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GI block > Robbins > Flashcards

Robbins Flashcards

1
Q

1-2 decades of life, Extremely painful, recurrent sores, associated with IBD, Celiac, and Behcet disease?

A

Aphthous ulcers

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2
Q

Shallow hyperemic ulcerations covered by gray exudate and surrounded by rim of erythema?

A

Aphthous ulcer

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3
Q

Recurrent oral ulcers, genital ulcers, and uvietis?

A

Behcet disease

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4
Q

Superficial, curdlike exudate gray/white inflammatory membrane composed of matted organisms in a fibrinosuppurative exudate that can be easily scraped off?

A

Oral candidiasis

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5
Q

Submucosal nodular lesion that forms due to chronic irritation causing reactive CT hyperplasia?

A

Fibroma

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6
Q

Pedunculated, richly vascularized, red-purple masses usually found on gingiva of children, adults, pregnant women?

A

Pyogenic Granuloma

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7
Q

“White patch or plaque that cannot be scraped off and cannot be characterized clinically or pathologically as any other disease?

A

Leukoplakia-> considered pre-cancerous until proven otherwise

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8
Q

Red velvety eroded area that is fat and depressed relative ti the surrounding mucosa?

A

Erythroplakia-> High risk of Cancer than Leuloplakia

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9
Q

Most common risk factor for Leukoplakia and erythroplakia?

A

Smoking

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10
Q

What are the two major RF for Oral SCC?

A

Smoking-> P53 + NOTCH1 mutations

HPV16-> p16 mutation + located in tonsillar crypts and base of tongue (better prognosis)

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11
Q

Mumps virus is known to causes inflammation of what 3 organs?

A

Parotid gland-
Orchitis-> sterility
Pancreatitis

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12
Q

Toddlers, fluctuant swelling of lower lip, cyst with Mac infiltrations that may change in size is association with meals?

A

Mucocele

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13
Q

Bacterial sialadenitis is often predisposed by what factors and caused by what organisms?

A 
RF= Stones, dehydration, injury, phenothiazine use
Organisms= S, aureus + Strep viridans
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14
Q

The likelihood that a salivary gland tumor is malignant is inversely related to what?

A

ITS SIZE
submandibular- 45% malignant
Sublingual= 90% malignant

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15
Q

What are the 2 most common salivary tumors?

A 
Pleomorphic adenoma (50%)
Warthin tumor (5%)
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16
Q

Most common Malignant tumors?

A 
Mucoepidermoid carcinoma (15%)
Acinic cell carcinoma (6%) 
Adenocarcinoma NOS (6%)
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17
Q

Painless, slow growing, mobile parotid gland mass?

A

Pleomorphic adenoma= consist of ductal and myoepithelial cells

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18
Q

Parotid mass displaying Heterogenic histology with evidence of cartilage and bone?

A

Pleomorphic adenoma

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19
Q

parotid gland Tumor containing cords, sheets or cysts lined by squamous, mucous, or intermediate cells?

A

Mucoepidermoid carcinoma

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20
Q

Cystic growth arising around crown of unruptured tooth resulting in degeneration of dental follicle, lined by squamous epithelium as a sign of Chronic inflammation?

A

Dentigerous cysts

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21
Q

Ora cyst that is locally aggressive and high recurrence rate?

A

Odontogenic keratocyst

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22
Q

Benign cystic tumor of parotid gland with abundant lymphocytes and Germinal centers?

A

Warthin tumor

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23
Q

Parotid gland tumor consisting of mucinous and squamous cells commonly damaging Facial nerve?

A

Mucoepidermoid carcinoma

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24
Q

Swollen, painful, parotid gland with purulent discharge. MCC?

A

Acute Sialadenitis= S. aureus

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25
Q

Episodic pain and swelling of parotid gland prior to eating a meal. MCC?

A

Chronic Sialadenitis== Due to Sialotlith (STONE)

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26
Q

Middle aged female, slow growing, painless, movable, firm mass for years NOW rapidly growing?

A

Pleomorphic Adenoma–> Becoming Malignant Carcinoma

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27
Q

Round, well circumscribed, non tender, movable rubbery mass on 50 yo female parotid gland. What is the most likely pathology?

