Lecture 7.1 Highlights Flashcards
Aphthous Ulcers (Canker Sores):
1) Etiology?
2) Timeframe?
1) Unknown
2) 7-10 days
Herpes virus Infection:
1) When is it reactivated?
2) Where can it occur?
1) Reactivated when there is a compromised host resistance
2) Hard palate, buccal mucosa , gingiva, and lips
Immunosuppression and microbiota disruption commonly cause what?
Candida albicans
The 2 pathogenic pathways of SCC are what?
1) Exposure to carcinogens (i.e. tobacco, ETOH)
2) HPV infection
Sialadenitis: What is the name for a blockage or rupture of the salivary gland duct [that may cause it]?
Mucocele
Achalasia: What is the triad of pathology?
1) Incomplete relaxation of LES
2) ↑ LES tone
3) Esophageal aperistalsis
Achalasia: What are the 2 types? Describe
1) Primary: failure of distal esophageal inhibitory neurons
2) Secondary: degenerative changes in the vagus nerve or dorsal motor nucleus of the vagus nerve.
What is the pathophysiology of esophageal varices? (4 steps)
1) Impedance of portal blood flow (in portal vein) →
2) portal hypertension →
3) portal blood to shunt to caval system →
4) ↑subepithelial/submucosal venous plexus in the distal esophagus
Esophageal varices:
1) Who is it common in?
2) Is it an emergency?
1) Cirrhotic patients (from alcohol); most commonly in association with alcoholic liver disease
2) Medical emergency! (rupture)
What happens to tone and pressure with GERD?
↓ LES tone
↑ abdominal pressure
Eosinophilic esophagitis: list 2 important characteristics
Chronic; marked eosinophil superficial epithelium
Barrett Espohagus:
1) What is it?
2) What does it confer an increased risk of?
1) Intestinal metaplasia in the esophageal squamous mucosa (squamous to columnar)
2) Esophageal adenocarcinoma
1) What is the most common esophageal tumor worldwide?
2) What are the majority (in US & Europe) the result of?
1) Squamous Cell
2) The use of ETOH and tobacco.
1) How prevalent is adenocarcinoma?
2) Where does it come from?
3) How does it present?
1) “On the rise”
2) Barrett’s and GERD
3) Pain, difficulty swallowing, progressive weight loss.
Chronic gastritis:
1) What is the most common etiology?
2) What are 2 other causes?
1) H. pylori.
2) NSAID’s & ETOH
Peptic Ulcer Disease(PUD):
1) 2 most common causes?
2) How can it heal?
1) H. pylori and NSAID use
2) -Suppression of gastric acid
d/c NSAID
-H. pylori eradication
Describe a way Insufficient inhibitions of stimulatory mechanisms such as gastrin can occur
Zollinger Ellison syndrome: multiple ulcers caused gastrin-producing tumors
Hirschsprung Disease (congenital aganglionic megacolon):
1) What 2 things cause the congenital defects in colonic innervation?
2) What 2 things are absent?
3) What is the Tx?
1) Mutations if the receptor tyrosine kinase RET most common
Defective neural crest cell migration from cecum to rectum
2) Lack of Meissner plexus (submucosal) and Auerbach plexus (myenteric) responsible for coordinated peristalsis [bc of neural crest issue]
3) Aganglionic segment surgical resection
1) What are diverticula?
2) What may diverticulitis lead to?
3) Where may diverticulitis pain occur?
1) Outpouchings
2) Perforation
3) LLQ pain
List 3 potential Sx of bowl obstructions
1) ABD pain/distention
2) Vomiting
3) Constipation
The most common cause of bowel obstruction in children < 2 years old that you should treat with and air or barium enema is called ____________.
intussusception
Bowl obstruction causes:
1) How is herniation a cause?
2) Which cause is most likely to occur with the sigmoid colon?
3) Which cause is most common in kids?
1) Herniation: incarceration leads to strangulation
3) Volvulus (twisting)
4) Intussusception
The 5 major types of diarrheal diseases are what?
1) Secretory: excessive secretion of intestinal fluid; i.e.,infections, tumors, excess laxative use
2) Osmotic: something in bowel is drawing water from the body into the bowel; i.e., antacids
3) Exudative: presence of blood and pus in the stool; i.e., infections, inflammatory bowel diseases
4) Malabsorption-related: defective digestion, reduced surface of small intestine, infections
5) Deranged motility: surgery, neural dysfunction, infections
Malabsorption Syndromes:
1) What is the hallmark of a lot of the manifestations?
2) List 3 examples
1) Steatorrhea
2) Celiac disease, pancreatic insufficiency, + Chron disease
What can consuming gluten containing grains with Celiac cause?
Loss of brush border surface area
[affects luminal and terminal digestion]
Lactase deficiencycauses an________________ bc of inability to break down or absorb lactate
osmotic diarrhea
Infective enterocolitis:
1) Vibrio choleraesecretes a preformed toxin that causes massive ___________ secretion.
2) Water follows the resulting osmotic gradient, leading to ____________ diarrhea
1) chloride
2) secretory
Infective enterocolitis: Most isolates of Campylobacter jejuni(traveler’s diarrhea cause) are ______________ (GB)
noninvasive
Infective enterocolitis: SalmonellaandShigellaspp. are invasive and associated with exudative ____________ diarrhea (dysentery).
bloody
Infectious Enterocolitis: Pseudomembranous colitis is often triggered by antibiotic therapy that disrupts the normal microbiota and allows_________________ to colonize and grow (hint: linked to abx use; wash hands)
C. difficile
Infectious Enterocolitis: the most common cause of severe childhood diarrhea is what?
Rotavirus
__________ and ____________ infections affect over half of the world’s population on a chronic or recurrent basis (stool studies can uncover)
Parasiticandprotozoal
1) What is a condition that involves complex interactions between host and microbiota and requires genetic predisposition?
2) What does this condition result in?
1) Inflammatory Bowel Disease
2) Inappropriate mucosal immune activation
Inflammatory Bowel Disease can result in inappropriate _____________ activation
mucosal immune
Risk of colonic epithelial dysplasia & ______________ ↑ if patient has 8-10+ year h/o IBD
adenocarcinoma
Crohn disease, describe the:
1) Site of origin
2) Pattern of progression
3) Thickness of inflammation
1) Terminal ileum
2) “Skip” lesions/ irregular
3) Transmural
Ulcerative colitis, describe the:
1) Site of origin
2) Pattern of progression
3) One complication
4) Risk of colon cancer
1) Rectum
2) Proximally contiguous
3) Toxic megacolon
4) Marked increase
True or false: diarrhea is usually not a Sx of appendicitis
True
List 2 genetic factors that play a role in colon cancer
1) Familial adenomatous polyposis
2) Lynch syndrome (Hereditary non-polyposis colon cancer)
True or false: Chron disease is a spectrum disease
True
