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Systems Pathology II Midterm > Intestines 1 > Flashcards

Intestines 1 Flashcards

1
Q

What is the most common location for an intestinal obstruction?

A

Small intestine

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2
Q

80% of all mechanical obstructions occur where?

A

Intestines

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3
Q

What is a herniation?

A

Abdominal wall defect leading to intestinal protrusion

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4
Q

What are the four types of intestinal obstructions?

A

1 herniation
2 adhesion
3 intussusception
4 volvulus

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5
Q

What are adhesions as seen in the intestines?

A

Inflammation leading to fibrosis of intestinal segments

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6
Q

What is intussusception?

A

Telescoping of the proximal bowel into the distal segment

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7
Q

What is volvulus?

A

Twisting a loop of bowel

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8
Q

What gender is more likely to develop a Meckel diverticulum?

A

Males (2X)

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9
Q

Meckel diverticulum is a congenital, blind-ended outputting of what organ?

A

Small intestine

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10
Q

Is Meckel diverticulum most commonly symptomatic or asymptomatic?

A

Asymptomatic

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11
Q

What is another name for Hirschsprung disease?

A

Congenital aganglionic megacolon

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12
Q

What is the location for Hirschsprung disease?

A

Rectum, sigmoid colon

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13
Q

What is Hirschsprung disease?

A

Lack of neurologic ganglia due to defective neural crest cell migration

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14
Q

How and when is congenital ganglionic megacolon diagnosed?

A

After failure to pass meconium

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15
Q

What is meconium?

A

First bowel movement

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16
Q

What is the gender bias associated with Hirschsprung disease?

A

More common in males

More severe in females

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17
Q

What is the treatment for Hirschsprung disease?

A

Surgical resection

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18
Q

What is another term for ischemic bowel disease?

A

Ischemic colitis

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19
Q

What arteries are involved with ischemic bowel disease?

A

Superior and inferior mesenteric

Celiac

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20
Q

What general things can cause ischemic bowel disease?

A

Thrombosis
Arterial embolism
Non-occusive ischemia

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21
Q

What are ways that IBD can occur by thrombosis?

A 
Atherosclerosis
Vasculitis
Hypercoagulability
Inflammation
Stasis (cirrhosis)
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22
Q

What are ways that IBD can occur by an arterial embolism?

A

Myocardial infarction
Angioplasty
Endarterectomy

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23
Q

What are ways that IBD can occur by non-occlusive ischemia?

A 
Heart failure
Hemorrhage (AAA)
Shock
Dehydration
Vasoconstrictive medications
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24
Q

What are miscellaneous ways that IBD can occur?

A

Volvulus
Dissecting aneurysm
Scarring/stricture

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25
Q

What type of IBD involves possibly hypovolemic shock and frank blood in stool?

A

Acute

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26
Q

What are the risk factors of IBD?

A

Elderly

Cardiovascular disease

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27
Q

What is the mortality rate for IBD, and what usually is the cause of death?

A

50%; septic or hypovolemic shock

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28
Q

What is the treatment IBD?

A

Prophylactic antibiotics
IV saline
Palliative care

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29
Q

What is the most common location for angiodysplasia in the intestines?

A

Cecum or ascending colon

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30
Q

What is angiodysplasia?

A

Malformed dilations and tortuous vessels

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31
Q

What is the hypothesis as to what causes angiodysplasia?

A

Mechanical stress like constipation

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32
Q

What is the location for hemorrhoids?

A

Anal and perianal vessels

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33
Q

What are hemorrhoids?

A

Dilated submucosal venous plexus

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34
Q

What is the most common vascular disorder of the GI tract?

A

Hemorrhoids

35
Q

What are the risk factors for hemorrhoids?

A

Anything that increases intra-abdominal pressure: pregnancy or constipation
Over 50 years old (rarely occurs in those under 30)

36
Q

What overlying condition can be a risk factor for the development of hemorrhoids?

A

Liver cirrhosis leading to portal hypertension

37
Q

What kind of hemorrhoids are found above the anorectal line? Below it?

A

Internal - above

External - below

38
Q

What are some signs and symptoms of hemorrhoids?

A

Perianal pruritus

Frank blood in stool

39
Q

How long does it take for hemorrhoids to heal on their own?

A

2-3 days

40
Q

What are the top three malabsorption conditions of the U.S.?

A

1 Pancreatic insufficiency
2 Celiac disease
3 Crohn’s disease

41
Q

Malabsorption issues manifest primarily as what symptom/sign?

A

Chronic diarrhea

42
Q

What is steatorrhea?

A

Excessive fat in feces

43
Q

What is the term for bloody diarrhea?

