lecture 3 Flashcards
What are the 5 GI diseases in this lecture?
- Acute appendicitis
- Diverticular disease
- inflammatory bowel disease
- Polyps
- Colon cancer
What is the population for acute appendicitis? What is the onset? why should you seek medical emergency?
- the common disease affects ages 10-30
- Severe sudden right lower quadrent pain
- Have to seek medical emergency to avoid sepsis
- Rebound tenderness
- WBC Left shift aka more immature
- Histologically the lumen is fucked and the epithelium is damaged
What causes Acute appendicitis?
-Ischemia due to fecalith obstruction (SHIT)
leads to peritonitis and perforation
How to treat acute appendicitis?
- Surgical removal,
- laparoscopic excision (quadrant)
- use of antibiotics if its in the early stages aka no gangrene or perforation
What is Diverticulosis? Where does it occur? Target population and causes?
- Outpouching of mucosa through the muscularis.
- happens in tinea coli because of its weaker areas
- OLD PEOPLE common 50% over 60 have it
- Usually due to fecalith obstruction SHit again
- If perforation leads to peritinitis then its problem
What are the inflammatory bowel diseases? how are they distinguished?
Crohn’s disease and ulcerative colitis.
- They’re both autoimmune and have systemic manifestations
- Occur in adults more common women 15-40
- Distinguished via distribution of bowel lesions and the morphology
What is one of the pathogenisis of IBD?
NOD2 gene, encodes for proteins that bind to bacterial peptidoglycans and stimulates T cells and macrophages.
What is Crohn’s disease distinguishing factors?
Diarrhoea, not very grossly bloody
- Fever
- Course more chronic and may resemble Acute Appendicitis
- Involves small bowl and colon, patchy and episodic
- Crohns bowl is very thick like garden hose
- Granulomas
What are the distinguishing features of Ulcerative colitis?
- ATTACKS of bloody diahhrea
- numerous bowel movements a day with expulsion of shit
- Limited to colon and asshole
- Can increase the risk of colon cancer
- Severe crypt architecture fuck up
- Superficial haemorrhage
- Cryptitis
- Can show Pseudopolyps
What are the systemic manifestations of IBD?
-Aphthous ulcers and stomatitis
What are the 4 different types of intestinal polyps?
Peutz-Jeghers
- Adenomas
- Damilial poyposis
- Hereditary nonpolyposos colerectal cancer (HNPC)
What are the distinguishing features of P-J polyps?
Extraintestinal manifestioation such as muccocutaneous hyperpigmentation usually precedes Gastrointestinal presentations
- Can occur anywhere in GI tract
- Can be solitary and are pednuclated
- Arborizing (branches like a tree from musularis mucosa)
- Covering mucosa is normal
- Its dominantly inherited
What are the two types of Intestinal Adenomas?
Tubular (More common)
-Villus (usually in rectum and sigmoid colon)
What distinguishes Intestinal adenomas? The tubular and villus?
Tubular:
-More common, Multiple lesions and pednuclated, APC gene related
Villous:
- Usually in rectum and sigmoid colon
- Larger and sessile
- Greater risk for cancer than tubular
What is FAP or familial adenomatous polyposis?
faP so APC gene mutation. Extremely high risk for colon cancer
