GI 4 Flashcards
abdominal pain/bloody diarrhea post surgery most likely has I___
colon receives blood via anastamoses of __ and ___ arteries
watershed regions are seen in __ flexure bw SMA/IMA and __ jxn bw Sigmoid artery and superior rectal artery
sensitive to __ states
condition could also be caused by T__
look for pale __ and petehcial __
ischemic colitis
SMA/IMA
splenic, RS
hypoTN
thrombosis
mucosa/hemorrhage
recurrent infections w Pseudomonas, chronic diarrhea, FtT dx is ___
steatorrhea/FtT due to M___ bc of panc insufficiency
tx by supplementing w ___
stay away from __ a somatostatin analogue, which dec __ secretion to intestines
Cystic fibrosis
malabsorption
panc enzymes
octreotide, panc enzyme
acute epigastric pain, unstable vitals, hematemesis should be __
duodenal ulcers more likely to occur A__
thus, P__ more common
posterior ulcers more likely to ___ the GD artery
peptic ulcer
anteriorly
perforation
hemorrhage
stool smear with iodine staining reveals elliptical cyst w smooth walls and 2 nuclei,, organism is ___
will colonize the __/__, leading to D/M/F
Tx w __
commonly acquired via drinking __
Giardia lamblia
D/J, dairrhea, malabsorption, flatulence
metro
contam water
Inflamm travelers diarrhea presents w stool of __/__
tx w __ or another F
M__ is antihelminth, acts on ___ of roundworms
ie A/A/E
A__ tx tapeworm Echinococcus
produces c__ normally
__ is opiate antimotility drug, used for __
E___ can be used for Campylobacter
blood/mcuus
cipro
mebendazole, microtubules
ascaris/ ancylcostoma/enterobius
albendazole
cysts
Loperamide, travelers diarrhea
erythromycin
pathogen transmitted from dog to human _ such as from Cattle/sheep/dogs/chicken
food such as undercooked __ and unpasteurized __
curved gram __ w filament for __ fashion
Transmission is __
presents w __ diarrhea, T, __ in stool
campylobacter
poultry
milk
neg, corkscrew
F-O
inflam, tenesmus, leuks
human pathogen transmitted F-O by dirty hands/fomites/lack of hygiene
CD most likely involves the T__
this results in loss of __, causing impaired __ absorption
lipids in bowel then bind to __ ions, and soap is excreted
thus, oxalate is unbound and absorbed, resulting in formation of ____
shigella
terminal ileum
BA, fat
Ca
oxalate kidney stones
__ is benign AR cx charactersed by defective excretion of bilirubin glucuronides, due to mutation in __ protein
pt presents w __ without trigger and otherwise asx
labs show __ hyperbilirubinemia
liver appears grossly __ due to impaired excretion of epinephrines in lyysosomes
Dubin johnson syndrome
jaundice
direct
black
When US is nonconclusive, use __ hepatobiliary scanning for Acute Cholecystitis
gallbladder will not be seen, as radiotracer accumulates in ___/___
presence of echogenic structures in gallbladder on US is __
look for __ sign, gallbladder wall __, or pericholecystic __
radionucleide scan
liver/CBD
nondiagnositc
murphy, thickening, fluid
__ supplies the stomach, duodenum, liver, spleen, pancreas
SMA/IMA anastaoses- marginal artery of ___ or arc of __
these supply __/__
these anastamoses protect the intestine from ___
venous drainage occurs via __/__ mesenteric veins
celiac trunk
Drummond, Riolac
S/L intestine
ischemia
superior/inferior
inflmmation of vessel wall in CD leads to narrowing, which is seen as the __
this indicates intestinal __
string sign
obs
in cirrhosis, hyperestrinism inc prodxn of E__
this results in inc __ binding to SHBG, and more free ___
reduced __ metabolism by liver
other manifestations inlcude T__ and dec ___, S
estradiol
testosterone, estrogen
estrogen
testicular atrophy, body hair, spider angiomata
complication of longstanding cholelithiasis is G___, with formation of cholecystoenteric ___ bw gallbladder/duodenum
allows passage of gallstone and trapping in __
develop sx of ___
such as pain, NV, __ bowel sounds, TTP
xray shows __ of bowel w air fluid levels
air entering biliary tree aka ___
gallstone ileus, fistula
ileus
SBO
high pitched
distended loops
pneumobilia
enteric bacteria can produce vitamins like __ and ___
seen in __ from Roux En Y gastric bypass
sx include N/B/discomfort/M\
deficient in most other ___
VK, folate
small intestinal bacteria overgrowth
bloating, malabsorption
vitamins
50% infectious dose corresponds to minimim number of organs to cause __ in 50% of affected individuals
very low infectious dose seen w ___
