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Gastrointestinal > Large intestines I > Flashcards

Large intestines I Flashcards

1
Q

What is the difference between diverticulosis and diverticulitis?

A

Diverticulosis is an outpouching. Diverticulitis is inflammation of that outpouching

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2
Q

What is the pathogenesis of diverticula?

A

Focal weakness in colonic wall, coupled with increased luminal pressure

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3
Q

What is the usual presentation of someone with diverticula?

A

Asymptomatic

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4
Q

What are the acquired form of diverticula?

A

Composed of mucosa, submucosa, with absent muscularis propria

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5
Q

What is the most common site of diverticula?

A

Sigmoid colon

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6
Q

Near what structures do diverticula usually form?

A

Mesenteric vessels d/t weakness in the wall of the intestines

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7
Q

What happens to the peristaltic contractions in with diverticula?

A

Overexaggerated

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8
Q

What are the three common causes of BRBPR?

A

Angiodysplasia
Diverticulitis
Hemorrhoids

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9
Q

What is the radiological findings of diverticula?

A

Sawtooth like appearance

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10
Q

What can happen if feces is stuck in one of the diverticula?

A

Fecalith can cause inflammation

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11
Q

What are the complications of diverticular disease?

A

Gross perforation
Abscesses
Fistulas
Peritonitis (if rupture)

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12
Q

Where do intestinal obstructions usually occur?

A

Small bowel

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13
Q

What are the causes of intestinal obstruction? (4)

A

Hernia
Adhesions
Intussusception
Volvulus

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14
Q

What are the three pseudo-obstruction causes?

A

Paralytic ileus
Vascular (bowel infarction)
Myopathies and neuropathies

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15
Q

What is the problem with hernias?

A

can becomes strangulated or incarcerated

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16
Q

True or false: volvulus is a medical emergency

A

True

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17
Q

Direct inguinal hernias occur where?

A

Hesselbach’s triangle

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18
Q

What are the border’s of hesselbach’s triangle?

A

Inguinal ligament
Inferior epigastric a
Lateral margin of the rectus sheath

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19
Q

What are indirect inguinal hernias?

A

Those that pass through the inguinal canal

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20
Q

What is the treatment for hernias?

A

Surgery with mesh

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21
Q

What is the cause of umbilical hernias?

A

Weakness of the rectus abdominus

Prego

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22
Q

What is diastasis recti?

A

Weakness of the rectus abdominus–usually presents in infants, and resolves on its own

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23
Q

What are adhesions?

A

Fibrous bridges between bowel segments or abdominal wall

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24
Q

What can cause adhesions?

A

Surgery

Infection/inflammation

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25
Q

What is the problems with adhesions?

A

Viscera may slide between the fibrous areas, it can become incarcerated an infarct

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26
Q

Where in infants does intussusception occur?

A

Small bowel

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27
Q

What causes the death of the intestines with intussusception?

A

Infarction secondary to vessel blockage

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28
Q

What does intussusception signify in adults?

A

Intraluminal mass or tumors as potin of traction

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29
Q

What is the cause of intestinal death with a volvulus?

A

Cut off blood supply

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30
Q

Where do volvuli usually occur?

A

SB in infants

SB and LB in adults

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31
Q

Why is it that the left side is more susceptible to obstruction?

A

Stool is harder and has lower water content

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32
Q

How does malabsorption usually present?

A

Diarrhea and steatorrhea

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33
Q

What is the cause of steatorrhea?

A

malabsorption of fat

34
Q

What is abetalipoproteinemia? Ssx?

A

Inability to make apoB100 (liver) and B48 (small intestinal), thus leading to steatorrhea

35
Q

What are the part of terminal digestion?

A

Hydrolysis of carbs and peptides by enzymes in the brush border of SB mucosa

36
Q

Where does intraluminal digestion begin?

A

Mouth with saliva

37
Q

What are the hematopoietic symptoms of malabsorption?

A

Macrocytic anemia (B12 and folate)

Bleeding (Vit K)

Microcytic anemia (Fe)

38
Q

What are musculoskeletal effects of malabsorption?

A

Osteopenia, tetany

39
Q

Which vitamin deficiency presents with neurological symptoms: b12 or folate?

40
Q

What are the three most common malabsorptive disorder in the US?

