Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI Week 3 > ICL 13.4: Disorders of the Small Intestine > Flashcards

ICL 13.4: Disorders of the Small Intestine Flashcards

1
Q

glossitis

A

plummer vincent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

multiple ulcers in the GI tract, diarrhea, increased gastric acidity, high gastrin levels

A

zollinger-elefson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

immunosuppressed patient with ulcers in the esophagus

A

CMV = ulcers

candida is a dirty, grey membrane, not ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

11/18 translocation

A

MALT lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Kukenburg tumor

A

ovarian mets from gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Kirchow node

A

left supraclavicular lymph nodes

enlarged in gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Barrett esophagus

A

squamous to columnar metaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

premalignant condition in the stomach

A

atrophic gastritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

protein losing gastropathy

A

Meinitrier disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

trichoboazar

A

hair balls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

produces urease

A

H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

tinitis plastica

A

involves entire thickness of the wall; it’s infiltrating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

63 year old chronic alcoholic with massive hemetemesis

A

esophageal varices

they happen due to portal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

signet ring cells

A

diffuse gastric cancer; gastric type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the congenital anomalies of the small intestine?

A
  1. heteroptopia
  2. atresia and stenosis
  3. Meckel diverticulum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is heteroptopia?

A

usually pancreas, but can be gastric mucosa appearing as small nodules in the mucosa or intestinal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is atresia and stenosis?

A

duodenal atresia is most common, followed by jejunum and ileum

stenosis can also be acquired e.g. intussusceptions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is Meckel diverticulum?

A

failure of the vitelline duct (connects the developing gut to the yolk sac) to involute

found on the anti-mesenteric side of gut within two feet of ileocecal valve

contains all three layers of normal bowel wall = true diverticulum!!

heterotopic rests of gastric or pancreatic tissue found in 50% –> peptic ulceration –> bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the complications of Meckel diverticulum?

A
  1. intussusception
  2. incarceration
  3. perforation

most are incidental findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is diarrhea?

A

an increase in stool mass, frequency or fluidity in most patients

characterized by pain, urgency, perianal discomfort and incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is dysentery?

A

low-volume, painful, bloody diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is secretory diarrhea? what bugs can cause it?

A

passage of >500 ml/day of watery stools, isotonic with plasma

ex. rotavirus, E. coli, V. cholaerae, villous adenomas and excessive laxative use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is osmotic diarrhea? what causes it?

A

pssage of > 500 ml/day of stools, osmolality exceeds that of plasma by > 50 mOsm

ex. lactase deficiency and antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are exudative diseases? what bugs cause it?

A

the passage of frequent purulent, bloody stools

ex. Shigella, Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is malabsorption? what conditions cause it?

A

bulky stools with excess fat that floats on the water (steatorrhea) and increased osmolality

ex. Celiac Sprue and Crohn disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is deranged motility? what causes it?

A

improper gut neuromuscular function causes variable patterns of increased stool volume

ex. surgical reduction of bowel length, diverticula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is infectious enterocolitis?

A

intestinal diseases of microbial origin

characterized by diarrhea and in some instances ulceration of the bowel

causes >12,000 deaths per day among children in developing countries and equals ½ of all deaths before age 5 worldwide

28
Q

a 7 year old boy present with watery diarrhea for 3 days. He reports that two if his best friends at school have the problem.

diagnosis?

A

viral infection! probably norwalk virus

watery diarrhea = infection = cholera or viral infection –> cholera is really more of a 3rd world country disease so this kid doesn’t have it

29
Q

which viruses can cause infectious enterocolitis?

A
  1. rotaviruses (infants)*
  2. norwalk virus*

school aged children; sometimes adults –> Norwalk virus is responsible for the majority of cases of nonbacterial food-borne epidemic gastroenteritis in all age groups

  1. adenovirus (infants)
  2. astroviruses (children)
30
Q

after an office potluck 5 members of the staff start vomiting and have diarrhea 3 hours after lunch where they ate egg and chicken salads.

diagnosis?

A

food poisoning caused by staph aureus!!

staph has really fast onset infections due to preformed toxins; salmonella and shigella take 3-4 days before symptoms present

31
Q

which bugs can cause food poisoning?