A

Pleomorphic Adenoma= Encapsulated + Ductal or cystic formations with Epithelium + Myxoid or chondroid matrix (2 Germ layers)

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28
Q

MC complication of Pleomorphic adenoma treatment?

A

Facial nerve injury

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29
Q

60 yo male smoker, with Slow growing mass, painless, firm @ the tail of Parotid gland?

A

Warthins tumor

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30
Q

What is the histology of Warthins tumor?

A

Cystic spaces lined by double layer of oncocytes, and Prominent LYMPHOID STROMA + GERMINAL CENTERS

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31
Q

59 yo female, parotid gland mass that is asymptomatic. Biopsy shows mixture of mucous and squamous cells. What is the prognosis of this mass dependent on?

A

Mucoepidermpoid Carcinoma=
GRADE
location
Stage

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32
Q

What esophageal abnormalities are discovered shorty after birth due to regurgitation during feeding?

A

Atresia
Fistulas
Duplications

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33
Q

Atresia are often associated with Eso-Tracheal fistulas causing what pathologies?

A

Aspiration pneumonia
Suffocation
Severe fluid and electrolyte imbalance

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34
Q

Characterized by the triad of:

  1. incomplete LES relaxation
  2. Increased LES tone
  3. Esophageal aperistalsis
A 
Esophageal Achalasia (Chalasia= Relaxation) 
primary-> idopathic
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35
Q

What is the MCC of secondary Esophageal Achalasia?

A

Chagas Dz= Trypanosoma cruzi

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36
Q

What is the pathogenesis of Chagas disease causing Achalasia?

A

Trypanosoma cruzi destroys the myenteric plexus= failure of LES relaxation + esophageal dilation

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37
Q

What are some other causes of Achalasia like disease?

A 
Diabetic autonomic neuropathy 
Malignancy 
Amyloidosis
Sarcoidosis 
Polio
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38
Q

What are the 2 MCC of Esophageal varices?

A

Cirrhosis

Schistosomiasis

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39
Q

MCC of death of advanced Cirrhosis patient?

A

Esophageal varices

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40
Q

Chronic alcoholics and bulimics present with Hematemesis due to GEJ tears?

A

Mallory-Weiss tears = Linear + longitudinally oriented tears heal rapidly

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41
Q

Transmural esophageal tears and Mediastinitis caused by Chronic vomiting?

A

Boerhaave syndrome= (Cutaneous Emphysema)

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42
Q

What conditions decrease LES tone and contribute to GERD?

A 
Tobacco
ETOH
Obesity-> increase Abdominal pressure
CNS depressants 
Pregnancy 
Hiatal hernia 
Delayed gastric emptying
Increased Gastric volume
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43
Q

What can be seen on the Esophagus during mild or Severe GERD?

A 
Mild= Hyperemia (redness)
Severe= Eosinophils + PMNs + Basal zone Hyperplasia
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44
Q

Pt with dysphagia, feeding intolerance, and large # of Eosinophils in esophageal biopsy far from GEJ?

A

Eosinophilic Esophagitis

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45
Q

Endoscopy shows patches of red, velvety mucosa extending upward from GEJ will most likely reveal what on microscopy?

A

Metaplastic Columnar cells with GOBLET cells= Barrett’s esophagus

**increased risk for Adenocarcinoma

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46
Q

MC esophageal neoplasm in US?

A

Adenocarcinoma= Due to GERD

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47
Q

Chronic alcoholic presents with Dysphagia, Odynophagia, wght loss, chest pain, and vomiting needs to be checked for what?

A

Adenocarcinoma= Barrett esophagus

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48
Q

What are the risk factors for Esophageal SCC?

A 
ETOH
Tobacco
Poverty
Achalasia
Plummer-Vinson syndrome
HOT TEA 
previous radiation
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49
Q

What is the lymph node spread for Esophageal SCC?

A

upper 1/3= Cervical LN
middle 1/3= Thoracic LN
Lower 1/3= Celiac LN

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50
Q

Esophagitis is most frequent in what kind of patients?

