Path: Intestines Flashcards
What is the mechanism of Hirschsprung Disease?
Lack of neural crest cell migration to form the enteric ganglia in the descending colon to the rectum. Leads to a chronic tonic colon because no VIP or NO to relax the colon.
Condition highly associated with Hirschsprung Disease.
Down Syndrome
What condition can lead to an acquired Hirschsprung Disease?
Chagas disease
What is the difference in diarrhea and dysentery?
Diarrhea: larger volume, usually watery
Dysentery: small volume, very painful, bloody
Which population presents with Necrotizing Enterocolitis (NEC)
Premature infants
How does NEC present?
Dilated abdomen, air seen on radiology outside the intestinal walls
Skin condition associated with Celiac Sprue
Dermatitis Herpetiformis
Neurologic Condition associated with Celiac Sprue
Tetany
3 cancers associated with Celiac Sprue
- Non-hodkins lymphoma
- Adenocarcinoma
- Esophageal Carcinoma
Symptoms presented in patients with Whipple disease.
Arthritis (brings them into the office)
GI symptoms
Vision problems
What can be seen on biopsy that indicates Whipple Disease?
Macrophages stained with PAS on intestinal mucosa biopsy
Four characteristics that differentiate Crohn Disease (CD) from ulcerative colitis (UC).
CD: granulomas, skip lesions, deeper lesions into the colonic mucosa, can extend from the rectum all the way up to the mouth
Major causes of Ischemic bowel disease
- arterial thrombosis
- arterial embolus
- heart failure or shock
Major cause of acquired diverticulosis in the U.S.
Lack of fiber in diet
Two biggest risks leading to GI adenocarcinomas.
- IBD (CD and UC)
2. Celiac Sprue
Type of polyp that doesn’t have a risk of turning into malignant cancer.
Hyperplastic Polyp
What is Peutz-Jeghers Syndrome?
Hamartomatous (benign) polyps throughout the GI tract with hyperpigmentation freckled on lips, oral mucosa, and genital skin.
Indicates increased risk for colorectal, breast, and gynecological cancers
What is Familial Adenomatous Polyposis (FAP)?
Genetic mutation resulting in a “carpet” of polyps covering the lining of the colon
What is Gardner Syndrome?
Polyps in the colon accompanied by extra-colic tumors:
Osteomas in skull
Thryoid tumors
sebaceous cysts
What is Turcot Syndrome?
Genetic mutation resulting in colonic polyps along with CNS tumors:
medulloblastomas
What are the differences between colonic adenocarcinoma in the proximal colon vs. distal colon.
Proximal: no obstruction, bleeding
Distal: “napkin ring” constriction w/ constipation, no bleeding
What is iron deficiency anemia in men > 50 and post-menopausal women until proven otherwise?
GI cancer (usually indicates very slow and almost unnoticeable GI bleed)
How is cancer staging based?
On the depth of the tumor
What is carcinoid syndrome?
Tumor that produces serotonin (5-HT) and its metabolite (5-HIAA) hydroxyindoleacetic acid. Patients present with flushed skin, diarrhea, and it can lead to heart failure and bronchoconstriction
What is dangerous about peritoneal tumors?
All are malignant
