DOC. ANDAL - GIT part2 Flashcards
FREQUENTLY AFFECTED BY INFECTIOUS AND INFLAMMATORY DISORDERS
SMALL INSTESTINE
COLON
MOST COMMONLY INVOLVED IN INSTESTINAL OBSTRUCTION
SMALL INTESTINE
4 TYPES OF INSTESTINAL OBSTRUCTION
[H-A-V-I]
1. HERNIAS
2. ADHESIONS
3.VOLVULUS
4. INTUSSUCEPTION
CC: ABDOMINAL PAIN NOT RELIEVED BY ANY MEDICATION
INSTESTINAL OBSTRUCTION
INSTESTINAL OBSTRUCTION PRESENTATION
[A-A-V-C]
1. ABD. PAIN
2. ABD. DISTENTION
3. VOMITING
4. CONSTIPATION
WEAKNES OR DEFECT IN ABD. WALL
PROTRUSION OF SEROSA-LINED POUCH
HERNIAS
MC FREQUENT CAUSE OF INSTESTINAL OBSTRUCTION WORLWIDE
SMALL BOWEL TYPICALLY INVOLVED
HERNIAS
TYPE OF HERNIA THAT TYPICALLY OCCUR ANTERIORLY
ACQUIRED HERNIAS
MOST OFTEN ACQUIRED TO BE CONGENITAL IN MOST CASES
FROMSURGICAL PROCEDURES (ENDOMETRIOSIS)
ADHESIONS
TWISTING OF BOWEL LOOPS
RESULT IN LUMINAL AND VASCULAR COMPROMISE
MC IN SIGMOID COLON
VOLVULUS
MC CAUSE OF INTESTINAL OBSTRUCTION IN CHILDREN YOUNGER THAN 2YEARS OLD
OTHER CAUSE: VIRAL INFXN, ROTAVIRUSVACCINE
RARE IN CHILDREN AND ADULT
“TELESCOPING”
INTUSSUSCEPTION
+ COMPLICATION OF INFERIOR MESENTERIC ARTERY
DISTAL COLON MIGHT DIE
ISCHEMIC BOWEL DISEASE
NO DEPER THAN MUSCULARIS MUCOSAE
MUCOSAL INFARCTION
INVOLVE MUCOSA AND SUBMUCOSA
MURAL INFARCTION
INVOLVES ALL 3 LAYERS
TYPICAL CAUSE: ACUTE VASCULAR OBSTRUCTION
TRANSMURAL INFARCTION
ONSET OF VASCULAR COMPROMISE
MIN. DAMAGE TO EPITHELIAL CELLS LININGIN THE INTESTINE
HYPOXIC INJURY
INITIATED BY RESTORATION OF BLOOD SUPPLY
LEAKAGE OF GUT LUMEN
NORMAL OR HYPERPROLIFERATIVE CRYPTS
REPERFUSION INJURY
INSCHEMIC INTESTINAL DISEASE
SEGMENTAL AND PATCHY
HEMORRHAGIC AND ULCERATED MUCOSA AND MUSCULARIS PROPRIA
THICKENED BOWEL WALL
CONGESTED AND DUSKY TO PURPLE RED
ISCHEMIC BOWEL DISEASE
S/S:
SUDDEN ONSET ODF CRAMPING
LEFT LOWER ABD. PAIN
DESIRE TO DEFECATE
BLOODY DIARRHEA
ISCHEMIC BOWEL DISEASE
MORTALITY IS DOUBLED IN PATIENTS WITH RIGHT-SIDED COLONIC DISEASE
ISCHEMIC BOWEL DISEASE
ACUTE RADIATION ENTERITIS
MANIFEST AS: ANOREXIA, ABD. CRAMPS & MALABSORPTIVE DIARRHEA
+RADIATION FIBROBLAST
RADIATION ENTEROCOLITIS
ACUTE DISORDER OF SI AND LI RESULT TO TRANSMURAL NECROSIS
MC GI EMERGENCY IN NEONATES
PRESENT WHEN ORAL FEEDING
NECROTIZING ENTEROCOLITIS
MALFORMED SUBMUCOSALAND MUCOSAL BLOOD VESSELS