A

Immunocomprimised pts= Candidiasis is sign of HIV-> AIDS

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51
Q

What are foveolar cells?

A

Mucus secreting cells in the Antrum (cardia) of stomach

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52
Q

What factors lead to developing Gastritis/ damage stomach mucosa?

A 
H pylori
NSAIDS
ETOH
Radiation/ Chemo
Aspirin
Smoking
Hyperacidity 
Duodenal-gastric reflux
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53
Q

What is the significant finding indicating inflammation of the Stomach lining?

A

PMNs above basement membrane–> IN direct contact with Epithelial cells

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54
Q

What are the defensive forces that protect the stomach lining?

A 
Mucus
HCO3 in mucus
Mucosal Blood flow
Apical membrane transport
Epithelial regeneration
Elaboration of PGs
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55
Q

What are the mCC of focal acute peptic injury?

A

NSAIDs

STRESS–> hypoxia induced

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56
Q

Peptic injury most commonly occurring in critically ill pts with Shock, sepsis, or severe trauma?

A

Stress Ulcers–> Systemic Acidosis

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57
Q

Peptic injury occurring in the proximal duodenum associated with severe burns or trauma?

A

Curling Ulcers

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58
Q

Peptic injury arising in stomach, duodenum, or esophagus of persons with intracranial disease with High incidence of perforations?

A

Cushing Ulcers–>

Intracranial injury= Increased Vagus stimulation= Acid Hypersecretion

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59
Q

What are the protective affects of PGs?

A

Induce HCO3 secretion

Enhance mucosal blood flow

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60
Q

Patient with nausea, vomiting, and “Coffee ground” hematemesis?

A

Gastric Ulcer

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61
Q

Nausea, upper abdominal discomfort, vomiting, but no Hematemesis?

A

Chronic Gastritis

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62
Q

MCC of chronic + atrophic?

A 
Chronic= H pylori 
Atrophic= Autoimmune

*less common= Radiation or Chronic bile reflux

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63
Q

What manifests as predominately antral gastritis with HIGH acid production despite Hypogastrinemia?

A

H pylori infection= increased risk for Duodena ulcers and ANTRAL gastritis

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64
Q

What are the four virulence factors of H pylori that allow it to infect the stomach?

A 
Flagella= confers motility in mucus 
Urease= generates NH3 from Urea to Lower pH
Adhesions= adhere to foveolar cells
Toxins= Cytotoxin-associated gene A (CagA) increases risk for ULCERS + CANCER
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65
Q

Chronic antral H pylori gastritis may progress to Pangastritis resulting in multifocal atrophic gastritis with Reduced acid secretion which Increases risk of what?

A

Metaplasia–> ADENOCARCINOMA

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66
Q

What tests can be used to detect H pylori infection?

A

Biopsy to identify organism or PCR
Serology for Anti- H pylori antibodies
Fecal bacterial detection
Urea breath test

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67
Q

What antibodies can be detected in serum and gastric secretions in autoimmune gastritis?

A

Antibodies to Parietal cells and Intrinsic factor

68
Q 
Gastric disorder characterized by 
Reduced serum Pepsinogen I levels
Antral endocrine cell Hyperplasia
V B12 deficiency 
Defective gastric acid secretion (achlorhydria)?
A

Autoimmune Gastritis

69
Q

What is the pathogenesis for the findings in Autoimmune Gastritis?

A

Antibodies destroy Parietal cells
Reduced HCl = Increased Gastrin release
Increased Gastrin= Hyperplasia of antrum G cells
Reduced IF= V B12 def= megaloblastic anemia
Chief cell loss= Reduced Pepsinogen

70
Q

What is often associated with both Achlorhydria and pernicious anemia?

A

Autoimmune Gastritis

71
Q

Contrast the difference in location differences btwn H pylori and AI gastritis?

