Wk3 Small intestine/Colon pt1 Flashcards

1
Q

List complications of Meckel’s diverticulum

A
  1. ulceration dt ectopic gastric mucosa
  2. perforation
  3. hemorrhage
  4. fistula w/bladder
  5. intussusception
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2
Q

List four kinds of diarrhea:

A
  1. Secretory – isotonic stools
  2. Osmotic – lactase deficiency
  3. Malabsorptive – steatorrhea
  4. Exudative – inflammatory, neutrophils, bloody stool
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3
Q

How is Whipple disease diagnosed?

A

-PCR on tissue biopsy

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4
Q

Most common (80%) cause of intestinal obstruction:

A

mechanical:

  • hernia
  • adhesion
  • intussusception
  • volvulus
  • tumor
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5
Q

loss of normal propulsive function of bowel in absence of mechanical obstruction:

A

ileus

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6
Q

Defect in the wall of peritoneal cavity:

A

hernia

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7
Q

fibrous band of scar tissue between bowel segments:

A

Adhesions

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8
Q

Twisting of bowel loop around its mesenteric base:

A

Volvulus

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9
Q

Segment of bowel telescopes into immediate distal segment of bowel:

A

Intussesception

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10
Q

Common cause of intussusception in infants?

A

anatomical defect

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11
Q

Common cause of intussusception in older children and adults?

A

intraluminal tumor or mass

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12
Q

Rule of 2’s?

A

Meckel’s diverticulum

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13
Q

Failed involution of which structure causes Meckel’s diverticulum?

A

vitelline duct

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14
Q

premature arrest of neural crest cell migration

premature death of ganglion cells

A

Hirschsprung’s disease

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15
Q

Most common location of Hirschsprung’s disease:

A

distal sigmoid colon and rectum

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16
Q

Two nerve plexuses affected by Hirschsprung’s:

A

submucosal (Meissner)

myenteric (Auerbach)

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17
Q

Pathophys of Hirschsprung’s disease:

A

absent peristaltic contractions and proximal dialation

18
Q

Global malabsorption?

A

diffuse mucosal involvement

or

reduced absorptive surface (ie. Celiac)

19
Q

Partial or segmental malabsorption?

A

interference with absorption of specific nutrients

ie. vit B12

20
Q

3 common causes of malabsorption in the USA?

A
  1. chronic pancreatitis
  2. celiac disease
  3. Crohn’s
21
Q

Clinical definition of diarrhea:

A

greater than 3 loose stools per day

22
Q

Acute diarrhea:

A

less than 14 days

23
Q

Chronic diarrhea:

A

greater than 4 weeks

24
Q

intraepithilial lymphocytes with vilious atrophy

A

celiac

25
Q

alleles associated with Celiac:

A

HLA-DQ2

HLA-DQ8

26
Q

Immune cells responsible for reaction in Celiac:

A

T-cells

27
Q

Gluten by product that becomes antigen on APC’s in celiac:

A

deamidated gliadin

28
Q

enzyme that converts gliadin to deamidated gliadin:

A

tTG

tissue transglutaminase

29
Q

Ab’s that may be dx for celiac?

A

Anti-tTG

30
Q

Histologic appearance of Celiac:

A

flattened vili

enlarged crypts

intraepithilial lymphocytes

31
Q

Celiac location?

A

duodenum

32
Q

Tropical sprue cause?

A

enteric bacteria

Tx: broad spec abx

33
Q

Location for Tropical sprue:

A

distal ileum

34
Q

Common deficiency in Tropical sprue?

A

B12

35
Q

mutation of MTP?

A

Abetalipoproteinemia

36
Q

Pathophys of abetalipoproteinemia?

A

Enterocyte can’t package TGs into chylomicrons

TG’s accumulate in cells

vit deficiencies

37
Q

burr cells

acanthocytes

A

Abetalipoproteinemia

lipid membrane defects

38
Q

Tropheryma whippelii

Gram ?

A

gram +

actinomycete

39
Q

Pathophys of Whipple disease?

A

Organisms accumulate in Mac’s –> clog up lamina propria –> lymphatic obstruction –> chylomicrons can’t get to blood

can affect other organs:

synovium

right heart valves

brain

40
Q

Definitive dx for Whipple disease:

A

PCR on tissue biopsy

41
Q

Most common type of disaccharidase deficiency:

A

lactase