A

Dysentery

44
Q

What fecal appearances can be associated with malabsorption?

A

Steatorrhea

Dysentery

45
Q

What is the clinical term for the noise made by a growling stomach?

A

Borborygmus

46
Q

What are the other names for celiac disease?

A

Celiac sprue

Gluten-sensitive enteropathy

47
Q

What condition is a noninfectious malabsorption that is immune-mediated?

A

Celiac disease

48
Q

Celiac disease is technically a reaction to what substance?

A

Gliadin (byproduct from gluten found in grains)

49
Q

What cellular damage is seen in celiac disease?

A

Lymphocytes damage the villi of the duodenum and jejunum (villous atrophy)

50
Q

How is celiac disease diagnosed?

A

IgG and IgA antibodies

Biopsy

51
Q

What is a big risk factor for celiac disease?

A

Familial history (HLA-DQ2 or -DQ8)

52
Q

What is the most common age of diagnosis for celiac d disease?

A

30-60 years

53
Q

What race is more likely to be affected by celiac disease?

A

Caucasians (seen in 1% of the U.S. and Europe)

54
Q

Although rare, at what pediatric age is celiac disease sometimes diagnosed?

A

6-24 months

55
Q

What are the symptoms of celiac disease?

A

Steatorrhea, diarrhea, failure to gain weight, bloating, abdominal distention

56
Q

What kind of blood issue and symptoms can accompany celiac disease?

A

Iron-deficiency anemia; fatigue and pallor

57
Q

What is the treatment for celiac disease?

A

Gluten-free diet

58
Q

Those with celiac disease are at an increased risk for developing what type of cancer?

A

Intestinal adenocarcinoma

59
Q

10% of celiac disease patients go on to develop what skin condition?

A

Dermatitis herpetiformis

60
Q

What location of the body becomes affected by dermatitis herpetiformis?

A

Arms, elbows, legs, buttocks

61
Q

What was the previous name for environmental enteropathy?

A

Tropical sprue

62
Q

What population is most commonly affected by environmental enteropathy?

A

Children ages 2-3

63
Q

What cycles does one with environmental enteropathy go through?

A

Mucosal injury
Malnutrition
Inflammation

64
Q

How does environmental enteropathy negatively affected the children that get it?

A

Diarrhea/steatorrhea lead to weight loss

Nutritional deficiencies lead to stunted growth

65
Q

Environmental enteropathy affects 150 million people worldwide living in or traveling to what areas?

A

Tropics

66
Q

What is the hypothesis as to what causes environmental enteropathy?

A

Possible infectious because patients respond to antibiotics, but no microbe has been found

67
Q

What cellular change is seen in patients with environmental enteropathy

A

Villus flattening (hinting at autoimmune)

68
Q

What are other clinical terms for lactase deficiency?

A

Lactose intolerance

Disaccharidase deficiency

69
Q

When is lactase deficiency most commonly acquired?

A

Young adulthood

70
Q

What kind of reaction is seen when a patient who is lactose intolerant consumes dairy?

A

Bloating, cramping, gas, and/or diarrhea 30 minutes postprandial

71
Q

What is the problem with those who are lactose intolerant?

A

Decreased amounts of lactase or none at all at the S.I. brush border therefore making it unable to digest lactose (found in dairy products)

72
Q

How is lactase deficiency diagnosed?

A

Breath hydrogen test (biopsy of SI is unremarkable)

73
Q

What is the treatment for lactase deficiency?

A

Avoid lactose

Lactase supplements

74
Q

What is the most common location for a small intestine neoplasm?

A

Duodenum

75
Q

What are the signs and symptoms of a small intestine neoplasm?

A

Abdominal pain, nausea, vomiting, weight loss

76
Q

What is the most common acute abdominal condition?

A

Acute appendicitis

77
Q

What kind of discomfort is felt in the early stage of acute appendicitis?

A

Periumbilical/epigastric discomfort

78
Q

Tenderness in what area is felt in the late stage of acute appendicitis?

A

Right lower quadrant (deep/constant pain progressing into sharp pain)

79
Q

What is the gender and age bias associated with acute appendicitis?

A

Males 20-40 years of age

80
Q

What is the treatment for appendicitis?

A

Excision (appendectomy)

81
Q

What is the most common cause of cute appendicitis (50-80% of the time)?

A

Obstruction which decreases venous outflow and ischemia leads to inflammation

82
Q

What can cause death due to acute appendicitis?

A

Perforation

83
Q

What is the most common type of tumor of the appendix?

A

Carcinoid

84
Q

What can be present on the appendix mimicking a tumor?

A

Mucocele

Systems Pathology II Midterm (7 decks)

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