begins w __ diarrhea, dysentery, T
also small ID w C/E/G
larger for S/V/C/E
disease
shigella
watery, tenesmus
campylobacter, enatamoeba, giardia
salmonella, vibrio, clostridium, e coli
__ is transmitted by filariform larvae in soil w human feces
larva penetrate ___, migrate to __, coughed up and swallow to intestines
form __ larvae in intestine and excreted
some can form filariform larvae, leading to ___ and __ throughout body
may present w multiorgan __/__
usually in patient taking __ or __ infection
impaired __ cellular immune response
particularly seen in __ (geography)
Sx pruritic, red, linear streaks aka larva __
as larva migrate from perianal region
dx w __ in stool
tx w ___
stronglyoides
skin, lungs
rhabditidiform
autoinfect/hyperinfect
failure/sepsis
IC, HTLV1
TH2
SE asia
currens
larvae
ivermectin
detection of parasite eggs in stool to dx __
__ deposits eggs in perianal folds
dx w scotch tape to __ region
tapeworms like T/T/D form proglottids and seen in stool
schistosomiasis
enterobius
perianal
T solium, T saginata, d latum
Lactase deficiency leads to incomplete hydrolysis of __, which ferments to short chain __
this __ the stool, __ pH
H2 gas is produced, w inc breath __
high amounts of undigested lactose lead to __ stool osmolality
monosacchs fatty acids acidifies, dec hydrogen inc
hyperTG, tx w __ to upregulate LPL (such as __)
these inhibit __ the RLS of bile acid synth
dec cholesterol __, promoting __ formation
avoid in pt w preexisting __ disease
another SE is __ esp w statins
fibrates, gemfibrozil
7A hydroxylase
solubility, gallstone
GB
myopathy
__ blocks cholesterol absorption, reducing __ content
SE include __ esp w statins and diarrhea
__ have high O3FA to inc BA synth, dec __ saturation, and inc gallbladder __
__ inc HDL and dec TG
Se is ___ mediated by prostaglandins
tx w ___
Ezetemibe, cholsterol
transaminitis
fish oils, cholesterol, mobility
niacin
flushing
NSAIDs
__ less likely to incarcerate due to wide neck
__ ligament is posterior to femoral hernia
__ lies posterior to IIH
Direct inguinal hernia
cooper
transversalis fascia
__ supplies upper GI
__ branches into GD artery, right gastric, upper hepatic artery
__ runs w portal vein and CBD, supplying the liver/right hepatic masses
__ supplies colon from splenic flexure to upper rectum
__ supplies pancreas, lower duodenum to transverse colon
celiac trunk
common hepatic artery
proper hepatic artery
IMA
SMA
Gram postive actinomycete __ causes whipple disease
involves SI/J/C
proliferate only in ___, thus there is no __ response
look for foamy macros w __ shaped and PAS positive, __ resistant grnauels
may have diarrhea, wl, arthropathy, P/C abnorms
tx w __
T whipplei
joints, CNS
macros, inflamm
rod, diastase
psychiatric/cardiac
antibiotics
IBD can present w symptoms of __
loss of bile acids leads to __ malabsorption and def in __
__ deficiency can present w easy bruising/hematoma/prolonged bleeding
Leukocytoclastic vasculitis seen w __ use or __ infection
look for P/P
AS
fat, FSV
VK
antibiotic, hepatitis
petechiae/purpura
Short bowel syndrome occurs in pt w SB __ and/or __
leads to loss of __, w decrease intestinal __
presents w postprandial __ and WL due to __
potentially a __ deificiency
postprandial fluid shifts more commonly seen w __
as hyperosmolar chyme enters __
resection, CD
absorptive surface, transit time
VB12
most common benign liver tumor is __
congenital, enlarge via __
hemangiomas are well circumscribed masses of __ consistency
look for __ vasc spaces of variable size w a single __ layer
most pts are __
avoid __ due to risk of hemorrhage
cavernous hemangioma
ectasia
spongy
blood filled, epithelial
asx
biopsy
acute interstitial panc present w __ tissue, __ necrosis and __ deposits
can progress to __ w ischemia and trypsin activation
seen w __ fat necrosis and __
edematous, fat, calcium
necrotizing panc
chalky white, hemorrhage
adenomatous polyp seen w __ glands and __ components
lined by __ columnar epitheial cells
__ of lumen is first event in AA pathogenesis
Fecaliths/hyperplastic __ follicles, __ bodies, or __ can cause obstruction
tubular, villous
dysplastic
obstruction
lympocytic, foreign, tumors
normal intestinal architecture w clear entercytes seen w accumulation of __ in absorptive cells
typical of __ caused by impaired formation of apoB containing __
dietary lipids processed in __ enterocytes
