DOC. ANDAL - GIT part2 Flashcards

1
Q

FREQUENTLY AFFECTED BY INFECTIOUS AND INFLAMMATORY DISORDERS

A

SMALL INSTESTINE
COLON

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2
Q

MOST COMMONLY INVOLVED IN INSTESTINAL OBSTRUCTION

A

SMALL INTESTINE

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3
Q

4 TYPES OF INSTESTINAL OBSTRUCTION

A

[H-A-V-I]
1. HERNIAS
2. ADHESIONS
3.VOLVULUS
4. INTUSSUCEPTION

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4
Q

CC: ABDOMINAL PAIN NOT RELIEVED BY ANY MEDICATION

A

INSTESTINAL OBSTRUCTION

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5
Q

INSTESTINAL OBSTRUCTION PRESENTATION

A

[A-A-V-C]
1. ABD. PAIN
2. ABD. DISTENTION
3. VOMITING
4. CONSTIPATION

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6
Q

WEAKNES OR DEFECT IN ABD. WALL
PROTRUSION OF SEROSA-LINED POUCH

A

HERNIAS

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7
Q

MC FREQUENT CAUSE OF INSTESTINAL OBSTRUCTION WORLWIDE
SMALL BOWEL TYPICALLY INVOLVED

A

HERNIAS

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8
Q

TYPE OF HERNIA THAT TYPICALLY OCCUR ANTERIORLY

A

ACQUIRED HERNIAS

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9
Q

MOST OFTEN ACQUIRED TO BE CONGENITAL IN MOST CASES
FROMSURGICAL PROCEDURES (ENDOMETRIOSIS)

A

ADHESIONS

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10
Q

TWISTING OF BOWEL LOOPS
RESULT IN LUMINAL AND VASCULAR COMPROMISE
MC IN SIGMOID COLON

A

VOLVULUS

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11
Q

MC CAUSE OF INTESTINAL OBSTRUCTION IN CHILDREN YOUNGER THAN 2YEARS OLD
OTHER CAUSE: VIRAL INFXN, ROTAVIRUSVACCINE
RARE IN CHILDREN AND ADULT
“TELESCOPING”

A

INTUSSUSCEPTION

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12
Q

+ COMPLICATION OF INFERIOR MESENTERIC ARTERY
DISTAL COLON MIGHT DIE

A

ISCHEMIC BOWEL DISEASE

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13
Q

NO DEPER THAN MUSCULARIS MUCOSAE

A

MUCOSAL INFARCTION

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14
Q

INVOLVE MUCOSA AND SUBMUCOSA

A

MURAL INFARCTION

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15
Q

INVOLVES ALL 3 LAYERS
TYPICAL CAUSE: ACUTE VASCULAR OBSTRUCTION

A

TRANSMURAL INFARCTION

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16
Q

ONSET OF VASCULAR COMPROMISE
MIN. DAMAGE TO EPITHELIAL CELLS LININGIN THE INTESTINE

A

HYPOXIC INJURY

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17
Q

INITIATED BY RESTORATION OF BLOOD SUPPLY
LEAKAGE OF GUT LUMEN
NORMAL OR HYPERPROLIFERATIVE CRYPTS

A

REPERFUSION INJURY
INSCHEMIC INTESTINAL DISEASE

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18
Q

SEGMENTAL AND PATCHY
HEMORRHAGIC AND ULCERATED MUCOSA AND MUSCULARIS PROPRIA
THICKENED BOWEL WALL
CONGESTED AND DUSKY TO PURPLE RED

