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GENPATH > GIT 2 Doc Villaroya > Flashcards

GIT 2 Doc Villaroya Flashcards

1
Q

Serosa-lined pouch of peritoneum

A

Hernial sac

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2
Q

Acquired hernias typically occurs ____ via the ___ (enumerate the 3)

A

Anteriorly, via the:
1. Inguinal and Femoral canals
2. Umbilicus
3. Site of surgical defects

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3
Q

It is the most frequent cause of intestinal obstruction

A

Hernias

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4
Q

Pressure at the __ of the pouch may impair the venous drainage of the entrapped viscus

A

Neck

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5
Q

Caused by surgical procedures, infection, or other causes of peritoneal inflammation

A

Adhesions

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6
Q

Where do adhesions usually occur?

A
  1. Between bowel segments
  2. Abdominal wall
  3. Operative sites
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7
Q

Sequelae, including obstruction and strangulation, are similar to _____

A

External hernias

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8
Q

This occurs when a loop of bowel twists about its mesenteric point of attachment and results in both luminal and vascular compromise

A

Volvulus

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9
Q

Volvulus presents with features of both ___ and ____

A

Obstruction and Infarction

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10
Q

Volvulus occurs most often in the ___

A

Large redundant Loops of the sigmoid colon

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11
Q

This occurs when a segment of the intestine, constricted by a wave of peristalsis, telescopes into the immediately distal segment

A

Intussusception

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12
Q

Untreated intussusception may progress to __, ___, and ___

A
  1. Intestinal obstruction
  2. Compression of mesenteric vessels
  3. Infarction
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13
Q

It is the most common cause of intestinal obstruction in children younger than 2 years of age

A

Intussusception

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14
Q

Intussusception is generally caused by an ____, that serves as the initiating point of traction.

A

Intraluminal mass or tumor

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15
Q

It can be used both diagnostically and therapeutically for idiopathic intussusception in infants and young children

A

Contrast enemas

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16
Q

Majority of the GI tract is supplied by the (enumerate 3)

A
  1. Celiac
  2. Superior mesenteric
  3. Inferior mesenteric arteries
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17
Q

In a large majority of cases, acute obstruction is caused by ___

A

Thrombosis or embolism

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18
Q

Most important risk factor for thrombosis

A

Severe atherosclerosis

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19
Q

Less common cause of thrombosis

A

Systemic vasculitides

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20
Q

Obstructive emboli most commonly originate from __

A

Aortic atheromas or Cardiac mural thrombi

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21
Q

Two phases of intestinal response to ischemia

A
  1. Hypoxic injury
  2. Reperfusion injury
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22
Q

What are the 3 major variables that determine the severity of ischemic bowel disease

A
  1. Severity of vascular compromise
  2. Time frame during which it develops
  3. Vessels affected
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23
Q

Watershed zones include:

A
  1. Splenic flexure
  2. Sigmoid colon and rectum
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24
Q

What terminates at the splenic flexure?

A

Inferior and Superior Mesenteric Arterial Circulations

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25
Q

What terminates at the sigmoid colon and rectum?

A

Inferior mesenteric, pudendal, and iliac arterial circulations

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26
Q

It can cause localized injury at watershed zones

A

Generalised hypotension or hypoxemia

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27
Q

These are cells found within the crypts and are necessary for recovery from epithelial injury

A

Epithelial stem cells

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28
Q

What is the morphologic signature of ischemic intestinal disease

A

Surface epithelial atrophy with normal or hyperproliferative crypts

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29
Q

Most common site of GI ischemia

A

Colon

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30
Q

Chronic ischemia is accompanied by fibrous scarring of the ____

A

Lamina propria

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31
Q

8n both acute and chronic ischemia, bacterial superinfection and enterotoxin release may induce ____, that resembles ____

A
  1. Pseudomembrane formation
  2. Clostridioides difficile - associated pseudomembranous colitis
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32
Q

It typically presents with sudden onset of cramping, left lower abdominal pain, desire to defecate, and passage of blood or blo9dy diarrhea

A

Acute colonic ischemia

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33
Q

What supplies theright side of the colon?

A

Superior mesenteric artery

34
Q

It may be the initial presentation of more widespread compromise of intestinal perfusion

A

Right-sided colonic ischemia

35
Q

This may progress to more extensive and transmural infarction if the vascular supply is not restored by correction of the insult

A

Limited zones of mucosal and mural infarctions

36
Q

It may masquerade inflammatory bowel disease with episodes of bloody diarrhea interspersed with periods of healing

A

Chronic ischemia

37
Q

It causes ischemic GI disease due to viral tropism for endothelial cells and resulting localized vascular obstruction

A

CMV infection

38
Q

It occurs when the GI tract irradiated and is due to a combination of epithelial and endothelial injury

A

Radiation enterocolitis

39
Q

Its presence within the stroma may provide an important clue to the etiology of radiation enterocolitis

A

Radiation fibroblasts

40
Q

This manifests as anorexia, abdominal cramps, and malabsorptive diarrhea

A

Acute radiation enteritis

41
Q

This type of radiation enterocolitis is often more indolent and may present as an inflammatory enterocolitis

A

Chronic radiation enteritis

42
Q

It is an acute disorder of the small and large intestines that can result in transmural necrosis. It is also the most common acquired GI emergency of neonates

A

Necrotizing enterocolitis

43
Q

It is characterized by malformed submucosal and mucosal blood vessels that are dilated and thin walled

A

Angiodysplasia

44
Q

It has the largest diameter of any colonic segment, thus it develops the greatest wall tension

A

Cecum

45
Q

It is characterized by defective absorption of fats, fat-and water soluble vitamins, proteins, carbohydrates, electrolytes and minerals, and water.