secreted as __ to liver, and form __
chylomicrons/VLDL synthesized around single __ molecule
__ is found in VLDL
__ is found in chylomicrons
lipids
Abetalipoproteinemia, lipoproteins
SB, chylomicrons
VLDL
apoB
apoB100
apoB48
__ is caused by loss of fxn in __ gene
manifests w M
low plasma __/Cholesterol/C/VLDL
__ entirely absent
deficient in __
form __ RBC w __ abnormalities
Abetalipoproteinemia MTP malabsorption TG, chlymicrons apoB
Fats/FSV
acanthocyte, neuro
__ deficiency predisposes membranes to oxidative injry
cells most susceptive include __ w long axons and __
thus, see __ dz and __ anemia
involvement of __ assc w lost proprioception/vibratory sense
__ involvement leads to ataxia/nerve dysfxn/hyporeflexia
VE
neurons, RBC
NM, hemolytic
dorsal column
spinocerebellar tract
chronic intake of __ may inc development of Ca- OX stones
also see N/D/pain
1st line tx for pt w hypercholesterolemia __
__ inhibit HMG CoA reductase
dec __ synthesis
Bile acid binding resins like __ to inc bile acid excretion
thus, __ is upregulated to inc hepatic cholesterol synthesis
thus, statins/resins counterract, leading to major __ in LDL
VC
statins
competitively
cholesterol
cholestyramine
HMG CoA reducatase
dec
mass w high grade dysplasia, villi like projections indicates __ adenoma
may have __/__ projection
tend to be __ and __
can secrete large amounts of __, producing __ and electrolyte abnorms
__ adenomas have dysplastic colonic mucos cells forming a tube
__ contain a mix
villous
velvety/cauliflower
large, sessile
mucus, secretory diarrhea
tubular
tubulovillous polyp
__ polyp has disorg mucosal glands, smooth muscle/CT
seen in __ syndrome or __
__ polyps form mucosal cells w glands/crypts
hamartomous
PJ, Juvenile polypsis
hyperplastic
__ causes portal HTN, splenomegaly and varices
there are no changes to __
__ shows centrilobular congestion/fibrosis
potral vein thrombosis
hepatic parenchyma
budd chiari
internal hemorrhoids has __ from inferior hypogastric plexus
have __ epithelium
external hemorrhoids covered by __ epitheium
somatic innervation from __ nerve, branch of __ nerve
pudendal nerve supplies perineum and __
very sensitive to pain/temp
autonomic innervation
columnar
modified squamous
inferior rectal, pudendal
external genitalia
__ sided CRC grow as bulky masses that protrude into lumen
more likely to cause __
__ sided CRC is smaller, narrowing the __
more likely to cause __
change in __, C, ab ___
__ and __ are common sites of metastasis
right
IDA
left
lumen
obstruction
bowel habit, constipation, distension
liver/lung
signet ring gastric carcinoma consists of cells that dont form __
contain abundant __
_ involvement of stomach
loss of __ adhesion protein
often cause __ appearance
factors for survival- __ of invasion and __ involvement
often met to __ and __ nodes
__ type adenocarcinomas of stomach resemble __ cancer w solid mass
well formed glands of __/__ cells
rapidly fill __
often _/__ so must differentiate from PUD
glands
mucus
diffuse, E cadherin
leathery
depth, regional LN
supraclavicular/periumbilical
intestinal type, colon
columnar/cuboidal
lumen
ulcerate/bleed
Chronic gastritis assc w __
inflammation of __ w gland __ and metaplasia
inc risk of gastric __
rugal thickening and acid hypersecretion seen in pt w __ syndrome
H pylori, mucosa, atrophy
carcinoma
ZES
right sided colon cancer unlikely to occlude the lumen bc it is __ than left side
__ is a glycoprotein for cell adhesion
inc in pt w __ cancer
higher is assc w worse __
upon follow up, can indicate __
many receieve __ based chemo
grade is determined __
wider
CEA
colon
prognosis
recurrence
oxiplantin
histologically
gastric ulcer caused by __has higher risk of gastric cancer
carcinoma of distal colon appears __ w __ of bowel
eosinophilic cytoplasm on HE stain of stomach indicates ___ cells
have abundant __
__ is found in ECL cells
regulates __ secretions and peristalsis
H pylori
annular, constriction
parietal cells
mitochondria
serotonin
intestinal
overprod of TGF A seen w __ disease
mucosal cell __ w gastric fold __
also see hypoplasia of __/__ cells
reduced __ secretion
menetrier
hyperplasia, enlargement
parietal/chief
GA
__ is typically earliest/most sverely affected nutrient w general malabsorption
test for fat is most __ strategy to screen for malabsorptive disorder
qualitative assay w __ identifies unabsorbed fat
Fats
sensitive
Sudan 3
