Gi1 Flashcards
gastric ulcers are in the
corpus (body)
sweet feculent breath in cirrhosis is a sign of
poor hepatic function and accumulation of metabolic toxins
atrophy of intestinal villi
celiac disease
collections of neutrophils within crypt lumina
Ulcerative colitis
infiltration of intestinal lamina propria w atypical lymphocytes
gi MALT lymphoma
crohn disease
clacium will form soap complexes with
soap complexes w excess fat in intestinal lumne; thus unavailbe for complexing w oxalate; as a result free oxalate absorption is increased and subsequently filtered into urine, promoting formatio nof oxalate kidney stones
embolism
superiro mesenteric ischemia: sudden severe abdominal pain vs chronic which is recurrent post prandail pain
dilation of sinusoids and perivenular hemorraghe
budd chiari
granulomatus destruction of bile ducts
PBC
intrahepatic hydatidi cysts
echinococcus infection
outpouching away from lumen
diverticulosis
neoplastic mucosal growth: solid protuberances into colonic lumen (rather than outpouching)
colonic polyp
avoidance of apoptosis
DCC INACTIVATION
large, reducible midline abdominal protrusion covered by skin
incomplete closure of umbilical ring: congenital umbilical hernia
midline hernation of abdominal contents within thin membranous sac
omphalocele
full thickness abdominal wall defec that presetns as evsiceration of exposed abdomnal contents at birth
gastroschisis
incompelte rotation of midgut prior to physiologic reduction into abdominal cavity
malrotation
alcohol acute pancreatitis, you see mcv what
mcv >100
macrocytosis due to poor nuttriioton (folate deficiency, liver disease)
HBV immune response
cytotoxic Cd8+ t lymphocytes destroy infected hepatocytes
antigen mimicry w generation of self antigen recogniziing cd4+ t lymphcoytes
autoimmune hepatitis
failure of closure of lateral body folds at umbilicus
omphalocele or gastroschifssi
failure of hindgut descent along IMA
imperforate anus
black liver in dubin johnson due to
impaired excretion of epinepherine metabolites that accumulate within lysosomes
chloride content of pancreatic secretiosn dereases as what increases
bicarbonate increaes
pseudopolyps seen in
ulceritive colitis
nodular lymphoid hyperplasia of intestine seen in
CVID
tenesmus and small caliber stool
rectal adenocarcinoma
recurrent grossly bloddy stool; low grade fever
UC
to encircle the upper stomach, gastric band must pass through
lesser omentum
lesser omentum extens from liver to
lesser curvature of stomach and beginning of duodenum
lesser omentum divided into 2 ligaments
hepatogastric and hepatoduodenal ligament
greater omentu: extends from greater curvature of stomach
tru
acute viral hepaptisis liver enzymes
significant elevations in ALT and AST (AlT >)
followed by rises in bilirubin and alkaline phospahtase
if hepatic bleeding persistsa after occlusion of portal triad, then what is injured
IVC or hepatic vein
portal triad runs through
hepatoduodenal ligament
third part of dudoenum close associated with what artery
superior mesenteric artery
ulcers in lesser curvature stomach penetrate
left and right gastric arteries
2 main vessels supplying small and large intestine
SMA and IMA: connected by a pair of anastomoes: marginal artery of drummon (prinicpal anastomosis ) and Riolan meandering artery
any abdominal processes (ruptured spleen, peritonitis, hemoperitoneum) irritating phrenic nerve sensory fibers around diapghram can cause referred pain to shoulder region (C3-5)
kehr sign
Charcot triad
cholangitis
fever
ruq abdominal pain
jaundice
diverticilulits age
older pt
crohn disease: perinanal fistual
true
arterial insufficiency at rectosigmoid junction
ischemic colitis
border bw sigmoid artery and superior rectal artery
rectosigmoid ajunction
most common location of intussuception
ileocecal valve
currant jelly stools
hepeatocyte apoptosis characterized by cellular shrinkage and nuclear fragmentse with intesne eosinophili
councilman bodies
hep A
what acidifies stoool in lactase defiecincey
short chain fatty acids from fermentation of undigested lactose by gut bacteria
enlargement of gastric folds
gastrin hypersencetion causeing pariet cell hyperplasia
menetrier disease : overproduction of
TGFa
mucosal cell hyperplasia; gastric fold enalrgement;
hypoplasia of parietla/cheifl cesl: glandular atrophy
horizontal transection of rectus abdominis performed w great caution as ____ enters this muscle at level of arcuate line
inferior epigastric arteries
superior epigasetric artery supplies
superior portion of rectus abdominis
live accentuated oral (sabin ) poliovirus produces strong )___ what immune response than ainacatviated salk
secretory IgA
impiared nutrietn absorption
malabsorption
impaired neural inhibiition
diffuse esophageal spas
simulationeous, non peristaltic contractiosn
inflammation of parietal peritoneoum
appendicitis
bilious emesis in neonate sign of
intestinal obstructino below second part of duodenum
result of vascular occlusion in utero
