Part 2 GI Flashcards
What are some causes to ischemic bowel disease?
Acute arterial obstruction/thrombosis
Mesenteric venous thrombosis
Hypoperfusion
Basically…there is ischemia…
Which bowel segments are most likely to be effected by ischemic bowel disease?
At the end of an arterial supply:
Splenic flexure
Sigmoid colon
Rectum
What are some complications of transmural bowel necrosis?
Sepsis –> shock (maybe) –> death (it could happen)
What causes the complications of transmural bowel necrosis?
Breakdown of mucosal barrier…makes sense…look at the name
What is angiodysplasia?
Malformed submucosal and mucosal blood vessels
What is the presentation of angiodysplasia?
GI bleeding
If acute…then massive bleeding
If chronic…then intermittent bleeding
What is malabsorption?
Impaired absorption of nutrients
I really hope this is a question
What are the four types of diarrhea?
Secretory (isotonic stools)
Osmotic (excess osmotic forces)
Malabsorptive diarrhea (w/ steatorrhea)
Exudative diarrhea (inflammatory process…bloody stool with increased neutrophils)
What is seen with celiac disease?
Symptoms of malabsorption
Dermatitis herpetiformis
What is dermatitis herpetiformis?
Itchy, blistering autoimmune skin disorder
What is abetalipoproteinemia?
A rare autosomal recessive disorder
No transport of triglycerides, cholesterol esters, and phospholipids from enterocytes –> accumulation in the cytoplasm
What is Whipple disease?
Systemic infection caused by Trophyerma whippelii (gram+ actinomycete) –> foamy macrophages
First Aid:
Most often in men
Cardiac symptoms, Arthralgias, and Neurologic symptoms are common
(Foamy whipped cream in a CAN)
How is Whipple disease diagnosed?
PCR on the tissue biopsy
What is the most common type of disaccharide deficiency?
Adult-onset lactase deficiency
First Aid:
Lactase is at tip of villi…damaged following injury like viral diarrhea
What is the most common cause of acute diarrhea?
Infectious diarrhea
What are some pathological findings of Ulcerative Colitis?
Mucosal and submucosal inflammation only
Continuous colonic lesions…always with rectal involvement
pANCA positive
First Aid:
Crypt abscesses, ulcers, bleeding (Th2)
What are some pathological findings of Crohn’s disease?
Transmural inflammation –> fistula
Non continuous (cobblestone)…can be anywhere but often the ileum
ASCA positive
First Aid:
Noncaseating granulomas and lymphoid aggregates (Th1)
What is diversion colitis?
Blind distal segment of the colon away from fecal stream…no feces = no bacteria = no short-chain FAs = inflammation
What is the pathology of diversion colitis?
Mucosal erythema
Friability (fancy talk for ‘can be crumbled’)
Nodularity (d/t mucosal lymphoid hyperplasia)
What is radiation enterocolitis?
Ulcers, fistulas, and serosal adhesions d/t radiation of GI tract
What causes radiation enterocolitis…beyond radiation?
Vascular injury…hyalinization and thickening of walls –> decreased luminal size
What is the pathology of radiation enterocolitis?
Patchy erythema
Who gets neonatal necrotizing enterocolitis?
Premies within 1st week of life
What is neonatal necrotizing enterocolitis?
Necrosis of both small and/or large bowel…can be anywhere along the GI tract
What is the pathology of neonatal necrotizing enterocolitis?
Bacterial overgrowth (decreased immunity) –> gas in wall of intestine –> air bubbles