A

H pylori= ANTRUM

AI= BODY and FUNDUS

72
Q 
Gastic pathology associated with:
PMNs and Subepithelial plasma cells
Increased Acid secretion
Normal Gastrin release
Hyperplastic/inflammatory polyps
What is RF and sequelae?
A

H pylori induced Antral Gastritis
RF: Low SE status + poverty + Rural areas
Sequelae: Peptic Ulcers + adenocarcinoma + Lymphoma

73
Q 
Gastric pathology defined by:
Lymphocytes and Macs invasion
Decreased HCl production
Increased Gastrin
Neuroendocrine hyperplasia
What is the Dx test and Sequelae?
A

Autoimmune Gastritis
Dx test: Antibodies to Parietal cells (Proton pump or IF)
Sequelae: Atrophy, Pernicious anemia, Adenocarcinoma, Carcinoid tumor

74
Q

What are the MC sites of PUD?

A

Antrum + 1st part of Duodenum

75
Q

PUD occurring in the small intestines of a child is often secondary to what?

A

Gastric heteropia within–>Meckel Diverticulum

76
Q

What is the fundamental cause of PUD?

A

Gastric Hyperacidity= MCC by H pylori

77
Q

What are some known Cofactors for developing PUD?

A 
chronic NSAIDS
Cigarettes-> impairs blood flow/ healing
ETOH
HD Corticosteroids= Inhibit PG synthesis/healing
Hyperparathyroidism
Chronic Renal failure
78
Q

What is the pathogenesis for Hyperparathyroidism and Chronic Renal failure causing PUD?

A

HYPERCALCEMIA= stimulates Gastrin release

79
Q

MC in the proximal duodenum, sharply punched-out lesion with smooth and richly vascularized granulation tissue?

A

PUD

80
Q

Pt complains of epigastric burning or aching, anemia, with pain occurring 1-3 hrs after meals and Worse at NIGHT. N/V and bloating?

A

PUD

81
Q

Causes increased Gastric production and MALT transformation into Lymphoma?

A

H pylori gastritis

82
Q

Found in patients with Hx of Familial adenomatous polypsosis and increased risk with proton pump inhibitors (due to Increased Gastrin)?

A

Fundic gland Polyps

83
Q

What are the MC risk factors for Gastric adenocarcinoma?

A

Mutations- CDH1 + APC genes
H pylori
EBV–> Diffuse with Lymphocytic infiltrates

84
Q

CDH1 mutation increased the risk of what type of gastric neoplasia and why?

A

Adenocarcinoma

Mutation= LOSS of E-cadherins

85
Q

Lauren classification of Gastric adenocarcinoma:

1: Elevated mass with heaped boarders and central ulceration
2. Dischohesive cells with SIGNET RING cells + Desmoplastic reaction causing Loss of RUGAE = Linitis plastic?

A
  1. Intestinal Adenocarcinoma-> closely associated with Atrophic gastritis
  2. Diffuse Adenocarcinoma= “leather bottle”
86
Q

What are the most powerful diagnostic indicators of Gastric adenocarcinomas?

A

Depth of invasion-> Locally invades

Nodal/ distant mets

87
Q

What are the most common types of Lymphomas in the GI tract?

A

Diffuse Large B cell

MALTomas

88
Q

Tan intramural or submucosal masses that elicit intense desmoplastic reaction causing kinking or bowel obstruction and histology shows trabeculae/ sheets of uniforms cells with Stippled nuclei?

A

Carcinoid tumor

89
Q

Often causes Cutaneous flushing, sweating. bronchospasms, colicky abdominal pain, diarrhea, and right sided cardiac valvular fibrosis?

A

Carcinoid tumor secreting Vasoactive substances

90
Q

What is the pathogenesis of 75-80% of Gastrointestinal stromal tumors (GIST)?

A

cKIT or PDGFRA mutations–> tyrosine Kinase

**Arises from Interstitial cells of CAJAL

91
Q

What is the most important factor when i comes to Carcinoid tumors?

A

LOCATION
Small intestines= Malignant
Appendix= Benign

92
Q

Small flask-like outpouchings that occur in btwn taeniae coli of the Sigmoid colon most commonly in pts >60yo?

A

Diverticulosis

93
Q

Thinning of the diverticula walls and fecal entrapment can lead to?

A

Diverticulitis –> perforation

94
Q

Often asymptomatic, or 60 yo male with Low fiber diet with intermittent cramping, lower abdominal pain, constipation, and diarrhea?

