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USMLE-Pathology-(Pathoma+ FA+UWorld) > Small Bowel Diseases > Flashcards

Small Bowel Diseases Flashcards

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USMLE® Step 1 flashcards
1
Q

Duodenal Atresia ?

A

Congenital failure of deuodenum to canalize

Pathoma-106

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2
Q

Double bubble sign in which disease ?

A

Duodenal atresia

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2
Q

Clinical features of duodenal atresia ?

A
  1. Poly hyramnios
  2. Bilious vomiting
  3. Double bubble sign - Dsitension of stomach & Blind loop of duodenum
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3
Q

Mekels diverticulum type ?

A

True diverticulum

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3
Q

Duodenal atresia assosiation ?

A

Down syndrome

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3
Q

Presentation of mekels diverticulum ?

A
  1. Bleeding-Heterotopic gastric mucosa
  2. Volvulus
  3. Intussusception
  4. Obstruction-Mimics appendicits
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4
Q

Cause of MD ?

A

Failure of viteline duct to involute

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4
Q

Meckel diverticum ?

A

Outpouching of all three layers of bowel wall

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5
Q

Volvulus ?

A

Twisting of bowel along the mesentry

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5
Q

Rules of 2 ?

A
  1. Population - 2%
  2. Long - 2inch
  3. 2 feet away from ileocecal valve
  4. Present first 2 year of life
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6
Q

Volvulus features ?

A
  1. Obstruction
  2. Disruption blood supply
  3. Infarction
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7
Q

Volvulus site ?

A
  1. Adult-Sigmoid colon
  2. Young-Cecum
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8
Q

Intussusception means ?

A

Telescoping of proximal segement of bowel forward into distal segement

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9
Q

Featuresn of intussusception ?

same as volvulus

A
  1. Obstruction
  2. Disruption blood supply
  3. Infarction
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10
Q

Association with leading edeg-Focus of traction ?

A
  1. Children-Lymphoid hyperplasia=Rotavirus =Terminal ileum = I into cecum
  2. Adults=Tumor most common
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11
Q

Small bowel infracy
small bowel highly susceptible to —-

A

Ischemic injury

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12
Q

Clinical features of small bowel infarction ?

A
  1. Ab pain
  2. Bloody diarrhea
  3. dec bowel sounds

Pathoma-107

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13
Q

Mucosal infarction occurs in —

A

HTN

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14
Q

Transmural inarction occurs in —

A
  1. Sup mesenteric artery
  2. Mesenteric vein

Thrombosis/Embolism

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15
Q

Lactase enzymes site >?

A

Brush border of enterocytes

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16
Q

Lactase enzymes function –

A

Lactose—Glucose + Galactose

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17
Q

Lactose intolerance ?

A

Dec function of lastase enzymes

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18
Q

Presentation of LI ?

A
  1. Abdominal distension
  2. Diarrhea

upon consumption of milk products

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19
Q

Cause of lactose intolerance ?

A
  1. Congenital-rare autosomal recessive disorder
  2. Acquired - late childhood development
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20
Q

Lactase is highly susceptible to —-

A

Injury

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21
Q

Gluten source ?

A
  1. Wheat
  2. Grains
  3. GLIADIN
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22
Q

Celiac disease ?

A

Immune mediated damage of small bowel villi- Gluten exposure

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23
Q

Celiac disease by Gluten ?

A

Helper T cell mediate tissue damage

24
Q

Gliadin process ?

A

Gliadin = Deaminated by Tissue transglutaminase (tTG) = Deamidated Gliadin is presented to Helper T cell by MHC-II

25
Q

Clinical presentation of adults ?

A
  1. Chronic diarrhea
  2. Bloating
25
Q

Clinical presentation in children ?

A
  1. Ab distension
  2. Diarrhea
  3. Failure to thrive
26
Q

Antigen presentation of celiac disease ?

A
  1. HLA-DQ2
  2. DQ8
27
Q

Dermatitis herpetiformis cause ?

A

IgA deposition at the tips of dermal papillae

27
Q

Skin presentation in celiac disease ?

