Part 2 GI

Question 1

What are some causes to ischemic bowel disease?

Answer 1

Acute arterial obstruction/thrombosis
Mesenteric venous thrombosis
Hypoperfusion

Basically…there is ischemia…

Question 2

Which bowel segments are most likely to be effected by ischemic bowel disease?

Answer 2

At the end of an arterial supply:
Splenic flexure
Sigmoid colon
Rectum

Question 3

What are some complications of transmural bowel necrosis?

Answer 3

Sepsis –> shock (maybe) –> death (it could happen)

Question 4

What causes the complications of transmural bowel necrosis?

Answer 4

Breakdown of mucosal barrier…makes sense…look at the name

Question 5

What is angiodysplasia?

Answer 5

Malformed submucosal and mucosal blood vessels

Question 6

What is the presentation of angiodysplasia?

Answer 6

GI bleeding

If acute…then massive bleeding
If chronic…then intermittent bleeding

Question 7

What is malabsorption?

Answer 7

Impaired absorption of nutrients

I really hope this is a question

Question 8

What are the four types of diarrhea?

Answer 8

Secretory (isotonic stools)
Osmotic (excess osmotic forces)
Malabsorptive diarrhea (w/ steatorrhea)
Exudative diarrhea (inflammatory process…bloody stool with increased neutrophils)

Question 9

What is seen with celiac disease?

Answer 9

Symptoms of malabsorption

Dermatitis herpetiformis

Question 10

What is dermatitis herpetiformis?

Answer 10

Itchy, blistering autoimmune skin disorder

Question 11

What is abetalipoproteinemia?

Answer 11

A rare autosomal recessive disorder

No transport of triglycerides, cholesterol esters, and phospholipids from enterocytes –> accumulation in the cytoplasm

Question 12

What is Whipple disease?

Answer 12

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)

Question 13

How is Whipple disease diagnosed?

Answer 13

PCR on the tissue biopsy

Question 14

What is the most common type of disaccharide deficiency?

Answer 14

Adult-onset lactase deficiency

First Aid:
Lactase is at tip of villi…damaged following injury like viral diarrhea

Question 15

What is the most common cause of acute diarrhea?

Answer 15

Infectious diarrhea

Question 16

What are some pathological findings of Ulcerative Colitis?

Answer 16

Mucosal and submucosal inflammation only
Continuous colonic lesions…always with rectal involvement
pANCA positive

First Aid:
Crypt abscesses, ulcers, bleeding (Th2)

Question 17

What are some pathological findings of Crohn’s disease?

Answer 17

Transmural inflammation –> fistula
Non continuous (cobblestone)…can be anywhere but often the ileum
ASCA positive

First Aid:
Noncaseating granulomas and lymphoid aggregates (Th1)

Question 18

What is diversion colitis?

Answer 18

Blind distal segment of the colon away from fecal stream…no feces = no bacteria = no short-chain FAs = inflammation

Question 19

What is the pathology of diversion colitis?

Answer 19

Mucosal erythema
Friability (fancy talk for ‘can be crumbled’)
Nodularity (d/t mucosal lymphoid hyperplasia)

Question 20

What is radiation enterocolitis?

Answer 20

Ulcers, fistulas, and serosal adhesions d/t radiation of GI tract

Question 21

What causes radiation enterocolitis…beyond radiation?

Answer 21

Vascular injury…hyalinization and thickening of walls –> decreased luminal size

Question 22

What is the pathology of radiation enterocolitis?

Answer 22

Patchy erythema

Question 23

Who gets neonatal necrotizing enterocolitis?

Answer 23

Premies within 1st week of life

Question 24

What is neonatal necrotizing enterocolitis?

Answer 24

Necrosis of both small and/or large bowel…can be anywhere along the GI tract

Question 25

What is the pathology of neonatal necrotizing enterocolitis?

Answer 25

Bacterial overgrowth (decreased immunity) –> gas in wall of intestine –> air bubbles