A

Diverticulosis

95
Q

Chronic condition of bowl resulting from inappropriate mucosal immune activation?

A

Inflammatory bowel disease

96
Q

Inflammation limited to COLON and RECTUM, and extends only into mucosa and submucosa?

A

Ulcerative colitis

97
Q

Transmural inflammation of Ileum leading to Strictures?

A

Crohn disease

98
Q

Skip lesions, transmural inflammation, ulcerations, and fissures?

A

Crohn disease

99
Q

Continuous colonic involvement beginning at RECTUM, and pseudo polyps and ulcer formations?

A

Ulcerative colitis

100
Q

What are the genetic links for Crohns vs. ulcerative colitis?

A 
Crohn= 50% rate in monozygotic twins
UC= 16% rate in monozygotic twins
101
Q

What is the gene responsible for increase susceptibility to Crohns disease?

A

NOD2= protein binds bacterial peptidoglycans and activated NF-kB

102
Q

What immune cells are the primary target of Crohns disease therapy?

A

Th1 and Th17 cells

**Th1 secrete IFN= activates Macs= Granulomas

103
Q

What cells are overreacting in ulcerative colitis?

A

Th2 –> overproduce IL-13

104
Q

What epithelial defects are associated with Crohsna and UC?

A

Defective intestinal epithelial tight junctions= NOD2

Paneth Cell granules= abnormal in Crohns

105
Q

How do appendicitis and smoking affect Crohns and UC?

A 
Appendicitis= reduced risk of UC
Smoking= Reduced risk of UC + increased Crohns
106
Q

Most common site of Crohn disease involvement?

A

Terminal Ileum
Ileocecal valve
Cecum

107
Q

What is the earliest lesion in Crohns disease?

A

Aphthous ulcer–> Cobblestone appearing–> Fissures between mucosal folds

108
Q

Transmural inflammation of Crohns causes what kind of reaction in Small bowel wall?

A

Wall thickening
Submucosal fibrosis
hypertrophy of muscularis propria
Creeping fat= strictures or perforations

109
Q

What are the microscopic features of Crohn disease?

A

Crypt abscess= PMNs within crypt + ulcers + branching crypts + GRANULOMAS

110
Q

Paneth cell metaplasia in Left colon + noncaseating granulomas are a hallmark of what disease?

A

Crohn disease

111
Q

Pt with mild NON-bloody diarrhea + fever, and abdominal pain?

A

Crohn disease

112
Q

What are the Extraintestinal manifestations of Crohn disease?

A 
Uveitis 
Migratory polyarthritis 
sacroiliitis 
ankylosing spondylitis 
Ertythema Nodosum
Clubbing
113
Q

Always involves Rectum and ascends into colon?

A

Ulcerative colitis

114
Q

Colonic mucosa appearing as granular, broad-based ulcers, mucosal atrophy, NO Strictures?

A

Ulcerative colitis

115
Q

Pt with ulcerative colitis develops a condition caused by inflammation and inflammatory mediators damaging muscularis mucous and disturb the neuromuscular function?

A

Toxic megacolon

116
Q

What are the histological features of Ulcerative colitis?

A 
Generalized superficial Inflammation
Crypt abscesses 
Crypt distortion
Epithelial metaplasia 
NO GRANULOMAS
117
Q

Pt with attacks of Bloody diarrhea, expulsion of stringy mucoid material, and Lower abdominal pain and cramping relieved by defecation?

A

Ulcerative colitis

118
Q

30 yo white female, abdominal cramps, bloody stool for 6 mo, wght loss, oral ulcers, blood on rectal exam and Fistula draining foul smelling fluid?

A

Crohn Disease

119
Q

What is the DDx for Toxic megacolon?

A
  1. C. difficile pseudomembranous colitis
  2. IBD (UC or Crohn dz)
  3. Obstruction: tumor or inflammation
  4. Functional disorder associated with psychiatric disease or meds
  5. Chagas Disease
120
Q

What is associated with failure of urorectal septum formation in cloaca (wk7) or failure of anal membrane opening (wk8) or Down syndrome?