A

Small herpes like vesicles

28
Q

Small herpes liek vesicles are called ?

A

Dermatitis herpetiformis

29
Q

Dermatitis herpetiformis Tx ?

A

Gluten free diet

30
Q

Lab findings of celiac disease ?

A

IgA antibodies against endomysium ,tTG or gliadin

31
Q

Other lab finidngs ?

A

IgG antibodies + IgA deficiency ( Inc incidence of IgA deficiency in Celiac disease )

32
Q

Most prominent damage in celiac disease ?

A

Duodenum

Less in ileum & jejunum

33
Q

Late complications of celiac disease ?

A
  1. Small bowel Ca
  2. T-cell lymphoma
34
Q

Duodenal biopsy result ?

A
  1. Flattening of villi
  2. Hyperplasia of crypts
  3. inc Intraepithelial lymphocytes
35
Q

Tropical sprue ?

A

Damage to small bowel villi resulting in malabsorption

Pathoma-108

36
Q

Tropical sprue occurs after –

A
  1. Infectious diarrhea
  2. Responds to antibiotics
37
Q

Tropical sprue common site ?

A

Jejunum & ileum

38
Q

Jejunum & ileum manifestation in Tropical sprue ?

A
  1. Secondary vitamin-B12
  2. Folate deficiency
39
Q

Other sites of WD >?

A
  1. Synovium of joints-Arthirits
  2. Cardiac valves
  3. Lymph nodes
  4. CNS
40
Q

Whipple disease ?

A

Systemic tissue damage by macrophage

41
Q

which organism in whipple disease ?

A

Tropheryma whippelii

42
Q

Positive stain >????

A

PAS stain

43
Q

Common site involvement in whipple disease ?

A

Small bowel lamina propria

44
Q

Process of tissue damage in Whipple disease ?

A
  1. Macrophage compress lacteals
  2. Chylomicrons cannot be transferred from enterocytes to lymphatics
  3. Fat malabsoption & steatorrhea
45
Q

AbetalipoProteinemia ?

A

Autosomal recessive deficiency of ApoLipoProtein= B48 & B100

PATHOMA-108

46
Q

AbetalipoProteinemia Clinical features ?

A
  1. Malabsorption-Defective chylomicron formation- B48
  2. Absent VLDL & LDL- B100
47
Q

Carcinoid tumor ?

A

Maliganant proliferation of neuroendocrine cells-Low grade malignancy

Pathoma-108

48
Q

Histo of carcinoid tumor ?

A

Submucosal polyp like nodules

48
Q

Carcinoid tumor characteristics ?

A

Tumor cells contains neurosecretory granules that are + for chromogranin

49
Q

Common site of carcinoid tumor ?

A

Small bowel

49
Q

Carcinoid tumor secretes ?

A

Serotonin

50
Q

Serotonin fate ?

A

Serotonin = 5-HIAA
by MAO

50
Q

Serotonin is metabolized by ?

A
  1. Liver monoamine oxidase -MAO
50
Q

5-HIAA excreted into –

A

Urine

108

51
Q

Metastasis of carcinoid tumor allows serotonin to bypass–

A

liver metabolism

52
Q

Seratonin is release in which vein ?

A

Hepatic vein

53
Q

Seratonin manisfestation ?

A
  1. Carcinoid syndrome
  2. Carcinoid heart disease
54
Q

Carcinoid tumor clinical features ?

A
  1. Bronchospasm
  2. Diarrhea
  3. Flushing of skin
55
Q

Carcinoid heart disease manifestation?

A
  1. Right sided valvular fibrosis
  2. Increased collagen
56
Q

Carcinoid tumor symptoms triggered by ?

A

Alchohol
\that stimulate serotonin release

57
Q

Right sided valvular disease feature ?

A
  1. tricuspid regurgitation
  2. pulmonary valve stenosis
58
Q

Left sided valvular fibrosis present ???????

A

NO
due to MAO

109-Pathoma

USMLE-Pathology-(Pathoma+ FA+UWorld) (75 decks)

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