A

Malabsorption

46
Q

Hallmark of malabsorption

A

Steatorrhea

47
Q

It is defined as an increase in stool mass, frequency, or fluidity, typically greater than 200g per day

A

Diarrhea

48
Q

Painful, bloody, small stool diarrhea

A

Dysentery

49
Q

It is a diarrhea that is characterized by isotonic stool and persists during fasting

A

Secretory diarrhea

50
Q

It is a diarrhea caused by excessive osmotic force by unabsorbed luminal solutes. It abates with fasting

A

Osmotic diarrhea

51
Q

It is a diarrhea that follows generalised failure of nutrient absorption, associated with steatorrhea and is relieved with fasting

A

Malabsorptive diarrhea

52
Q

It is a diarrhea due to inflammatory disease and is characterized by purulent, often bloody stools that continue during fasting

A

Exudative diarrhea

53
Q

Cystic fibrosis primarily affects the ___

A

Lungs

54
Q

It is an immune-mediated disorder triggered by the ingestion of gluten-containing foods in genetically predisposed individuals

A

Celiac disease

55
Q

It is the alcohol-soluble fraction of gluten that contains most of the disease-producing components

A

Gliadin

56
Q

It triggers the activation of CD8+ intraepithelial lymphocytes

A

Il-15

57
Q

These cells are expressed by the lymphocytes and is defined as a natural Killer cell marker and receptor for MIC-A

A

NKG2D

58
Q

It is a disorder prevalent in areas and populations with poor sanitation and hygiene

A

Environmental Enteric Dysfunction

59
Q

It is an x-linked disorder characterized by severe persistent diarrhea and autoimmune disease that occurs most often in young children

A

Autoimmune enteropathy

60
Q

It is an autosomal recessive disorder caused by a mutation in the gene encoding lactase

A

Congenital lactase deficiency

61
Q

It is a disorder caused by downregulation of lactase gene expression

A

Acquired lactase deficiency

62
Q

It is an autosomal recessive disorder of vesicular transport that leads to deficient brush-border assembly, it is sometimes referred as “Davidson disease”

A

Microvillus Inclusion Disease

63
Q

Microvillus Inclusion Disease is caused by mutations in the ____

A

MYO5B gene

64
Q

It is a rare autosomal recessive disease characterized by an inability to assemble triglyceride-rich lipoproteins

A

Abetalipoproteinemia

65
Q

Abetalipoproteinemia is caused by a mutation in ___

A

Microsomal Triglyceride Transfer Protein (MTP)

66
Q

It is the most common cause of lower intestinal bleeding in those older than 60 years old

A

Angiodysplasia

67
Q

It is the fourth most common cause of death worldwide

A

Diarrheal disease

68
Q

It is the most common bacterial enteric pathogen in high income countries and is an important cause of traveler’s diarrhea and food poisoning

A

Campylobacter jejuni

69
Q

What are the 4 major properties that contribute to virulence

A
  1. Motility
  2. Adherence
  3. Toxin production
  4. Invasion
70
Q

Campylobacter infection can result in reactive arthritis primarily in patients with ____

A

HLA-B27 genotype

71
Q

It is one of the most common causes of bloody diarrhea

A

Shigellosis/Shigella spp

72
Q

Most common cause of salmonellosis

A

Salmonella enteritidis

73
Q

Infections are most frequently linked to ingestion of pork, raw milk, and contaminated water and tend to cluster in the winter

A

Yersinia

74
Q

Fatal complication of psedomembranous colitis

A

Toxic megacolon

75
Q

Most common cause of non bacterial gastroenteritis

A

Norovirus

76
Q

Common cause of pediatric diarrhea

A

Adenovirus

77
Q

Cause decreased expression of brush-border enzymes, microvillus damage, and apoptosis of small intestinal epithelial cells

A

Giardia lamblia

78
Q

It is characterized by chronic, relapsing abdominal pain, bloating, and changes in bowel habits

A

Irritable Bowel Syndrome

79
Q

It is a chronic condition resulting from complex interactions between intestinal microbiota and host immunity in genetically predisposed individuals

A

Inflammatory Bowel Disease

80
Q

Cases where features of both Crohn disease and ulcerative colitis overlap

A

Indeterminate colitis

81
Q

This occurs following allogeneic hematopoietic stem cell transplantation

A

Graft-Versus-Host Disease

GENPATH (2 decks)

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