Dobson lecture 3: Small Bowel, Colon, Peritoneum

Question 1

What are the most common causes of Intestinal obstruction

Answer 1

80% due to hernias, adhesions, volvulus, intussusception

Question 2

most common cause of obstruction worldwide?

Answer 2

hernias

Question 3

most common cause of obstruction in US

Answer 3

adhesions

-from surgery or trauma

Question 4

Volvulus, what causes it

Answer 4

twisting of bowel

pdistention and tympanic sounds

Question 5

Which obstruction gets kids?

Answer 5

intussusception

-bowel telescopes in

Question 6

Presentation of ischemic bowel disease?

Answer 6

older people and it’s sudden

Question 7

What artery occlusion portends to the worst outcome?

Answer 7

SMA!

Question 8

Which desease is the only one associated with defective lymphatic transport?

Answer 8

whipple disease

Question 9

What is another name for celiac disease?

Answer 9

immune-mediated enteropathy

Question 10

what does biopsy look like on celiac disease?

Answer 10

• LOSS OF VILLI-

- increased lymphocytic T-cells

Question 11

What lab test can be used for celiac disease

Answer 11

TTG test (tissue transglutaminase)

Question 12

What happens on the skin with celiac disease?

Answer 12

dermatitis herpatiformis

Question 13

What to think about when celiac disease symptoms recurr?

Answer 13

malignancy, or off diet

• EATL
• adenocarcinoma

Question 14

Tropical sprue

Answer 14

happens in NOT the duodenum

Question 15

Guillan barre, what causes it?

Answer 15

campylobacter species

Question 16

What causes pseudomembranous collitis?

Answer 16

C. dificile

Question 17

What is the histo look like on pseudomembransous collitis?

Answer 17

volcanic erupting crypts

Question 18

worms out the butt hole, what is it?

Answer 18

pinworms…. enterobius species

Question 19

IBS, what is unique about it?

Answer 19

there’s NO PATHOLOGIC ABNORMALITY

Question 20

What are the two entities in IBS?

Answer 20

Crohn disease and Ulcerative colitis

Question 21

Crohn disease?

Answer 21

skip lesions

• transmural
• creeping fat (fat wrapping)
• fistulas and strictures
• noncaseating granulomas
• RLQ location usually

Question 22

Ulcerative colitis?

Answer 22

starts at rectum and goes proximally

• NOT transmural
• no granulomas
• relapsing disrder
• PSC

Question 23

Extra intestinal manifestation of Crohn’s

Answer 23

clubbing of fingertips, strictures, increased risk for adenocarcinoma

Question 24

What kind of polyp do you want to have?

Answer 24

the hyperplastic kind!

• least likely to be malignant
• rule out serrated adenoma

Question 25

Hamartomatous polyps?

Answer 25

peutz jagers and Juvenile polyposis

Question 26

Peutz jaghers

Answer 26

looks like they have freckles IN their mouth

• 40% risk of malignancies
• multiple hamartomas (intussusception)

Question 27

Adenoma

Answer 27

intraepithelial neoplasms that range from small, often pedunculated, polyps to large sessile lesions

Question 28

FAP

Answer 28

100-1000 as teenagers

-risk of cancer is 100%

Question 29

what is the most common cancer of the GI tract?

Answer 29

adeno carcinoma of the colon

Question 30

HNPCC?

Answer 30

earlier age and right sided colon cancer

Question 31

left sided cancers what do they look like?

Answer 31

napkin ring tumors

-pencil-like stools

Question 32

What trumps everything in prognosis of these tumors?

Answer 32

depth of invasion and number of nodes metstasized to

Question 33

Appendicitis… how does it present

Answer 33

mcBurney’s sign

• enterobius organisms
• pain starts periumbilically and goes towards RLQ

Question 34

What color are carcinoid tumors in the tip of the appendix?

Answer 34

it will always be yellow!