Gastric 1

Question 0

Celiac Disease, pathologic component of Gluten

Answer 0

Gliadin
is deaminated by tTG
deaminated gliadin is presented to APCs via MHC II
Helper T cells mediate tissue damage

Question 1

Three sugars absorbed by stomach

Answer 1

Glucose, Galactose, lactose

Question 2

Lab findings for Celiac Disease

Answer 2

IgA antibodies against endomysium (covering of muscle fibers), tTG (tissue Trans Glutaminase), gliadin

subset of patients of patients will be IgA deicient, so IgG can be used for diagnosis

Question 3

Place of most damage for celiac disease

What kind of damage?

Answer 3

Duodenum is most involved

Flattening of villi, hyperplasia of crypts

Question 4

Celiac symptoms that persist even after removing gluten from diet could be indicator of

Answer 4

Small bowl carcinoma and T-cell lymphoma (most lymphomas are B cell) also called EATL: Enteropathy Associated T Cell Lymphoma

Question 5

Tropical Sprue damage location

Answer 5

Jejunum and Ileum (as opposed to Celiac) > leading folic acid and B12 deficiency (potentially)

due to infectious diarrhea in the Caribbean, responds to antibiotics

Question 6

Whipple Disease
what is it?
Site of involvement?
Classic symptoms?

Answer 6

Systemic tissue damage characterized by macrophages loaded with Tropheryma whippelii
Partially destroyed organized present in macrophages

Small bowl lamina propia

Fat malabsorption and steatorrhea

Question 7

Other sites of involvement for Whipple Disease

Answer 7

Synovium of joints (arthritis)
Cardiac valves
Lymph nodes
CNS

Question 8

What is Chromogranin?

Answer 8

Positive indicator for Carcinoid Tumor

which is malignant proliferation of neuroendocrine cells
relatively low grade (high grade is small cell carcinoma)

Question 9

What is carcinoid syndrome?

Answer 9

Carcinoid Tumor starts in small bowl
secrets in serotonin, but it is broken down in the liver to 5-HIAA which is excreted into urine
HOWEVER if metastasis into Liver, then it will secrete serotonin into HPV, and you have symptoms os carcinoid syndrome:
bronchospasm
diarrhea
flushing of skin

Question 10

What is carcinoid heart disease?

Answer 10

Seratonin from metastatic Carcinoid Tumor travels from HPV into heart, and causes fibrosis

Question 11

Carcinoid syndrome symptoms

Answer 11

Bronchospasm, diarrhea, flushing of skin

triggered by alcohol or emotional stress

Question 12

Why do you not get left sided heart disease from carcinoid tumor?

Answer 12

Because from right heart, it goes to lungs which also has MONOAMINE OXIDASE (MAO) which breaks down seratonin