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GI II Exam 1 > Bowel Path III > Flashcards

Bowel Path III Flashcards

1
Q

tropical sprue

A

developing countries

bacterial overgrwoth of cyclospora, e coli, hemophilis

physical and neuro deficits

tx with broad antibiotics usually unsuccessful

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2
Q

autoimmune enteropathy

A

x-linked disorder

persistant diarrhea
-young children

IPEX- foxp3 mutation - defective CD4

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3
Q

foxp3 mutation

A

IPEX - defective CD4

with autoimmune enteropathy

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4
Q

lactase deficiency

A

congeintal - rare - auto recessive

acquired - with infection

histo bx is unremarkable

osmotic diarrhea**

avoid milk products - may resolve over time

aka disaccharidase deficiency

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5
Q

abetalipoproteinemia

A

rare auto recessive
-presents at infancy

  • failure to thrive, diarrhea, steatorrhea
  • MTP mutation

failure of transepithelial transport of lipids

see lipid vacuolization of epithelium**

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6
Q

lack of apolipoprotein B48 and B100

A

abetalipoproteinemia - cannot transport lipids across epithelium

malabsorption of fat soluble vits

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7
Q

acanthocytosis

A

abnormal star shaped RBCs

burr cells

in abetalipoproteinemia

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8
Q

abetalipoproteimia

A

degeneration of retina - Vit A

neuropathies - vit E

genetic test - necessary for diagnosis

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9
Q

chronic relapsing abdominal pain, bloating, changes in bowel habits

A

IBS - syndrome

clinical diagnosis**

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10
Q

IBS

A

clinical diagnosis
-20-40yo F

clinical criteria:

  • abdomen pain 3 days per month over 3 months
  • improvement with defecation
  • change in stool frequency or form

avoid surgery**

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11
Q

IBD

A

crohn and ulcerative colitis

altered mucosal immunity

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12
Q

ulcerative colitis

A

limited to colon and rectum and only to mucosa/submucosa

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13
Q

crohn disease

A

transmural - and any part of GI tract

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14
Q

noncaseating granuloma in mouth

A

crohn until proven otherwise

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15
Q

IBD path

A

abnormal T cell response

-CD4 T cells - Th17

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16
Q

pANCA

A

in ulcerative colitis

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17
Q

ASCA

A

in crohn disease

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18
Q

crohn disease

A

white, jews, females

smoking - risk fx

20-30yo
60-70yo

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19
Q

unaffected skip areas, transmural mucosa, noncaseating granulomas, fistula formation

A

crohn disease

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20
Q

creeping fat

A

crohn disease

-serosal extension of mesenteric fat

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21
Q

cobblestone

A

crohn disease

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22
Q

common site of crohn

A

terminal ileum, ileocecal valve, cecum

has skip lesions

early lesion - aphthous ulcer

23
Q

crohn histo

A

crypt abscess - with PMNs

mucosal damage

ulceration

transmural

fissure formation

noncaseating granulomas

24
Q

crohn clinical

A

episodic

mild diarrhea, fever, abdomen pain, weight loss

chronic life long course

fistula - bad

clubbing of fingertips

risk for GI ca - 5-6x

erythema nodosum - shins
-inflammation of fat cells under skin

25
Q

ulcerative colitis

A

inflammation of colon - mucosa and submucosa

continuous spread proximal from rectum

primary sclerosing cholangitis

26
Q

UC epidemiology

A

white, female, 20-25yo, smoking may relieve symptoms**

27
Q

UC clinical

A

relapsing - bloody mucoid diarrhea

-cramping, abdominal pain

at least 1 relapse in 10 years

risk for adenocarcinoma of colon

tx - colectomy

28
Q

UC pathology

A

continuous - no skip areas
entire colon - pancolitis

ulcerations - pseudopolyps
-chronic

toxic megacolon

29
Q

UC morph

A

rectum

  • goes proximal
  • pancolitis
  • broad-based ulcers
  • regenerating mucosa - pseudopolyps

-normal serosa

no granulomas

30
Q

microscopic colitis

A

collagenous - old women
lymphocytic - older male and female (assocaited with celiac)

chronic watery diarrhea - 3-20x/day

benign - usually resolves

31
Q

diverticular disease

A

diverticulosis - and if inflamed - diverticulitis

focal weakness in wall - high pressure - form outpouchings

tx - high fiver diet

32
Q

false diverticula

A

acquired - most common sigmoid colon

33
Q

bleeding of diverticuli

A

often stops on own

34
Q

second most common killer in US

A

tumors of colon

majority old age - 50+ yo

35
Q

small elevation of mucosa

A

sessile

36
Q

growth with a stalk

A

pedunculated

core with vessels and lymphatics

easily removed

37
Q

most common neoplastic polyp

A

adenoma

-potential to progress to cancer

38
Q

hamartomatous polyp

A

almost always pednuculated

juvenile and peutz-jeghers
-non-neoplastic

39
Q

adenoma

A

majority sessile

40
Q

non-neoplastic polyps

A

inflammatory
hyperplastic
hamartomatous
lymphoid

41
Q

inflammatory polyp

A

non-neoplastic
-chronic IBD - often UC

part of solitary rectal ulcer syndrome

42
Q

solitary rectal ulcer syndrome

A

inflammatory lesion
-rectal bleeding, mucous discharge, inflammation lesion of anterior rectal wall

impaired relaxation of anorectal sphincter - abrasion and ulceration

mucosal prolapse can occur

fibromuscular hyperplasia

43
Q

hyperplastic polyp

A

non-neoplastic

sessile

most common polyp

majority 50yo

44
Q

strain with stooling

A

push against anterior rectum/anus - mucosa prolapse that becomes inflamed

solitary rectal ulcer syndrome - inflammatory polyp

anterior**

45
Q

serrated, saw tooth glands in polyp

A

hyperplastic polyp

non-neoplastic

no malignant potential

must distinguish from serrated adenoma**

46
Q

peutz jeghers syndrome

A

hamartomatous polyp

age 10-15

mutation in STK11 - AMP kinase related pathway

risk of colonic adenocarcinoma

47
Q

juvenile polyposis

A

hamartomatous polyp

less than age 5 SMAD4, BMPR1A TGF-beta signaling mutations

risk of gastric small intestinal, colonic, and pancreatic carcinoma

association with congenital malformations

48
Q

familial adenomatous polyposis mutation

A

APC

49
Q

hamartomatous polyps of stomach, small intestine, colorectum that are like juvenile polyps with cystic crypt dilatation and lamina propria edema and inflammation

A

cronkhite-canada syndrome

nonhereditary - individuals over 50yo get it

often die**

50
Q

juvenile polyp

A

retention polyp

  • young <5yo
  • pedunculated
  • rectum
  • bleeding occurs
  • sporadic solitary majority
  • auto dom - many polyps - this group has risk of cancer

dilated glands and cysts in lamina propria

cystically dilated crypts

SMAD4, BMPR1A TGF-beta signaling pathway

51
Q

peutz jeghers polyp

A

rare auto dom - 10-15yo

pigmented mucocutaneous macules

increased risk of multiple malignancies

pedunculated GI polyps

splayed smooth m in polyp

52
Q

pigmented lesions on lips

A

petuz jeghers syndrome

53
Q

loss of STK11 kinase tumor suppressor gene

A

AMP-kinase related

peutz jeghers syndrome

54
Q

glandular polyp with smooth muscle

A

peutz jeghers syndrome

GI II Exam 1 (29 decks)

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