A

Anorectal stenosis or Atresia

121
Q

Male 60 yo, with chronic gastritis and atrophy/ intestinal metaplasia is diagnosed with gastric adenoma. The risk of this lesion becoming an adenocarcinoma is related to what?

A

SIZE= >2cm = Higher risk

122
Q

Familial diffuse gastric adenocarcinoma is associated with what genetics?

A

CDH1 mutation= Loss of E-cadherins

123
Q

Patients with FAP have a mutation in what gene that increases their risk for Intestinal Gastric adenocarcinoma?

A

APC= deactivates Beta catenin

124
Q

Pt with sweating, redness, colicky abdominal pain, bronchospasms, diarrhea, and Right sided valvular fibrosis?

A

Carcinoid syndrome

125
Q

75% of GIST have what gain of function mutation and arises from what GI cells?

A

c-KIT= Tyrosine kinase

Interstitial cells of Cajal

126
Q

Microscopic examination of intestines reveals atrophy and sloughing of surface epithelial cells but hyperplastic crypts?

A

Ischemic bowel

127
Q

Older patient with sudden severe abdominal pain, tenderness, N/V, bloody diarrhea, and melanotic stool?

A

Acute transmural intestinal infarction

**Decreased bowel sounds-> shock

128
Q

Patient present with rectal bleeding, mucus discharge, and inflammatory lesion on anterior rectal wall?

A

Solitary rectal ulcer syndrome

**caused by impaired relaxation of anorectal sphincter

129
Q

5 yo male with rectal bleeding, and prolapsed mass in the rectum?

A

Juvenile polyp

**SMAD4 mutation

130
Q

AD disorder characterized by multiple GI hamartomatous polyps in small intestines and mucocutaneous hyper-pigmentation?

A

Peutz Jeghers syndrome

131
Q

Smooth nodular protrusions of mucosa, most common in Left colon, with SERRATED glands and lots of goblet cells?

A

Hyperplastic polyps

132
Q

Pre-cancerous colonic lesions in 50 yo patients?

A

Adenomas

133
Q

Polyp with surface erosions, cystically dilated crypts filled with mucus, PMNs, and debris in a childs rectum?

A

Juvenile polyp

134
Q

Polyp in small intestine with complex glandular architecture and bundles of Smooth Muscle?

A

Peutz-Jeghers polyp

135
Q

Pt with intestinal polyps, osteomas of mandible, and desmoid and thyroid tumors?

A

Gardners Syndrome

136
Q

Pt with intestinal adenomas, CNS tumors

(medulloblastomas or glioblastomas)?

A

Turcot syndrome

137
Q

DNA mismatch repair mutation or MSH2/MLH1, causing predominately RIGHT sided sessile serrated adenomas or mucinous adenocarcinomas?

A

HNPCC

138
Q

APC/WNT pathway mutation causing LEFT sided colonic tubular or villous adenomas or adenocarcinoma?

A

Sporadic Colon cancer

139
Q

What syndrome was described as a familial clustering of colorectal, endometrial, stomach, ovarian, ureter, brain, small bowel, and skin cancers?

A

LYNCH syndrome or HNPCC

140
Q

Describe the APC/Beta catenin pathway to colonic adenocarcinoma?

A

APC is negative regulator of Beta catenin
Beta catenin is part of WNT proliferative pathway
Mutation in APC= Increased Beta catenin
Beta catenin-> translocates into nucleus and activates MYC and cyclin D= Increased Prolif

141
Q

Describe the molecular changes in the adenoma-carcinoma sequence?

A

Normal= Inherited APC mutation
Second HIT= LOSS of APC= Increased Bcatenin
Adenoma-Early > KRAS mutations
Adenoma Late–> SMAD 2+4 + p53 mutations
Carcinoma- Telomerase mutation

142
Q

What are the Early and Late mutations in the Adenoma-> carcinoma sequence of colon cancer?

A 
Early= KRAS
Late= p53
143
Q

What is microsatellite instability?

A

DNA mismatch repair deficiency mutations accumilate in microsatellite repeats
**Silence unless in BAX or TGF-beta encoding sequences

144
Q

What is the molecular changes leading to colonic carcinoma in the mismatch repair pathway?

