Gastro Flashcards
Non-bilious emesis after eating in a 3-6 week old infant to a primogravida (first male born), signs of dehydration (sunken fontanella, dry mucous memb). Rel to Macrolide use. Olvide-shaped mass. Prominent peristaltic waves. Dg?
Infantile Hypertrophic piloric stenosis
Órganos que provienen del 1) endodermo 2)mesodermo 3)ectodermo
1) GI track, liver, pancreas, lungs, thyroid, bladder, urethra
2) Spleen, kidney,ureter, muscle, peritoneum, adrenal cortex.
3) sensory organs, brain (and related)
Which mechanism explains the Zenker diverticulum ?
Chricopharingeal motor dysfunction
Common causes of pneumoperitonium
1)perforated duodenal ulcer
2) Perforated viscus
3)tumors
4)trauma
Which structures can be affected by an occlusion of the hepatoduodenal ligament?
-Hepatic triad (hepatic A, Common bile duct, hepatic portal v)
-IVC
Breastfed infants supplementation?
Vit K, Vit D
Differences between Mallory Weiss and Boerhaave
Mallory: mucosal tear, hematemesis, heal spontaneously. Upper GI endoscop.
Boerhaave: transmural tear, crepitus and crunching sound, emergency sx. Esophagography or CT scan
What’s a Hiatal Hernia?
Circumpherential laxity of the phrenoesophageal membrane at the gastroesophageal junction.
Aging effects on liver?
-increased size of hepatocyte
-accumulation of lypofuscin
-Decreased activity C-P450
Hirschsprung Diseases profile
Infant with bilious emesis, abdominal distension, chronic refractory constipation, delayed passage meconium (neonates). Barium enema shows narrow rectum, rectosigmoid area and dilated colon. Cause: Failure of neural cell migration
Name osmotic laxatives and related disease
Polyethylene glycol and lactulose. Lactose intolerance.
SIBO is a common complication of:
Scleroderma
Findings in biopsy of dermatomyositis
Perifascicular atrophy of muscles. Affects only striated muscle of upper esophagus
Cholangiocarcinoma findings in CT scan
Dilated both right and left hepatic bile ducts (klatskin tumors)
Mid-gut malrotation features
Duodenojejunal flexure and Cecum rest in RUQ. Fibrous Ladd-bands. Intestinal obstruction signs.
Mid-gut malrotation features
Duodenojejunal flexure and Cecum rest in RUQ. Fibrous Ladd-bands. Intestinal obstruction signs. Bilious emesis, ando distension.
What’s Shigellosis invasion mec?
Invades intestinal epithelial barrier, enterocytes and Microfold (M) cells (found in Peyer patches in ileum)
Duodenum anatomic correlations:
-1st partion: only part that’s NOT retroperitoneal
-2nd portion: head of pancreas
-3rd portion: abdominal Ao, IVC, uncinate process of pancreas, SMA and SMV.
Carcinoembryonic antigen (CEA) fx?
Monitoring, sensitive indicator of colorectal cancer recurrence.
Crohn disease is characterized by
Patchy granulomatous inflam
Terminal Ileum involvement
Steatosis
Oxalate Kidney Stones
Chronic mesenteric ischemia is characterized by
Postpandrial epigastric pain with food aversion or weight loss
Chronic mesenteric ischemia is similar to stable cardiac angina because
Food absorption increases blood demand.
Physical exertion increases myocardial O2 demand.
Hypoperfusion in both cases causes pain.
GERD is characterized by
-Heartburn, odynophagia, nocturnal cough, laringitis, wheezing
-Elongation of Lamina Propria Papillae, scattered neutros and eosinophils
-Decreased LES tone, gastroesophageal junction incompetence
What can mod-severe burns cause ?
Consumption of adipose reserves. In the abdo the SMA is supported by mesenteric fat, when this is reduced it can compress the transverse portion of the duodenum (3rd)
What intestinal obstruction causes bilious vomit?
Obstruction of the 3rd duodenum
Reasons why the liver is a common metastatic place
-Fenestrated sinusoidal epithelium
-Dual blood supply from portal systemic circulation.
Reasons why the liver is a common metastatic place
-Fenestrated sinusoidal epithelium
-Dual blood supply from portal systemic circulation.
Cause of gallstones
Decrease bile acids and phospholipids
Chronic diarrhea, Pseudomonas infection, failure to thrive and family history of pulmonary infections is characteristic of ? What can help improve?
Cystic fibrosis
Pancreatic lipase
Profuse mucoid diarrhea + Mass in sigmoid colon showing long glands with finger-like/velvety/cauliflower-like projections is typically associated to
Villous adenoma
Th1 (granuloma formation) and Th2 (inflam and damage ) are hallmarks of which IBD respectively?
Crohn’s and UC
Fistulas and abscesses are associated to which IBD?
Crohn’s (transmural inflam)
Bilirubin-induced neurologic disfx affects and causes
Basal ganglia and brainstem nuclei.
Causes severe neonatal jaundice, distonic mov and gaze abnormalities
Which signs are triggered by hyperestrogenic state in cirrhosis?
Ginecomastia, spider angiomata
Features of Eosinophilic esophagitis ?
Th2 mediated, triggered by food antigens
Food importation, intermittent dysphagia, reflux, vomiting
History of atopic conditions
Ring-like indentations in endoscopy