A

BACTERIA
1. e. coli (food borne; invasive & non-invasive forms)

  1. vibrio cholerae (water borne; enterotoxin –> secretory diarrhea)
  2. S. aureus* (food poisoning; preformed toxin)
  3. salmonella and shigella (invasive bloody diarrhea; toxins)
  4. typhoid fever
  5. MAI (AIDs associated)
  6. clostridium difficile (antibiotic associated colitis)

PARASITES
1. giardia lamblia* –> malabsorption; steatorrhea

  1. entamoeba histolytica* –> bloody diarrhea; dysentery
32
Q

what is the clinical presentation of a c. diff infection?

A

65 year old woman comes in with bloating and severe purulent diarrhea and a week ago she was hospitalized for pneumonai

she has pseudomembranous colitis caused by antibiotics!

33
Q

a 25 year old medical student presents with steatorrhea and abdominal pain 3 weeks after his return from spring break where he vacationed with his friends I the Grand Cayman.

diagnosis?

Tests:

A

giardia

steatorrhea = malabsorption

34
Q

how is AIDS associated with diarrhea?

A

there is diarrheal illness in 50% of AIDS patients in developed countries

some malbsorption, some ulcerative colitis, infections with other organisms; possibly due to HIV mucosal damage, itself

35
Q

how are transplants associated with transplants?

A

bone marrow transplants have high rates of diarrhea due to graft vs. host reaction

36
Q

what miscellaneous things can cause diarrhea?

A
  1. drugs
  2. radiation
  3. neutropenic colitis
37
Q

what is malabsorption?

A

characterized by suboptimal absorption of fats, fat-soluble and other vitamins, proteins, carbohydrates, electrolytes and minerals, and water

38
Q

what is the pathogenesis of malabsorption? what conditions are associated with each cause?

A
  1. defective intraluminal digestion
    ex. pancreatic insufficiency, Zollinger-Ellison syndrome, bacterial overgrowth
  2. primary mucosal cell abnormalities
    ex. defective terminal digestion (lactose intolerance*), defective epithelial transport (abetalipproteinemia)
  3. reduced small intestinal surface area
    ex. Chrohn disease, celiac sprue
  4. lymphatic obstruction
    ex. TB, lymphoma
  5. infections
    ex. Whipple disease*, tropical sprue
  6. iatrogenic
    ex. gastrectomy, distal ileal resection
39
Q

what is the clinical presentation of malabsorption?

A
  1. chronic diarrhea and steatorrhea = bulky, frothy, greasy, foul smelling stools
  2. weight loss
  3. anorexia
  4. abdominal pain

if multiple systems are involved and it’s prolonged, it can lead to these symptoms due to vitamin deficiencies:

  1. anemia
  2. petechiae
  3. hemorrhages
  4. dermatitis
  5. bone pain
  6. peripheral neuropathy
  7. latent tetany
  8. menstrual and reproductive disturbances

in the USA, US pancreatic insufficiency, Celiac Sprue and Crohn disease are most important

40
Q

a 60 year old male presents with bloating, diarrhea and arthralgias for six months.

PE: Hyperpigmented patches of his hands and neck

mini mental exam reveals some confusion

diagnosis?
tests?

A

Whipple disease

joint, skin, neuro problems

41
Q

what is whipple disease?

A

a rare systemic disease of primarily the intestines, joints, and CNS

caused by gram-positive actinomycete, Tropheryma whippelii

pathogenesis unknown

patients are usually white, M:F = 10:1, 40-50 years of age

once neuro manifestations have happened, you can reverse everything else except the neuro symptoms

42
Q

how do you diagnose whipple disease?

A

lamina propria is laden with distended macrophages, containing tiny rod-shaped bacilli that are PAS positive!!!!

43
Q

what is the clinical presentation of whipple disease?

A
  1. malabsorption syndrome
  2. anthropathy is often the initial presentation = joint disease
  3. lymphadenopathy
  4. hyperpigmentation
  5. polyarthritis
  6. cardiac and neurologic signs

responds to broad spectrum antibiotics

44
Q

a 40 year old African American lady present with a chronic complaint of bloating and excessive gas especially after she eats pizza at the weekly bingo evening at her church

diagnosis?

pathogenesis?

A

disaccharidase (lactase) deficiency

african america, bloating, pizza

45
Q

what is lactase?