MC LOCATION : CECUM AND RIGHT COLON
ANGIODYSPLASIA
ECTATIC NEST OF TORTOUS VEINS, VENULES AND CAPILLARIES
ANGIODYSPLASIA
PRESENTS MC AS CHRONIC DIARRHEA
MALABSORPTION
HALLMARKOF MALABSORPTION
STEATORRHEA
4 PHASES OF NUTRIENT ABSORPTION
- INTRALUMINAL DIGESTION
- TERMINAL DIGESTION
- TRANSEPITHELIAL TRANSPORT
- LYMPHATIC TRANSPORT OF ABSORBED LIPIDS
INCREASE IN STOOL MAS, FREQUENCY OR FLUIDITY
GREATER THAN 200g PER DAY
DIARRHEA
ABSENCE OF EPITHELIAL CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR (CFTR)
DEFECT IN CHLORIDE AND BICARBONATE ION SECRETION
CYSTIC FIBROSIS
AKA CELIAC SPRUE OR GLUTEN SENSITIVE ENTEROPATHY
TRIGGERED BY INGESTION OF GLUTEN CONTAINING FOODS (WHEAT, RYE OR BARLEY)
CELIAC DISEASE
INCREASED # OF INTRAEPITHELIAL CD8+ T LYMPHOCYTES, CRYPT HYPERPLASIA AND VILLOUS ATROPHY
CELIAC DISEASE
+ SEROLOGY AND VILLOUS ATROPHY WITHOUT SYMPTOMS
SILENT CELIAC DISEASE
+ SEROLOGY
- VILOUS ATROPHY
LATENT CELIAC DISEASE
BETWEEN 6 & 24 MONTHS
INTRODUCTION OF GLUTEN
PEDIATRIC CELIAC DISEASE
NON INVASIVE SEROLOGIC TEST FOR CELIAC DISEASE
- IgA ANTIBODIES AGAINTS TRANSGLUTAMINASE (MOST SENSITIVE)
- IgA ANTI-ENDOMYSIAL ANTIBODIES
- ABSENCE OF HLA-DQ2 & HLA-DQ8
MC CELIAC DISEASE-ASSOCIATED CANCER
ENTEROPATHY ASOCIATED T-CELL LYMPHOMA
AKA TROPICAL ENTEROPATHY
AKA TROPICAL SPRUE
POPULATIONS WITH POOR SANITATION AND HYGIENE
ENVIRNMENTAL ENTEROPATHY
UNKNOWN CAUSE
DEFECTIVE INTESTINAL BARRIER, CHRONIC EXPOSURE TO FECAL PATHOGENS
REPEATED BOUTS OF DIARRHEA 1ST 2 OR 3 YEARS OF LIFE
ENVIRONMENTAL ENTEROPATHY
X LINKED DIOSRDER
SEVERE PERSISTENT DIARHEA
AUTOIMMUNE DISEASE IN YOUNG CHILDREN
AUTOIMUNE ENTEROPATHY
GERMLINE LOSS OF FUNCTION MUTATION IN THE FOXP3 GENE AND IPEX (IMMUNE DYSREGULATION, POLYENDOCRINOPATHY, ENTEROPATHY, & X LINKAGE)
AUTOIMUNE ENTEROPATHY
IMUNOSUPPRESSIVE DRUGS IN AUTOIMUNE ENTEROPATHY
CYCLOSPORINE
MUTATION IN GENE ENCODING LACTASE
RARE AR DISORDER
EXPLOSIVE DIARHEA WITH WATERY,FROTHY STOOLS & ABD. DISTENTION UPON MILK INGESTION
CONGENITAL LACTASE DEFIECIENCY
DOWNREGULATION OF LACTASE GENE EXPRESSION
ABD. FULLNESS & DIARRHEA, + FLATULENCE
ACQUIRED LACTASE DEFICIENCY
MYO5B GENE
AKA DAVIDSON DISEASE
AR DISORDER OF VEHICULAR TRANSPORT THAT LEADS TO DEFIECIENT BRUSH BORDER ASSEMBLY
MICROVILLUS INCLUSION DISEASE