A

ISCHEMIC BOWEL DISEASE

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19
Q

S/S:
SUDDEN ONSET ODF CRAMPING
LEFT LOWER ABD. PAIN
DESIRE TO DEFECATE
BLOODY DIARRHEA

A

ISCHEMIC BOWEL DISEASE

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20
Q

MORTALITY IS DOUBLED IN PATIENTS WITH RIGHT-SIDED COLONIC DISEASE

A

ISCHEMIC BOWEL DISEASE

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21
Q

ACUTE RADIATION ENTERITIS
MANIFEST AS: ANOREXIA, ABD. CRAMPS & MALABSORPTIVE DIARRHEA
+RADIATION FIBROBLAST

A

RADIATION ENTEROCOLITIS

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22
Q

ACUTE DISORDER OF SI AND LI RESULT TO TRANSMURAL NECROSIS
MC GI EMERGENCY IN NEONATES
PRESENT WHEN ORAL FEEDING

A

NECROTIZING ENTEROCOLITIS

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23
Q

MALFORMED SUBMUCOSALAND MUCOSAL BLOOD VESSELS
MC LOCATION : CECUM AND RIGHT COLON

A

ANGIODYSPLASIA

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24
Q

ECTATIC NEST OF TORTOUS VEINS, VENULES AND CAPILLARIES

A

ANGIODYSPLASIA

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25
Q

PRESENTS MC AS CHRONIC DIARRHEA

A

MALABSORPTION

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26
Q

HALLMARKOF MALABSORPTION

A

STEATORRHEA

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27
Q

4 PHASES OF NUTRIENT ABSORPTION

A
  1. INTRALUMINAL DIGESTION
  2. TERMINAL DIGESTION
  3. TRANSEPITHELIAL TRANSPORT
  4. LYMPHATIC TRANSPORT OF ABSORBED LIPIDS
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28
Q

INCREASE IN STOOL MAS, FREQUENCY OR FLUIDITY
GREATER THAN 200g PER DAY

A

DIARRHEA

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29
Q

ABSENCE OF EPITHELIAL CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR (CFTR)
DEFECT IN CHLORIDE AND BICARBONATE ION SECRETION

A

CYSTIC FIBROSIS

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30
Q

AKA CELIAC SPRUE OR GLUTEN SENSITIVE ENTEROPATHY
TRIGGERED BY INGESTION OF GLUTEN CONTAINING FOODS (WHEAT, RYE OR BARLEY)

A

CELIAC DISEASE

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31
Q

INCREASED # OF INTRAEPITHELIAL CD8+ T LYMPHOCYTES, CRYPT HYPERPLASIA AND VILLOUS ATROPHY

A

CELIAC DISEASE

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32
Q

+ SEROLOGY AND VILLOUS ATROPHY WITHOUT SYMPTOMS

A

SILENT CELIAC DISEASE

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33
Q

+ SEROLOGY
- VILOUS ATROPHY

A

LATENT CELIAC DISEASE

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34
Q

BETWEEN 6 & 24 MONTHS
INTRODUCTION OF GLUTEN

A

PEDIATRIC CELIAC DISEASE

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35
Q

NON INVASIVE SEROLOGIC TEST FOR CELIAC DISEASE

A
  1. IgA ANTIBODIES AGAINTS TRANSGLUTAMINASE (MOST SENSITIVE)
  2. IgA ANTI-ENDOMYSIAL ANTIBODIES
  3. ABSENCE OF HLA-DQ2 & HLA-DQ8
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36
Q

MC CELIAC DISEASE-ASSOCIATED CANCER

A

ENTEROPATHY ASOCIATED T-CELL LYMPHOMA

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37
Q

AKA TROPICAL ENTEROPATHY
AKA TROPICAL SPRUE
POPULATIONS WITH POOR SANITATION AND HYGIENE

A

ENVIRNMENTAL ENTEROPATHY

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38
Q

UNKNOWN CAUSE
DEFECTIVE INTESTINAL BARRIER, CHRONIC EXPOSURE TO FECAL PATHOGENS
REPEATED BOUTS OF DIARRHEA 1ST 2 OR 3 YEARS OF LIFE

A

ENVIRONMENTAL ENTEROPATHY

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39
Q

X LINKED DIOSRDER
SEVERE PERSISTENT DIARHEA
AUTOIMMUNE DISEASE IN YOUNG CHILDREN

A

AUTOIMUNE ENTEROPATHY

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40
Q

GERMLINE LOSS OF FUNCTION MUTATION IN THE FOXP3 GENE AND IPEX (IMMUNE DYSREGULATION, POLYENDOCRINOPATHY, ENTEROPATHY, & X LINKAGE)

