ALL THINGS GUT- FINAL Flashcards
different types of esophageal motility disorders
Achalasia
diffuse esophageal spasm
nutcracker esophagus
hypertensive lower esophageal spasm
Achalasia is characterized by
increased tone and pressure at the lower esophageal sphincter (LES), diminished to absent peristalsis in the distal portion of the esophagus and lack of a coordinated LES relaxation in response to swallowing
characteristic finding in achalasia following barium swallow is
“bird’s beak” appearance
the underlying pathophysiology that results in achalasia is
lymphocytic infiltration of Auerbach’s plexus and destruction of ganglion cells
Diffuse esophageal spasm is characterized by
uncoordinated contractions and several segments of the esophagus contract simultaneously
Nutcracker esophagus is characterized by
contractions proceed in a coordinated manner but the amplitude is excessive
barium swallow findings for nutcracker esophagus
corkscrew esophagus
Mallory–Weiss tears refers to bleeding in the
mucosa at the junction of the stomach and esophagus,
The tear involves mucosa and submucosa but not the muscular layer (not a transmural tear).
Boerhaave’s syndrome is a
full thickness tear or rupture of the esophageal wall
Barrett’s esophagus is characterized by
transformation of cells at the lower end of the esophagus from normal squamous epithelium lining to columnar epithelium.
Micrograph of biopsy showing Barrett’s esophagus with characteristic goblet cells
Hirshsprung’s disease is a disorder of the gut which is caused by
the failure of the neural crest cells (enteric ganglion cells) to migrate completely during fetal development of the intestine
Auerbach plexus involvement
___________ is suspected in a baby who has not passed meconium within 48 hours of delivery.
Hirshsprung’s disease
Intestinal volvulus is defined as
a complete twisting of a loop of intestine around its mesenteric attachment site.
An intussusception occurs when
a part of the intestine has migrated into another section of intestine, similar to the way in which the parts of a collapsible telescope may slide into one another
Celiac disease small intestine changes
There is blunting and flattening of villi with celiac disease, and in severe cases a loss of villi with flattening of the mucosa as seen here. Over 95% of affected patients will express the DQw2 histocompatibility antigen, which suggests a genetic basis for the condition
Crohn’s vs Ulcerative Colitis in terms of location
Crohns- anywhere from mouth to anus
UC- restricted rectum and colon
Microscopic findings of Crohn’s vs Ulcerative Colitis
Crohn’s- transmural lesions
UC- mucosal involvement, crypt abscess
is Crohn’s or ulcerative colitis associated with increased risk of adenocarcinoma?
Ulcerative Colitis!!!!
Across all age groups, what’s the most common cause of viral enteritis?
Norwalk virus
Amongst children and infants what’s the most common cause of viral enteritis (diarrhea)?
Rotavirus
What are the most common causes of food-borne illnesses world wide?
Norovirus- #1 cause
Salmonella- #1 cause in infants
Clostridium perfringens
Campylobacter- #1 cause of bloody diarrhea
what’s associated with ‘picnic food poisoning’?
Staph aureus
what’s associated with contaminated meat or rice from chinese restaurants?
Bacillus cereus
what’s associated with contaminated shellfish?
Vibrio (cholera and non-cholera)
what’s associated with improperly home canned fruits and veggies?
Clostridium botulinum
a cause of antibiotic associated diarrhea (AAD)? AKA pseudomembranous enterocolitis
Clostridium difficile
Benign small bowel tumors
Hyperplastic polyps Adenomas Leiomyomas- only one he talks about Lipomas Hamartomas
Histologic findings of leiomyoma
the elongated spindle cells containing cigar-shaped nuclei and no evidence of increased mitotic activity is seen.
Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by
mucocutaneous pigmentation (i.e. lesions on the face, lips, and buccal mucosa) and benign GI hamartomas.
Histologically the Peutz-Jeghers lesions appear
frond-like appearance
the most common type of small bowel malignancy in the US is?
adenocarcinma
less common types of small bowel malignancies
carcinoid tumors
lymphomas
carcinoid tumors
Nests of carcinoid tumor have a typical endocrine appearance with collections of small round cells containing nuclei that are consistent in size and shape and surrounded by cytoplasm which stains pink to pale blue
with Juvenile polyposis syndrome (the appearance of mutliple polyps in the GI tract esp in the young) there is an increased risk of developing what?
adenocarcinoma
with Familial Adenomatous Polyposis (congenital condition marked by hundreds to thousands of polyps in the large intestines) there is an increased risk of developing what?
colon cancer
The combination of polyposis, osteomas, fibromas and sebaceous cysts is termed
Gardener’s syndrom
microscopically neoplastic glands of adenocarcinoma have
crowded nuclei with hyperchromatism and pleomorphism
Atrophic gastritis is usually caused by
H. pylori
In Atrophic gastritis, impairment in the secretion of hydrochloric acid, pepsin, and intrinsic factor can lead to
B12 deficiency
The characteristic histologic findings of gastric adenocarcinoma is
singlet ring cell pattern
carcinoid tumors are a class of neuroendocrine tumors that arise from
neuro-endocrine neoplasms that arise from enterochromaffin cells
