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51 Cards in this Set
- Front
- Back
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cryptitis
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neutrophils in the glandular epi
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crypt abcess
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neutrophils in the lumen of glands
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clostridium difficile
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may cause PMC
enerotoxin A - cell damage and inflammation cytotoxin B - celldeath third tonin - stimulates colonic motor activity discrete raised indurated creamy yellow plaques firmly attached to underlying tissues, may coalesce and resemble ischemic enterocolitis exclusively large bowel mushroom shaped pseudomembran, epithelial debris, fibrin, mucous, polymorphs mucosal necrosis |
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tubular adenoma
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colonic neoplastic polyp
incidence increases w/ age |
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villous adenoma
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colonic neoplasti polyp
single, large, sessile w/ an irregular surface made up of numerous fronds frequent in rectum |
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most important factor for malignant potential of colonic neoplastic polyps is...
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size
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famillial adenomatous polyposis
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dominant
extracolonic: periampullary adenocarcinomas, hepatoblastomas, congenital hypertrophy of the retinal pigment epithelium, osteomas, desmoids, brain yumors germlinemutation of APC gene - tumor supressor on chromosome 5 mucous and blood in stool adenomas for 10 yrs b4 symptoms microscopically like tubular adenomas develope adenocarcinomas |
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lynch syndrome
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hereditary nonpolyposis colorectal carcinoma
mutations in DNA mismatch repair genes |
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schilling test
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pernicious anemia, ileal dysfunction, SI bacterial over growth
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radiolabled glycocholate or D-xylose breth test
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bacterial overgrowth
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small bowel biopsy
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intrinsic SI diease
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D-xylose urine or serum
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intrinsic small intestinal disease and bacterial overgrowth
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celiacs
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fecal fat tsets not as bad as pancreatic insuffuciency,
small intestinal biopsy (deep crypts, lymphocytes, plasmacytes), serum and urine D-xylose, endomesial antibodies |
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whipples
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anaerobic bacteria-tetracycline
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cholestyramine
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bile salt binding resin
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distal SI incompetance
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schilling, bile salt breath
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pancreatic insufficiency
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72hr fat test x2 w/ pancreatic enzymes
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whipples
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weight loss
hyperpigmetation of skin infection PAS positive granules in macrophage polyarthritis lymphadenopathy enteric involvement steatorrhea |
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duodenal absorbtion
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Fe
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cck-secretin duodenal drainage
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tests pancreatic secretion of bicarb
chronic pancreatitis: low peak bicarb, normal to high volume obstruction:normal bicarb low volume |
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celiac
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cuboidal instead of columnar, nuclei not as basal, scalloped mucosa in duodenum
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fragmentation of barium
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not diagnostic, but consistent with sprue
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intrinsic small intestinal disease
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celiac
giardiasis tropical sprue whipples intestinal lymphangiectasia amyloidosis |
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celiac sprue antibodies
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anti-endomesial, anti tissue tranglutaminase
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bacteria deconjugate...
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gut bile salt which will then be absorbed proximally
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cimetidine interactions
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phenytoin, warfarin, theophylline
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PPI
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taken up by parietal cells
metabolized in liver protonated (trapped) in parietal cell and form irreversible bond with proton pump |
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omeprazole interactions
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phenytoin, warfarin, diazepam
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sucralfate
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for problems relatedto bile reflux in stomach
??prophylaxis of stress ulcer sucrose aluminum octosulfate adheres to proteins in GI tract and forms insoluble coagulum binds bile salts works best at acidic pH hardly any systemic absorbtion some alluminum can be absorbed (problem in renal insuff.) aluminum causes constipation may bind and delay absorbtion of other drugs |
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sulfasalazine
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combo of sulfonamide and salicylate
for rheumatoid arthritis and UC sulfapyridine-systemic toxicity 5 ASA - anit-inflamm. |
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mesalamine
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5-ASA in pH dependant release capsule OR enema form
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pentasa
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5 ASA in controlled release form (SI too)
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olsalazine
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2 5-ASA linked by azo bond
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tegaserod
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5-HT4 agonist
constipation predominant IBS |
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alosteron
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5-HT3 antagonist
diarrhea predominant IBS highly regulated |
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Mg based antacids
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diarrhea
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Al based antacids
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constipation
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Ca based antacids
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constipation
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causes of diarrhea
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antibiotics, PPIs, sorbitol, misoprostol
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drugs for diarrhea
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codine phosphate
loperamide lomotil (diphenoxylate and atropine) |
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causes of constipation
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verapamil
sucralfate |
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drugs for constipation
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osmotic agents (Mg, PEG)
avoid lactulose polyethyline glycol |
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increased req during pregnancy
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folate, iron, zinc
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benefits of breat milk
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decreased diarrhea, otitis media, athsma, RTI, UTI, overweight
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nutrition probs in children
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growth retardation, anemia, obesity, and dental caries
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iron def
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anemia, slowed growth and cognitive dev.
and increased lead absorbtion |
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copper def
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impairs brain fct, neutropenia, vascular and bone integrity, and control of glucose and lipid metabolism
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zinc def
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impaired immune response, skin lesions, poor wound healing, impaired taste and appetite, and delayed development
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lead poisoning and iron def
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decresed intellectual ability
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in utero effects on *growth congnition and morbidity from...
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toxins, infection, and maternal diabetes
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Vit A def
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decreased tissue regeneration
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