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GI > Small Intestine and Colon Pathology > Flashcards

Small Intestine and Colon Pathology Flashcards

1
Q

Ileus

A

Loss of normal propulsive function of bowel in absence of mechanical obstruction

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2
Q

Hernia

A

Defect in wall of peritoneal cavity, leading to protrusion of hernia sac.

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3
Q

Complication from hernia

A

Infarction or entrapment

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4
Q

Bowel adhesions

A

Fibrous bands of scar tissue between bowel segments, abdominal wall, or operative sites.

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5
Q

When do bowel adhesions usually occur?

A

After surgery, infection, other causes of peritoneal injury/inflammation. Rarely congenital.

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6
Q

Complications from bowel adhesions

A

Obstruction or formation of closed loops.

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7
Q

Volvulus

A
  • -Twisting loop of bowel about mesenteric base, leads to bowel infarction.
  • -Commonly in sigmoid colon
  • -Caused by embryologic malrotation
  • -See dilated colon and absence of air in rectum on X-ray
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8
Q

Intussusception

A
  • -Segment of bowel telescopes into immediately distal segment
  • -Peristalsis further propels down and causes obstruction
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9
Q

Intussusception association in infants/children

A

Anatomic defects

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10
Q

Intussusception association in older children/adults

A

Intraluminal tumor or mass

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11
Q

Stenosis

A

Form of atresia. Lumen decreased in size. Commonly have fibrous thickening of the wall.
–Esophagus, small bowel, anus common locations

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12
Q

Atresia

A

Incomplete development. Ex. esophageal atresia and TE fistula

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13
Q

Omphalocele

A

Incomplete closure of ventral abdominal musculature. Abdominal viscera herniates into peritoneal sac

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14
Q

Gastroschisis

A

Incomplete closure of all layers of abdominal wall with abdominal viscera herniating

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15
Q

Meckel’s diverticulum

A
  • -True diverticulum of small bowel

- -Failed involution of vitelline duct

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16
Q

Complications of Meckel’s diverticulum

A
  • -Ulceration
  • -Perforation
  • -Hemorrhage
  • -Fistula formation to bladder
  • -Intussusception
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17
Q

Meckel’s Diverticulum Rule of 2’s

A
  • -Located on antimesenteric side of ileum in 2% of population
  • -Present within 2 feet of ileocecal valve
  • -2 inches long
  • -2x more common in males
  • -Symptoms occur by age 2 (if present)
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18
Q

Hirschsprung’s disease (congenital aganlionic mesocolon) pathologic abnormality

A

Loss of ganglion cells of affected segment in submucosal (Meissner’s) and myenteric (Auerbach’s) plexuses

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19
Q

What mutation often present with Hirschsprung’s disease?

A

Heterozygous for loss-of-function mutation for receptor tyrosine kinase RET

20
Q

Hirschsprung’s disease clinical presentation

A
  • -Failure to pass meconium
  • -Infants and older children present with obstructive constipation, abdominal distention, vomiting
  • -4x more common in males
  • -10% of cases occur in patients with Down syndrome
21
Q

Malabsorption

A

Impaired absorption of nutrients. Involves at least one phase of nutrient absorption

22
Q

Diarrhea

A

Excessive increase in stool mass, frequency, fluidity.
>3 loose stools/day. Acute 4 weeks
> 200 g stool day.

23
Q

4 types of diarrhea

A
  • -Secretory
  • -Osmotic
  • -Malabsorptive
  • -Exudative
24
Q

Secretory diarrhea

A

Isotonic stool

25
Q

Osmotic diarrhea

A

Excessive osmotic forces from unabsorbed luminal solutes

26
Q

Malabsorptive diarrhea

A

Failure of global nutrient absorption w/steatorrhea

27
Q

Exudative diarrhea

A

Inflammatory processes, w/bloody stools, increased stool neutrophils

28
Q

Celiac disease pathologic findings

A

Immune-mediated enteropathy triggered by gluten ingestion–>damage to surface of epithelium of small bowel

29
Q

Histologic findings of celiac disease

A
  • -Intraepithelial lymphocytes

- -Villous atrophy

30
Q

Lab tests for celiac disease

A

HLA-DQ2 and HLA-DQ8

31
Q

Tropical sprue

A
  • -Mimics celiac disease
  • -Occurs in tropics
  • -Thought to be secondary to some infectious agent causing overgrowth of aerobic enteric bacteria
32
Q

Tropical sprue location and histologic changes

A
  • -Location: usually distal small bowel

- -Inflammatory small bowel changes with milder degree of villous atrophy than celiac disease

33
Q

Complication of tropical sprue?

A

Vit B12 deficiency

34
Q

Treatment of tropical sprue

A

Broad spectrum antibiotics

35
Q

Abetalipoproteinemia inheritance type and mutation

A
  • -Autosomal recessive

- -Mutation in microsomal triglyceride protein (responsible for assembling glycerides into chylomicrons

36
Q

Abetalipoproteinemia is an example of what?

A

Disorder in transepithelial transport

37
Q

What happens to in abetalipoproteinema?

A

Accumulate in cytoplasm because they are not moved by chylomicrons

38
Q

Presentation of abetalipoproteinemia

A
  • -Infants
  • -FTT
  • -Diarrhea
  • -Steatorrhea
  • -Absent ApoB
  • -Deficiency in fat soluble vitamins
39
Q

Lab findings in abetalipoproteinemia

A

Lipid membrane defects in RBCs produces Burr cells (acanthocytes)

40
Q

Whipple disease cause

A

Infection by G+ actinomycete (Tropheryma whippelli)

41
Q

Diagnosis of Whipple disease

A

H and E stain

–Effacement of normal lamina propria by sheet of swollen macrophages

42
Q

Symptoms of whipple disease?

A
  • -Diarrhea
  • -Weight loss
  • -Malabsorption
  • -Abdominal pain
  • -Arthritis
  • -Arthralgia
  • -Fever
  • -Lymphadenopathy
  • -Neurologic
  • -Endocarditis
  • -Pulmonary disease
43
Q

Pathology of Whipple disease

A

Macrophages filled with organism accumulate in lamina propria of small bowel and mesenteric lymph nodes–> lymphatic obstruction

44
Q

Where can macrophages accumulate in Whipple disease?

A

Lamina propria of small bowel, mesenteric lymph nodes, synovial membranes, cardiac valves, brain and other organs

45
Q

Most common type of disaccharidase deficiency

A

Adult onset lactase deficiency

46
Q

Pancreatic insufficiency common causes (in adults and in children)

A

Often due to EtOH induced chronic pancreatitis in adults and CF in children

47
Q

Pancreatic insufficiency pathology

A

Decreased luminal lipase and trypsin–> undigested fats and protein. Carbohydrate absorption not affected.

GI (12 decks)

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