intestinal atresia of midgut (jejunum, ileum, proximal colon)
apple peel atresia occurs when superior mesenteric artery is obstructed
result is blind ending proximal jejunum, lenght of absent bowel and mesentery and finally a terminal ileum spiraled around ileocolic vessel
absence of ileuk and jejunum
intestinal atresai
shock symptoms in setting of untreated ulcerative colitis
toxic megacolon
diagnoist imaging of study for toxic megacolon
plain abdominal x ray
colonoscopy and barium enema contraindicated bc they may cause perforatoin
pancreatic tissue encircling descending duodenum
annular pancreas
failure of ventral pancreatic bud to properly migrate and fuse w dorsal bud
spleen supplied by splenic artery which is derived from
foregut derivative
which arteris branch from splenic artery
short gastric
left gastroepiploic
right gastric artery from the
proper hepatic
gastric ulcers occur in what part of stomach
corpus
dxylose is a monosaccharide that can be absorbed directly
does not need pancreas to degrade it: pancreasee will secrete amylase to go from poly to mono saccahride
LDL receptors located in the
liver
preferred intial imaging test for acute cholecystisi
ULTRasonography
nuclear medicine hepatobiliary scanning (cholescintigraphy) used to assess
patent cystic duct
strictures seen in
crohn disease
stricutres are preseented with
hypertrophy of muscolaris mucosase, which narrows intestinal lumen; this can progress to bowel obstruction
histology: thickening of subepithelial collagen bond
collagenous (micrsocpic colitis)
system mastocystoiss: clonal mast cell proliferation mutation in
KIT receptor tyrosine kinase
system mastoctoiss causes an increase in
histamine
gastric hypersecretion
increased susceptibility of neuronal and ertyrocyte membranes to ox stress.
ataxia, impaired proprioception, vibratory sensation, hemolytic anemia;
deffieincy in what vitamin
Vit E
uniform cells
eosinophilic cytoplasm
oval to roudn stippled nuclei
carcinoid tumor
where can carcionid tumors found
appendix; tip of appendix; can cause appendicits
finely granular ,DIFFUSE ,homogenous pale pink cytoplasm
ground glass hepatocytes HEP B
clumped, amorphous eosinophilic intracytoplasmic inclusoins made up of tangled intermeidate filaments
mallory bodies
hepatic steaotsisi
elongation of lamina propria pappillae, basal zone hyperplasia, scattered eosinophils and neutrophils
geJ junction mcompetence
numerous supericially located intrapeithelail eosinophisl
eosionphilic esopahgits
absent peristaltic movemetns
systemic scerlosis
villous atrophy in celiac diseas causes what
nutrient absorption impairmetn
shrunk liver; widespread centrilboular necorsis and inflammation of portal tracts
lethal fulminant hepatitis; cant be disthignised from hepatiis
cauliflower mass in sigmoid colon
villous adenoma
villous adneomas can produce large quatnities of prostaglandin E2 which results in increased mcuin production and secretory diarrhea; mucin is a potassium rich glycoprotein; excessive prodcution: hypoproteiniemia hypokalemia
true
increased activity of GABA
hepatic encephalopathy
bacterial action on lactulose results in acidficiation of colonic contents which then converts absorbable ammonia into nonabsorbable ammonium ions, trapping it in the stool
true
in cirrhosis you have decreased BUN? why?
bc ammonia cannot be efficient converted to urea by failing liver
increased GI absorption of nitrogenous substances by gut
hepatic encephalopatyhy
GI bleeding causes increased nitrogen delivery to gut inn form of hemoglboin which is then converted into mamonia
loss of function mutation in the MTP gene
abetalipoproteinema : first few years of life
SIBO causes an increase in
vit k and folate
bile acids are reabsorbed in the
terminal ileum
thus in crohns’s loss of bile acids: fat malbsasorption: defiicney in a D E K
autoimmune hpeatitis
more often in women
more associated with UC
superficial upper glandular layer of gastric body and fundus houses
parietal cells
critically ill pt : inflammation of gallbladder; no gallstones
acalculous cholecystisi
fibrotic shrunken gallbladder
chronic cholecystisi
whcih vein drains blood from gastric fundus into spleni vein
short gastric vein into the splenic vein
AFFECTS ONLY THE GASTRIC FUNDUS
azygos vein drains blood from esophageal veins into
SVC
pancreaticoduodenal vein drains pancreas and duodenum into SMV. SMV also drains blood from lower stomach and small intestine; variceal formation in lower stomach
true
complete or partial obstruction of extrehepatic bile ducts in young child; elevated CB
biliary atresia
in first two weeks of birth breast milk jaundice increase in
indirect hyperbilirubinae
due to enzyme beta glucuronidase deconjugating bilirubin: increase absorption and increaesed enterohepatic ciruclation of bilirbuin
blood supply to colon from splenic flexure to upper rectum
inferior mesentric artery
supplies blood to pancreas and intestine from lower part of duodenum to first two thirds of transverse colon
superior mesentirc artery
