Diseases of Organ Systems GI - 34% Flashcards
What is diabetes mellitus type 1? signs? Who gets it?
Insulin dependent DM due to insulting deficiency cause by beta cell destruction. Associated antibodies to beta cells of the pancreas
- weight loss, more prone to diabetic ketoacidosis
- common in children and teens. HLA DR3 or 4 genetic predisposition
What is diabetes mellitus type 2? Who?
Insulin insensitivity. Non-insulting dependent DM. Insulin levels may even be elevated.
- common in obese adults, many have family history of diabetes
What are signs of DM type 2?
- polyuria, polydipsia, polyphagia, prone to hyperosmolar non-ketoacidosis coma
- Cause narrowing of small and medium-size vessels
- premature cataracts and retinopathy may be related to accumulation of sorbitol
What is MODY type
Mature onset diabetes in the young
- not dependent on insulin, no antibodies, not obese
- <25 years
What is gestational diabetes?
Occurs in 4% of pregnancies, usually revolves with the end of pregnancy. Some may progress to type 2 DM
What is carcinoid syndrome? Signs?
How many metastize? How many are multiple?
Tumors of the neuroendocrine cells in the gut.
Results in recurrent diarrhea, cutaneous flushing and bronchial wheezing
1/3 metastasize, 1/3 are multiple
What is insulinoma?
Pancreatic beta-islet cell tumor. Hypoglycemia relieved by food
What is gastrinoma?
Excess gastrin from GI tumor. Recurrent peptic ulcer disease. Aka Zollinger-Ellison syndrome. May be part of MEN type 1
What is Zollinger-Ellison syndrome?
Gastrinoma causing excess gastrin from GI tumor
What is MEN type 1?
Multiple Endocrine Neoplasia
Wermer’s Syndrome - 3 P’s
- pituitary adenoma, parathyroid adenoma, pancreas adenoma
What is MEN type 2a?
Multiple Endocrine Neoplasia
Sipple’s syndrome - 2Ps + 1M
- medullary thyroid cancer, pheochromocytoma, parathyroid hyperplasia
What is MEN type 2b?
Multiple endocrine neoplasia
1P + 3Ms
- marfanoid features, medullary thyroid cancer, mucosal neuromas, pheochromocytoma
Achalasia
Failure of LES to relax, dysphagia for fluids not solids
Hiatal hernia
Protrusion of stomach into the chest through the diaphragm
Esophageal varices
Dilated veins in the lower esophagus seen in portal hypertension
GERD
Chronic inflammation of lower esophagus due to acid regurgitation
Barrett’s esophagus
Premalignant metaplastic change in lower esophagus due to GERD
Esophageal cancer? Risks?
Squamous cell carcinoma
excess nitrosamines in the diet and smoking.
Adenocarcinoma after Barrett’s esophagus
Mallory-Weiss syndrome
Linear tear in lower esophagus due to prolonged vomiting and retching
Peptic ulcer disease due to? Where?
H.Pylori infection, ulcer along lesser curvature of stomach (70%) or duodenum (95%)
How can you tell the difference between gastric and duodenal ulcers based on sx?
Epigastric pain is greater with meals in gastric ulcer and duodenal is pain after meals