A

Celiac
Chronic pancreatitis
IBS

41
Q

What is the pathogenesis of celiac sprue?

A

T cell reaction to gliadin

42
Q

What are the genes implicated in celiac sprue?

A

DQ2, HLA B8

43
Q

What are the histology of celiac sprue?

A

Proximal villous atrophy

44
Q

What is the risk of celiac sprue?

A

T cell lymphomas

Carcinomas

45
Q

Giant cells = ?

A

Chronic inflammation

46
Q

What is tropical sprue? How do you treat it?

A

Tropical disease caused by bacteria overgrowth

Broad spectrum abx

47
Q

What is whipple disease?

A

Infection with tropheryma whippelii (gram + actinobacteria)

causes CNS and joint symptoms, malnutrition

48
Q

Where is tropheryma whippelii found?

A

within macrophages throughout the body

49
Q

The majority of tumors in the small and large intestines are of what origin?

A

Epithelial

50
Q

What is the most common type of cancer of the GI tract?

A

Adenocarcinoma and carcinoids

51
Q

What is the most common site for GI tumors?

52
Q

What are the most frequent benign tumors of the GI tract?

A

Adenoma

Mesenchymal tumors

53
Q

What is the most common cause of SB tumors?

A

FAP or Gardener’s syndrome

54
Q

What is the most common site of adenomas in the GI tract?

A

Ampulla of vater

55
Q

What is the characteristic growth pattern of small bowel carcinomas?

A

Napkin ring encircling pattern

56
Q

What are polyps? What causes them?

A

Small elevations of he mucosa; mass protruding into gut lumen

abnormal mucosal transformation

57
Q

Are most polyps benign or malignant?

58
Q

What is the most common neoplastic polyp?

A

Adenomatous polyp

59
Q

What are the three non-neoplastic polyps?

A

Hyperplastic polyps
Hamartomatous polyps
Inflammatory polyps

60
Q

What are hyperplastic polyps?

A

Normal tissue swollen up

61
Q

Where do hyperplastic polyps usually occur?

A

Rectosigmoid areas

62
Q

What is the cause of hyperplastic polyps?

A

Decreased epithelial cell turnover and delayed shedding

63
Q

What is the morphology of hyperplastic polyps?

A

Well formed glands and crypts, lined by non-neoplastic mature goblet and absorptive cells

64
Q

True or false: most hyperplastic polys have no neoplastic potential

65
Q

What are hamartomatous polyps?

A

focal hamartomatous malformations of mucosal epithelium and lamina propria

66
Q

Juvenile polyps are usually of what type?

A

Hamartomatous polyps

67
Q

in whom does retention polyps usually form?

68
Q

In what polyps in juvenile polyposis syndrome is the chance of developing into CA increased?

A

NOT in the hamartomatous polyps

69
Q

What is Peutz-Jeghers syndrome?

A

an autosomal dominant genetic disease characterized by the development of benign hamartomatous polyps in the gastrointestinal tract and hyperpigmented macules on the lips and oral mucosa

70
Q

What is the genetic cause of Peutz-Jeghers syndrome?

A

STK11 mutation

71
Q

What are the polyps of Peutz-Jeghers syndrome made of?

A

Smooth muscle, lined by intestinal epithelium

72
Q

What are patient with Peutz-Jeghers syndrome more susceptible to? (2)

A

Intussusception and carcinoma in many places in the body

73
Q

What are the oral findings of Peutz-Jeghers syndrome?

A

Hyperpigmented macules

74
Q

True or false: adenomas are precursor to colrectal CA?

75
Q

When do adenomas of the GI tract become adenocarcinomas?

A

When they penetrate the Basement membrane

76
Q

What are the four types of neoplastic polyps?

A

Tubular adenoma
Tubulovillous adenoma
Villous adenoma
Serrate adenoma

77
Q

What is the biggest prognostic factor for the malignancy risk with adenomas? What are the other, lesser two?

A

Size

Histological architecture
Severity of dysplasia

78
Q

What are tubular adenomas?

A

stalk with piled up cells on top (strawberry on a stick)

79
Q

What are villous adenomas?

A

Flat carcinoma with finger like projections coming up

80
Q

What are serrated adenomas?

A

Saw tooth pattern that lacks dysplastic features

Gastrointestinal (42 decks)

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