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Neo Boards > GI > Flashcards

GI Flashcards

1
Q

What fetal GI structures develop at 3.5 weeks?

A

Foregut and hindgut

Liver bud

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2
Q

What fetal GI structures develop at 4 weeks?

A

Esophagus and stomach separate (foregut)
Intestine (single tube)
Hepatobiliary system (foregut)
Pancreas (midgut)

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3
Q

What fetal GI structures develop at 5-9 weeks?

A

Mouth, esophagus, stomach move to normal position
Intestine herniates into umbilical cord, rotation occurs
Jejunal villi form

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4
Q

What fetal GI structures develop at 10 weeks?

A

Intestines return to abdomen
Microvilli form
Crypts of Lieberkuhn develop

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5
Q

What fetal GI structures develop at 12 weeks?

A 
Parietal cells (stomach)
Taste buds
Muscularis/muscle layers (13)
Disaccharides
Islet cells 
Bile secretion
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6
Q

What fetal GI structures develop at 16 weeks?

A 
Sucking/swallowing
Villi throughout intestine (14)
Meconium
Lipase
Trypsin
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7
Q

What fetal GI structures develop at 18 weeks?

A

Ganglion cells

Crypts (19)

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8
Q

What fetal GI structures develop at 20-24 weeks?

A 
Amylase (oral)
Ciliated columnar cells
Maltase
Sucrase
Pancreatic amylase (22)
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9
Q

What fetal GI structures develop at 28 weeks?

A

Disaccharidases at adult levels (30)

Lactase ^

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10
Q

What fetal GI structures develop at 32 weeks?

A

Normal gastric emptying

HCl detected in stomach

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11
Q

What fetal GI structures develop at 34-36 weeks?

A

Coordinated suck/swallow
Rapid peristalsis
Lactases at adult levels (36)

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12
Q

What are the enzymes that aid in carbohydrate digestion?

A 
Pancreatic amylase
Glucoamylase
Intestinal disaccharidases
Colonic bacteria
Glucose transport
Lactase
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13
Q

When does the fetus develop pancreatic amylase

A

Present at 22 weeks

Decreased secretion at birth

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14
Q

What is the function of glucoamylase?

A

Fully active at birth
Located in intestinal brush border
Removes glucose from end of starch

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15
Q

What are the glucosidases/disaccharidases and when do they reach normal levels?

A

Sucrase
Maltase
Isomaltase

28 weeks

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16
Q

What is the role of colonic bacteria in carbohydrate digestion?

A

Ferment malabsorbed carbohydrates to acids–>
colonic absorbtion

Colonic salvage pathway

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17
Q

Where does glucose transport occur in the GI tract?

A

In the small intestine

Less efficient with decreasing gestational age

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18
Q

Lactase reaches adult levels at

A

36 weeks

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19
Q

Chymotrypsin and trypsin are present in the

A

Duodenum

Decreased in preterm and term infants

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20
Q

Dipeptidase is present in

A

Mucosa

Present early in gestation

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21
Q

Amino acid transport capacity reaches normal levels at

A

Early gestation

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22
Q

Fat digestion occurs primarily through the action of

A

Bile acids

Pancreatic lipase

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23
Q

To compensate for decreased bile acids and pancreatic lipase at term, preterm and term infants digest fats through

A 
Lingual lipase
Gastric lipase
Breast milk lipase
Chylomicron formation
Increased medium chain fatty acids in diet
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24
Q

Enzymes present in the mouth are

A

Salivary amylase

Lingual lipase

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25
Q

Enzymes present in the stomach are

A 
Pepsinogen
Acid
Chyme
Intrinsic factor
Gastrin
Gastric lipase
26
Q

Pancreatic enzymes are

A 
Pancreatic amylase
Chymotrypsinogin
Chymotrypsin
Trypsinogen
Trypsin
Pancreatic lipase
27
Q

Liver produces ____ for digestion

A

Bile

28
Q

Small intestine enzymes are

A 
Enterokinase
Glucoamylase
Disaccharidases (maltase, sucrase, lactase)
Amino peptidases
Dipeptidase
Intestinal
Cholecystokinin
Secretin
Gastrin inhibitory peptide
Motilin
29
Q

