GIT: Small Intestine Flashcards
Meckel diverticulum is caused by incomplete _____
Meckel diverticulum is caused by incomplete involution of vitelline duct
describe how Meckel diverticulum is an example of heterotopia
Meckel diverticulum contains gastric mucosa and pancreatic tissue
describe complications of Meckel diverticulum
- complications:
- hemorrhage and peptic ulcer
- intestinal obstruction
- diverticulitis
- perforation
- fistula
describe intestinal changes that occur in celiac sprue
- typical: villous atrophy (reduced area for absorption)
- increased intraepithelial lymphocytes
- elongated and hyperplastic crypts
- increased lymphocytes, macrophages, plasma cells in lamina propria
describe the pathogenesis of celiac sprue
describe the image
describe serologic tests done in celiac sprue
- serologic tests:
- anti-gliadin and anti-endomysial antibodies
- anti-tissue transglutaminase (tTG) antibodies
name the HLA genotypes associated with celiac sprue
HLA-DQ2 (majority) and HLA-DQ8
in patients with celiac sprue, there is a long-term risk of ____
in patients with celiac sprue, there is a long-term risk of intestinal T-cell lymphomas
describe tropical sprue (post-infectious sprue)
- pathogenesis related to bacterial infection superimposed on pre-existing small intestine injury
- as opposed to celiac sprue, all parts of small intestine equally involved
- responds to antibiotics
as opposed to celiac sprue, in tropical sprue, ____
as opposed to celiac sprue, in tropical sprue, all parts of small intestine are equally involved
describe Whipple disease
- mainly involves intestine, joints and CNS
- G+ve sickle-shaped bacteria
- mucosa laden with distended macrophages in lamina propria; contain PAS positive granules
- may have granulomatous inflammation
- treated with antibiotics
Whipple disease is caused by _____
Whipple disease is caused by G+ve sickle-shaped bacteria (Tropheryma whippelii)
describe the image
Whipple disease
describe Giardia
-
protozoan gut pathogen with flagellum
- trophozoites and cysts are shed
- usually acquired from drinking water contaminated with cysts
- poor sanitation and crowded living conditions predispose to infection
- immunosuppression increases risk
describe predisposing factors for luminal obstruction
- predisposing factors:
- false teeth
- gastrectomy
- intestinal adhesions
- inadequate mastication and large amounts of food
list therapeutic agents that can lead to luminal obstruction
barium sulphate and antacid gels
___, or ingested hairs, can cause luminal obstruction
bezoars, or ingested hairs, can cause luminal obstruction
roundworms, such as _____, can cause luminal obstruction
roundworms, such as Ascaris lumbricoides, can cause luminal obstruction
list 2 endogenous origins of luminal obstruction
-
meconium ileus in infants with CF
- thick mucus at mid-terminal ileum
-
gallstone ileus
- usually a stone >2.5 cm in diameter lodges in terminal ileum
- usually through cholecystoduodenal fistula
- rarely small stone grows in biliary tree
list the 3 conditions of the small intestine that lead to ischemia
- volvulus
- strangulated hernia
- gangrene
describe acute appendicitis
- inflammation of the appendix
- underlying obstruction of the lumen in 50-80% of cases
list the complications of acute appendicitis
- complications:
- perforation
- peritonitis
- periappendiceal abscess
- liver abscess
- bacteremia
describe an adenoma, a low-grade appendiceal mucinous neoplasm (LAMN), and a mucinous adenocarcinoma
- adenoma:
- confined to lumen, wall normal
- LAMN:
- mucin, epithelium in wall; non-destructive
- can metastasize to ovary and peritoneum
- mucinous adenocarcinoma:
- high-grade, destructive invasion
describe a pseduomyxoma peritonei
- peritoneal involvement by mucinous implants
- most: appendix
- low-grade tumors (LAMN)
- abundant mucin
- scant low-grade neoplastic epithelium
- high-grade tumors (mucinous adenocarcinoma)
- abundant malignant epithelial cells
- signet ring cells can be present