A

AUTOIMUNE ENTEROPATHY

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41
Q

IMUNOSUPPRESSIVE DRUGS IN AUTOIMUNE ENTEROPATHY

A

CYCLOSPORINE

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42
Q

MUTATION IN GENE ENCODING LACTASE
RARE AR DISORDER
EXPLOSIVE DIARHEA WITH WATERY,FROTHY STOOLS & ABD. DISTENTION UPON MILK INGESTION

A

CONGENITAL LACTASE DEFIECIENCY

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43
Q

DOWNREGULATION OF LACTASE GENE EXPRESSION
ABD. FULLNESS & DIARRHEA, + FLATULENCE

A

ACQUIRED LACTASE DEFICIENCY

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44
Q

MYO5B GENE
AKA DAVIDSON DISEASE
AR DISORDER OF VEHICULAR TRANSPORT THAT LEADS TO DEFIECIENT BRUSH BORDER ASSEMBLY

A

MICROVILLUS INCLUSION DISEASE

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45
Q

COMMA SHAPED
GRAM - BACTERIA
RAPIDLY GROW AT WARM TEMP
SHELLFISH, MUSSELS, CONTAMINATED WATER

A

CHOLERA
VIBRIO CHOLERA

46
Q

VIRULENT FACTORS OF CHOLERA

A

1.FLAGELLAR PROTEINS
2. HEMAGGLUTININ

47
Q

ASYMPTOMATIC
RICE WATER WITH FISH ODOR

A

CHOLERA

48
Q

TRAVELER’S DIARRHEA
INGESTION IMPROPERLY COOKED CHICKEN, UNPASTEURIZED MILK OR CONTAMINATED WATER
-FOOD POISONING

A

CAMPYLOBACTER ENTEROCOLITIS

49
Q

PATHOGENESIS OF C. ENTEROCOLITIS

A

[M-A-T-I]

MOTILITY
ADHERENCE
TOXIN
INVASION

50
Q

CAN RESULT IN
REACTIE ARTHRITIS IN HLA-B27PATIENTS
40% GUILLAIN-BARRE SYNDROME

A

CAMPYLOBACTER ENTEROCOLITIS

51
Q

GRAM - BACTERIA
UNENCAPSULATED - ENTEROBAC FAMILY
FECAL ORAL ROUTE
AFFECT CHILDREN IN DAYCARE

A

SHIGELLOSIS

52
Q

RESISTANT TO HARSH ACIDIC ENVIRONMENT OF STOMACH
S. DYSENTERIAE SEROTYPE 1 RELEASE:

A

SHIGATOXIN STX

53
Q

MOST PROMINENT ON LEFT COLON
ILEUM CAN BE INVOLVED
MUCOSA - HEMORHAGIC ULCERATED AND PSEUDOMEMBRANES
TROPISM FOR M CELLS

A

SHIGELLOSIS

54
Q

INITIAL WATERY DIARRHEA PROGRES TO DYSENTERIC PHASE

A

SHIGELLOSIS

55
Q

TRIAD OF:
1. REACTIVE ARTHRITIS
2. URETHRITIS
3. CONJUNCTIVITIS

  • HEMOLYTIC UREMIC SYNDROME (HUS)
  • ENTEROHEMORRHAGIC E.COLI (EHEC)
A

SHIGELLOSIS

56
Q

PEAK INCIDENCE IN SUMMER
CAUSEFOOD POSIONING
INGESTION OF CONTAMINATED FOOD, RAW AND UNDERCOOKED MEAT, POULTRY, EGGS AND MILK

A

SALMONELLA

57
Q

POSSES VIRULENCE GENES ENCODE TYPE 3 SECRETION TRANSFER BACTERIAL PROTEINS INTOM CELLS AND ENTEROCYTES

A

SALMONELLA

58
Q

LOOSE STOLS TO CHOLERA LIKE PROFUSE DIARHEA TO DYSENTERY
ORGANISMS SHED IN THE STOOL
SELFLIMITED
RISK FX - MALIGNANCIES, IMUNOSUPPRESSION, ALCOHOLISM, CARDIOVASCULAR DYSFUNCTION

