozoan is cultured. Which of the following would appear on histology?
A. Pear shaped organism B. Flattened villi and elongated crypts C. Mucus ladened macrophages (foamy appearance) D. Anti-mesenteric boarder E. Studding of the brush boarder
SZ
Ans. A Pear shaped organism
The patient has Giardia
B. Flattened villi and elongated crypts - Celiac
C. Mucus ladened macrophages (foamy appearance)- Whipple Disease
D. Anti-mesenteric boarder - Meckel Diverticulum
E. Studding of the brush boarder - Crytosporidium
Which of the following would not cause a luminal obstruction?
A. Food bolus B. Tumor C. Bezoars D. Round worms E. TB
SZ
Ans. E. TB
TB causes a transmural obstruction