Large intestine contributes to digestion through the

A

Salvage pathway

30
Q

Esophageal duplication presents as

A

Posterior mediastinal mass that can compress trachea and cause respiratory distress
Can also compress esophagus and cause feeding intolerance

31
Q

Esophageal cysts are

A

Located in muscular wall and lined by ciliated, gastric, or squamous epithelium

32
Q

The most common type of TEF is

A

Esophageal atresia with distal TEF (85%)

33
Q

Most TEFs are

A 
Isolated anomalies (30-40% with other anomalies) 
Rarely familial

Can be associated with VACTERL

34
Q

Occurrence of pyloric stenosis is associated with

A

3/1,000 birth
5 to 1 males»>females
O and B blood types

35
Q

Duodenal atresia is commonly associated with

A 
Trisomy 21
Malrotation
CHD
Annular pancreas
Esophageal atresia
GU anomalies
36
Q

Duodenal atresia occurs due to

A

Failed recannelization of intestinal tube, 8 to 10 weeks gestation

37
Q

Jejunal-ileal Atresia most often occurs with _____ atresia in the _____

A

Single atresia

Distal ileum

38
Q

Jejunal-ileal Atresia occurs due to

A

Ischemic injury after intestinal development

39
Q

Small left colon syndrome is associated with

A 
Maternal diabetes
Maternal hypothyroidism
Maternal toxemia / magnesium
Prematurity
Cecal perforation
40
Q

Microcolon is a result of

A

Functional immaturity of the ganglion cells

41
Q

Colonic atresia is caused by

A

Ischemia

42
Q

Most infants with hirschsprung disease are

A

Male (80%) and related to an individual who also has hirschsprung disease

43
Q

hirschsprung disease is associated with

A 
Trisomy 21
Heterochromia
Waardenberg syndrome
Congenital deafness
13Q deletion
Pheochromocytoma
Neurofibromatosis
Neuroblastoma
44
Q

hirschsprung disease most often occurs in the

A

Rectosigmoid colon

45
Q

Meconium plug is differentiated from meconium ileus by

A

Location in the colon, in contrast with meconium ileus which involves distal ileum

46
Q

Meconium plug is caused by

A

Immaturity of myenteric plexus nerve cells in the colon

47
Q

Imperforate anus associated with rocker bottom perineum usually indicates

A

Sacral agenesis

48
Q

Pancreatic insufficiency associated with Schwachmann-Diamond syndrome includes

A

Bone marrow dysfunction
Short stature

Normal sweat test

49
Q

Pancreatic insufficiency associated with cystic fibrosis includes

A

Chr 7 508 position mutation
CFTR chloride transporter abnormality

FTT
vitamin k malabsorption
Hypocalcemia
Cholestasis
Rectal prolapse
Nasal polyps
Peptic ulcers
Pancreatitis
50
Q

Pentalogy of Cantrell includes

A 
Sternal cleft
Anterior midline diaphragmatic abnormality
Pericardial defect
Ectopic cordis
Omphalocele
51
Q

All infants with gastroschisis also have

A

Malrotation

52
Q

Omphalocele is more common in

A

Males (3:1)

Association with other defects/syndrome (59-89%)

53
Q

Associated syndromes with omphalocele are

A

Trisomy 13, 18, 21
Pentalogy of Cantrell
Beckwith-Wiedeman
OEIS

54
Q

Cause of omphalocele is

A

Intestinal loops fail to return to abdomen at 11 weeks

Somatic folds fail to complete abdominal wall at 18 weeks

55
Q

The ________ distinguishes upper from lower GI bleeding

A

Ligament of Treitz

56
Q

___% of infants <1500g will develop NEC

A

10%

57
Q

Bloody stools and focal pneumatosis is NEC stage ____

A

2A

58
Q

Abdominal findings including edema/ascites with portal venous gas on x-ray is NEC stage ____

A

2B

59
Q

Diffuse systemic signs with abdominal edema/erythema and persistent bowel loops distention is NEC stage ____

A

3A

60
Q

NEC stage 3B is marked by

A

Pneumoperitoneum

61
Q

Prognosis for short bowel syndrome is worse if

A

Colon resected
Ileocecal valve removed
>25cm bowel+ ileocecal valve resected
>40cm resected without valve

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