A

SALMONELLA

59
Q

ENTERIC FEVER
SALMONELLA ENTERICA
HUMANS ARE THE SOLE RESERVOIR
GALLBLADDER COLONIZATION

A

TYPHOID FEVER

60
Q

ENLARGEMENT OF PEYER PATCHES IN THE TERMINAL ILEUM
PLATEAU LIKE ELEVATIONS UP TO 8CM INDIAMETER

A

TYPHOID FEVER

61
Q

ROSE SPOTS IN CHEST AND ABDOMEN

A

TYPHOID FEVER

62
Q

INGESTION OF PORK, RAW MILK ANDCONTAMINATED WATER
USES ADHESINS TO BIND TO HOST B1 INTEGRINS TO INVADE M CELLS
MC IN ILEUM, APPENDIC & RIGHT COLON
APTHOUS LIKE EROSIONS
MIMIC ACUTE APPENDICITIS

A

YERSINIA

63
Q

GRAM - BACILI COLONIZING THE GI TRACT

A

ESCHERICHIA COLI

64
Q

TRAVELLERS DIARHEA
HEAT LABILE TOXIN
HEAT STABLE TOXIN

A

ETEC

65
Q

ACTIVATE ADENYLATE CYCLASE = INCREASED cAMP

A

LT TOXIN

66
Q

BIND TO GUANYLATE CYCLASE = INCREASED cGMP

A

ST TOXIN

67
Q

ENDEMIC DIARHEA OUTBREAKS IN <2 Y/O
ATTACHING AND EFFACING LESIONS

A

EPEC

68
Q

E. COLI 0157:H7 & NON-O157:H7
INADEQUATELY COKED GROUND BEEF
PROD. SHIGA LIKE TOXIN

A

EHEC

69
Q

SIMILAR TO SHIGELLA
YOUNG CHILDREN & DEVELOPING COUNTIRES

A

EIEC

70
Q

UNIQUE PATTER
ADHERANCE FIMBRAIE
NON BLOODY DIARRHEA - INDIVIDUALS WITH AIDS

A

EAEC

71
Q

AGENT: C. DIFFICILE
ABX-ASSOCIATED COLITIS

A

PSEUDOMEMBRANOUS COLITIS

72
Q

FORMATION OF PSEUDOMEMBRANES
SUPERFICIAL DAMAGED CRYPTS

A

PSEUDOMEMBRANOUS COLITIS

73
Q

TX FOR PSEUDOMEMBRANOUS COLITIS

A

METRONIDAZOLE
VANCOMYCIN

74
Q

RARE, MULTIVISCERAL CHRONIC DIASEASE
G+ ACTINOMYCETE (TROPHERYMA WHIPPELI)
MALABSORPTIVE DIARHEA

A

WHIPPLE DISEASE

75
Q

HALLMARK: FOAMY MACROPHAGES IN SI AT LAMINAPROPRIA

A

WHIPLE DISEASE

76
Q

sSRNA GENOME
MC IN ALL POPULATION

A

NOROVIRUS

77
Q

MC IN PEDIATRIC PATIENTS

A

ROTAVIRUS

78
Q

dSRNA GENOME
MC PEDIATRIC DIARHEA

A

ADENOVIRUS

79
Q

Ascaris lumbricoides

A

GIANT ROUNDWORM

80
Q

Strongyloides stercoralis

A

LARVAE
PERIPHERAL EOSINOPHILIA

81
Q

Necator duodenale and Ancylostoma duodenale

A

HOOKWORMS

82
Q

Enterobius vermicularis

A

PINWORM
D-SHAPED EGGS

83
Q

Trichuris trichiura

A

WHIPWORM

84
Q

Schistosomiasis

A

SNAIL
BLADDER

85
Q

Intestinal Cestodes

A

TAPEWORM
CAUSE: TAENIASIS

86
Q

Entamoeba histolytica

A

AMEABIASIS
FLASK-SHAPED ULCER

87
Q

Giardia lamblia

A

GIARDASIS
LAMBLIASIS
PEAR-SHAPED
OLD MANS FACE
DECREASE IN LACTASE

88
Q

Cryptosporidium

A

SPOROZOITES
CHRONICDIARHEA

89
Q

CHRONIC, RELAPSING ABDOMINAL PAIN
MICROSCOPIC - NORMAL

A

IRITABLE BOWEL SYNDROME

90
Q

ABDOMINAL DISCOMFORT OR PAIN AT LEAST 3 DAYS/ MONTHS OVER 3 MONTHS
POORLY DEFINED

A

IRRITABLE BOWEL SYNDROME

91
Q

2 PROTOTYPES
CROHNS DISEASE OR ULCERATIVE COLITIS

A

INFLAMMATORY BOWEL DISEASE

92
Q

ILEUM +/- COLON
SKIP LESIONS
+ STRICTURE
THICK WALL
TRANSMURAL INFLAMMATION
MODERATE PSEUDOPOLYPS
DEEP KNIFE LIKE ULCERS

A

CROHNS DISEASE

93
Q

COLON ONLY
DIFUSE
RARE STRICTURE
NORMAL WALL
MUCOSA INFLAMMATION
MARKED PSEUDOPOLYPS
SUPERFICIAL, BROAD BASED ULCERS

A

ULCERATIVE COLITIS

94
Q

NOD2 POLYMORPHISM
ATG16L1
10X IN:

A

CROHNS DISEASE

95
Q

COBBLESTONE APPEARANCE

A

CROHNS DISEASE

96
Q

NON CASEATING GRONULOMA
SERPENTINE ULCER
NORMAL & ABNORMAL MUCOSA (SKIPING)

A

CROHNS DISEASE

97
Q

NO SKIPPING LESIONS
COLON AND RECTUM

A

ULCERATIVE COLITIS

98
Q

OUTPOUCHING
MUCOSA AND SUBMUCOSA
MC IN SIGMOID
CIRCULARIS LAYER HYPERTROPHY

A

SIGMOID DIVERTICULA

99
Q

PATHOLOGIC AND CLNICAL OVERLAP OF CC & UC
75% WITH PANCA

A

INTERMEDIATE COLITIS

100
Q

MC CANCER IN THE WORLD
2ND MC CAUSE OF CANCER DEATH

A

COLON CA

101
Q

MORE RISK OF DEVELOPING COLON CA

A

ULCERATIVE COLITIS

102
Q

NEOPLASTIC ADENOMAS
RED MEAT, SATUIRATED FAT, REFINED CARBS, ALCOHOL

A

COLORECTAL POLYPS

103
Q

o Familial adenomatous polyposis (FAP)
o Hereditary nonpolyposis colon cancer (HNPCC)

A

FAMILIAL CANCER
(HEREDITARY COLORECTAL CANCER) - HCC

104
Q

MUTATION OF APC

A

FAMILIAL ADENOMATOUS POLYPOSIS

105
Q

MC THAN FAP
MUTATION OF THE MISMATCH REPAIR GENE

A

HEREDITARY NON-POLYPOSUS COLORECTAL CANCER (HNPCC)
AKA. LYNCH SYNDROME

106
Q

LYNCH SYNDROME OR HNPCC
CRITERIA

A
  1. 1ST DEGREE RELATIVE
  2. 2 SUCCESIVE GENERATIONS
  3. 3 RELATIVED WITH HNPCC
  4. FAP
  5. DX BEFORE AGE 50
  6. PATHO EXAMINATION
107
Q

APCG MUTATION
KRAS
P53
MIN PATHWAYS (BETTER PROGNOSIS)

A

GASTRIC ADENOCARCINOMA

108
Q

SIGNS OF METSADENOCARCINOMA

A

CACHEXIA (LOSS OF WT.)
LOSS OF APETITE
HEPATOMEGALY
BONE PAIN

109
Q

MC IN ADENOCARCINOMA

A

RECTUM ( 38%)

110
Q

TEST FOR ADENOCARCINOMA

A

FOB -GUAIAC TEST (HEMATOCRIT) - 50% SENSITIVITY
IMMUNOLOGICAL TEST
STOOL DNA
DOUBLE CONTRAST BRAIUM ENEMA - 82.9 SENSITIVITY
COLONOSCOPY/SIGMOIDOSCOPY - 5mm
CT COLONOGRAPHY - 92 % SENSITIVITY

111
Q

BLOOD TEST TUMOR MARKER
ADENOCARCINOMA

A

CEA

112
Q

ADENOCARCINOMA

A

+METS = STAGE 4
ADJUVANT CHEMOTHERAPY = BEFORE OPERATION