Final: SI + LI

Question 1

congenital anomalies:

Answer 1

• duodenal atresia–assoc. w/ trisomy

- dudoneal most common followed by ideal

Question 2

Hirschprungs

Answer 2

• congenital aganglionic megacolon: failure of NEURAL CREST CELLS to migrate

Obstipation/obstruction of bowel

may see intestinal volvulus w/ this
loss of motility and dilation of bowel PROXIMAL to region of involvement

Question 3

intestinal volvulus-

Answer 3

• twisting of loop of intestine
• May occur at ANY age and usually NOT d/t congenital conditions
• SIGMOID most common

Question 4

intussusception

Answer 4

• intestine migrates into another part (telescoping)
• Triad: abdominal pain, bilious vomiting, red “currant jelly” stool
• “coil spring” sign

Question 5

Meckel’s diverticulum

Answer 5

• out pouching from intestine located in the distal ileum.

- MOST FREQUENT malformation of GI tract

Question 6

True diverticulum:

Answer 6

• invovled all 3 layers

- congenital almost always TRUE

Question 7

False diverticulum

Answer 7

• just mucosa and submucosa

- Acquired usually FALSE

Question 8

Diverticulosis

Answer 8

• out pocketings of mucosa/submucosa

- SIGMOID colon. UNCOMMON

Question 9

diverticulitis

Answer 9

diverticula become inflamed

LLQ pain, fever and increased WBC

Question 10

Celiac

Answer 10

sx: chronic diarrhea, failure to thrive, fatigue

VILLOUS ATROPHY is characteristic but NOT pathognomic

Question 11

IBD

Answer 11

• inflammatory conditions of colon and SI

- Crohn’s and UC

Question 12

Crohn’s

Answer 12

• can affect ANYWHERE. Has SKIP lesions
• transmural lesions
• granule atoms w/ epithelium cells, giant cells, lymphocytes
• slight increase risk for colon CA

Question 13

UC

Answer 13

• restricted to colon and rectum
• Restricted to mucosa
• CRYPT abscesses only in UC
• SIGNIFICANT risk for colon CA

Question 14

Enterotoxins

Answer 14

• most commonly infectious

- NORWALK virus followed by ROTAVIRUS (more severe and longer)

Question 15

endotoxins

Answer 15

Mostly destroyed by heating–botulinum, corynebacterium diphtheria with Exotoxin,

Question 16

enterotoxin

Answer 16

chromosomally encoded exotoxins, mostly HEAT-STABLE

Question 17

s. Aureus

Answer 17

picnic food poisoning

Question 18

bacillus cereus

Answer 18

rice/Chinese food

Question 19

vibrio

Answer 19

crabs and shrimp

Question 20

Clostridium botulinum

Answer 20

home canned goods

Question 21

pseudomembranous colitis

Answer 21

• C. diff
• yellow-green plaques/exudate on mucosa
• complications: toxic megacolon

Question 22

peutz-Jeghers syndrome

Answer 22

• autosomal dominant. Mucocutaneous pigmentation and benign GI HAMARTOMAS
• usually found in small bowel
• histo: frond-like appearance. Nuclear atypical absent

Question 23

malignant small bowel tumors

Answer 23

rare, mostly ADENOCARCINOMA

Question 24

carcinoid tumor

Answer 24

nests of carcinoid tumor have typical endocrine appearance w/ small round cells containing nuclei that are consistent in size and shape

Question 25

Adenomataous polyps

Answer 25

some risk for malignant trains: villous–>tubule-villous –>tubular (mot to least likely)

Question 26

juvenille polyposis syndrome

Answer 26

• multiple polyps in GI tract

- mostly benign but slight increased risk for adenocarcinoma

Question 27

Familial adenomatous polyposis

Answer 27

• hundreds to thousands of polyps
• VERY likely to transform into malignant
• Combo of polyposis, osteomas, fibromas, sebaceous cysts: GARDNER syndrome

Question 28

leiomyosarcoma

Answer 28

more than 2 mitotically active nuclei per HPF is consistent

Question 29

Adenocarcinoma

Answer 29

long and frond like; similar to villous adenomatous polyps