A

Normal= Inherited MSH2 + MLH 1 mutations
Sessile serrated adenoma= Microsatellite instability
Carcinoma= BAX & BRAF mutations

145
Q

What kind of tumors are found in the RIGHT vs LEFT colon?

A 
Right= polypoid, exophytic, bleeding 
Left= Annular + obstructive
146
Q

Hyperplastic polyps must be distinguished from what due to their malignant potential?

A

Sessile serrated polyps

147
Q

What is the difference in cancer transformation timelines btwn FAP and HNPCC?

A 
FAP= develop cancer EARLY (<30yo)
HNPCC= Cancer late in life
148
Q

Comma shaped organism found in warm waters around Ganges valley in India and Bangladesh causing severe watery diarrhea?

A

V cholera

149
Q

What are the complication associated with C jejuni infections?

A

Guillian Barre
Erythema Nodosum
Reactive arthritis= HLA-B27 +

150
Q

G- bacillus, Uncapsulated and nonmotile. Important cause of Bloody diarrhea?

A

Shigellosis

151
Q

Pt with 6 days of diarrhea that started off watery but changes to Bloody, and complications include Reiters syndrome (“cant pee, see, climb Tree”)?

A

Shigella

152
Q

Primary cause of Travelers diarrhea, Expresses LT that acts similar to Cholera toxin and ST that increases cGMP intracellular?

A

ETEC (enterotoxigenic E coli)

153
Q

After inadequately cooked ground beef consumption patients develops dysentery and kidney failure caused by what organism that secrete Shiga like toxin?

A

EHEC (O157:H7)

154
Q

Serotype of normal GI flora that causes bloody diarrhea via invasion of gut epithelium but does NOT produce toxins?

A

Enteroinvasive E coli

155
Q

Causes gastroenteritis via spread through uncooked poultry and eggs?

A

Salmonella enteritidis

156
Q

What is the pathogenesis of Salmonella induce gastroenteritis?

A
  • *T3 secretion system transfers Bacterial proteins into M cells
  • *Proteins activate host Rho GTPase causing bacterial endocytosis
  • *Causes chemoattractant release- PMNs damage mucosa
157
Q

Pt with acute onset of abdominal pain, N/V, bloody diarrhea, progresses to HIGH fever, small maculopapular lesions, and in LLQ?

A

Salmonella typhi= Typhoid fever

  • *Rose spots= maculopapular lesions
  • *SCD= Osteomyelitis
158
Q

What is the morphology seen in MCC of antibiotic associated colitis?

A

C difficile= Pseudomembranes

159
Q

Hospitalized patient with fever, leukocytosis, abdominal pain, cramps, Hypoalbuminemia, watery diarrhea, and dehydration?

A

C difficile

160
Q

30 yo Pt returning from cruise suffer acute onset of N/V, watery diarrhea and abdominal pain. Fecal culture show no bacterial growth. Most likely diagnosis?

A

Norovirus infection

161
Q

MCC of severe childhood (6-24mo) diarrhea and related deaths worldwide?

A

Rotavirus

162
Q

What is the pathogenesis of Rotavirus induced bacteria?

A

Selectively infects and destroys Mature Enterocytes in small intestines
Villus surface is repopulated by IMMATURE cells causing decreased Absorption= Osmotic diarrhea

163
Q

Nematode that infects intestinal mucosa by ingested eggs that hatch and penetrate mucosa, Circulate to LIVER and cause Abscesses and even Pneumonitis?

A

Ascaris lumbricoides

164
Q

Larvae lives in fecally contaminated soil and penetrates broken skin. Larvae mature in intestines , release eggs and cause LIFE long auto infections?

A

Stronglyoides

165
Q

This parasite is the leading cause of IRON deficiency anemia in the developing World?

A

Hookworms

166
Q

Most common human parasitic infections, resistant to chloride treatment, Decreases Brush boarder enzymes and causes apoptosis of epithelial cells. Causes CHRONIC diarrhea and malabsorption?

A

Giardia

GI block (6 decks)

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