A

disaccharidase is an apical membrane enzyme that cleaves lactose

if you don’t have lactase, lactose builds in the gut lumen which leads to osmotic purgative effective causing osmotic diarrhea and malabsorption!

46
Q

what is the pathogenesis of lactase deficiency?

A

incomplete breakdown of disaccharide (lactose) into glucose and galactose leads to osmotic diarrhea

bacterial fermentation of unabsorbed sugar leads to increased hydrogen production and gaseous symptoms

47
Q

what are the 2 forms of lactase deficiency?

A
  1. congenital form

2. acquired form

48
Q

what is the congenital form of lactase deficiency?

A

presents in infants on exposure to milk or milk products

explosive, watery diarrhea and abdominal distension that stops when taken off milk

49
Q

what is the acquired form of lactase deficiency?

A

more common

adults, blacks and Native Americans > whites; sometimes related to viral or bacterial enteric infection

50
Q

75 year old hypertensive, hyperlipidemic diabetic patient prestns with sever diffuse abdominal pain and bloody diarrhea for 2 days.

PE: tenderness and guarding lower abdomen

diagnosis?

A

ischemic bowel disease

he has atherosclerosis of blood vessels that led to ischemia

bloody diarrhea from infarcted intestine

51
Q

what is ischemic bowel disease?

A

can be restricted to either the small or large intestine, or both

infarctions seen with acute occlusion of celiac, superior and inferior mesenteric arteries

insidious loss of one vessel may go unnoticed due to rich anastomoses

52
Q

what are the causes of ischemic bowel disease?

A
  1. arterial thrombosis
  2. arterial embolism
  3. venous thrombosis
  4. nonocclusive ischemia; e.g. cardiac failure, shock, etc.
  5. radiation injury
  6. volvulus
  7. stricture
53
Q

what are the types of lesions you can see in ischemic bowel disease?

A
  1. transmural infarction
  2. mural and mucosal infarction
  3. chronic ischemia
54
Q

what are transmural infarction in ischemic bowel disease?

A

all layers due to sudden occlusion of major vessels

bowel is swollen, gangrenous and perforates in few days

55
Q

what are mural and mucosal infarctions in ischemic bowel disease?

A

most commonly due to hypoperfusion in watershed areas

necrosis of mucosa only; mucosa hemorrhagic; serosa normal

56
Q

what is chronic ischemia in ischemic bowel disease?

A

mucosal atrophy; ulcerations; mural fibrosis

can lead to stricture

57
Q

what are the clinical features of ischemic bowel disease?

A

short time between symptoms and perforation so if you think they have ischemia you have to act quickly!!

TRANSMURAL INFARCTS
1. sudden severe abdominal pain and tenderness; sometimes nausea, vomiting and bloody diarrhea or melena

  1. shock and vascular collapse in hours
  2. peristalsis is diminished

MUCOSAL/MURAL INFARCT
1. may not be fatal if cause corrected

  1. nonspecific abdominal complaints and intermittent bloody diarrhea, but may progress to extensive infarction & sepsis

CHRONIC ISCHEMIA
insidious with intermittent bloody diarrhea, resembling inflammatory bowel disease

58
Q

PAS positive rods

A

whipple disease

59
Q

osmotic diarrhea

A

lactose intolerance

60
Q

bloody painful low volume diarrhea

A

desentery

infection with entamoeba

61
Q

rotavirus

A

infant diarrhea

62
Q

giardia

A

malabsorption

63
Q

norwalk virus

A

school aged kid diarrhea

64
Q

16 year old African American high school junior presents with bloating, excessive gas 4 hours after enjoying ice cream and cake at her best friend birthday party.

diagnosis?

A

lactase deficiency

bloating and gas because the bacteria is fermenting the lactose that isn’t being cleaved into glucose

65
Q

56 year old male presents with mental confusion for six months and hyperpigmentation of his hands he also reports foul smelling diarrhea.

diagnosis?

A

whipple disease

due to T. whippelii PAS gram + rods in macrophages in the lamina propria of the intestine

66
Q

Mom brings in her 3 month old infant as she has noticed watery diarrhea for the last 3 days he goes to a baby sitter who takes care of five other infants.

daignosis?

A

rotavirus

GI Week 3 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions