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51 Cards in this Set

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cryptitis
neutrophils in the glandular epi
crypt abcess
neutrophils in the lumen of glands
clostridium difficile
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
tubular adenoma
colonic neoplastic polyp
incidence increases w/ age
villous adenoma
colonic neoplasti polyp
single, large, sessile w/ an irregular surface made up of numerous fronds
frequent in rectum
most important factor for malignant potential of colonic neoplastic polyps is...
size
famillial adenomatous polyposis
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
lynch syndrome
hereditary nonpolyposis colorectal carcinoma
mutations in DNA mismatch repair genes
schilling test
pernicious anemia, ileal dysfunction, SI bacterial over growth
radiolabled glycocholate or D-xylose breth test
bacterial overgrowth
small bowel biopsy
intrinsic SI diease
D-xylose urine or serum
intrinsic small intestinal disease and bacterial overgrowth
celiacs
fecal fat tsets not as bad as pancreatic insuffuciency,
small intestinal biopsy (deep crypts, lymphocytes, plasmacytes), serum and urine D-xylose, endomesial antibodies
whipples
anaerobic bacteria-tetracycline
cholestyramine
bile salt binding resin
distal SI incompetance
schilling, bile salt breath
pancreatic insufficiency
72hr fat test x2 w/ pancreatic enzymes
whipples
weight loss
hyperpigmetation of skin
infection
PAS positive granules in macrophage
polyarthritis
lymphadenopathy
enteric involvement
steatorrhea
duodenal absorbtion
Fe
cck-secretin duodenal drainage
tests pancreatic secretion of bicarb
chronic pancreatitis: low peak bicarb, normal to high volume
obstruction:normal bicarb low volume
celiac
cuboidal instead of columnar, nuclei not as basal, scalloped mucosa in duodenum
fragmentation of barium
not diagnostic, but consistent with sprue
intrinsic small intestinal disease
celiac
giardiasis
tropical sprue
whipples
intestinal lymphangiectasia
amyloidosis
celiac sprue antibodies
anti-endomesial, anti tissue tranglutaminase
bacteria deconjugate...
gut bile salt which will then be absorbed proximally
cimetidine interactions
phenytoin, warfarin, theophylline
PPI
taken up by parietal cells
metabolized in liver
protonated (trapped) in parietal cell and form irreversible bond with proton pump
omeprazole interactions
phenytoin, warfarin, diazepam
sucralfate
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
sulfasalazine
combo of sulfonamide and salicylate
for rheumatoid arthritis and UC
sulfapyridine-systemic toxicity
5 ASA - anit-inflamm.
mesalamine
5-ASA in pH dependant release capsule OR enema form
pentasa
5 ASA in controlled release form (SI too)
olsalazine
2 5-ASA linked by azo bond
tegaserod
5-HT4 agonist
constipation predominant IBS
alosteron
5-HT3 antagonist
diarrhea predominant IBS
highly regulated
Mg based antacids
diarrhea
Al based antacids
constipation
Ca based antacids
constipation
causes of diarrhea
antibiotics, PPIs, sorbitol, misoprostol
drugs for diarrhea
codine phosphate
loperamide
lomotil (diphenoxylate and atropine)
causes of constipation
verapamil
sucralfate
drugs for constipation
osmotic agents (Mg, PEG)
avoid lactulose
polyethyline glycol
increased req during pregnancy
folate, iron, zinc
benefits of breat milk
decreased diarrhea, otitis media, athsma, RTI, UTI, overweight
nutrition probs in children
growth retardation, anemia, obesity, and dental caries
iron def
anemia, slowed growth and cognitive dev.

and increased lead absorbtion
copper def
impairs brain fct, neutropenia, vascular and bone integrity, and control of glucose and lipid metabolism
zinc def
impaired immune response, skin lesions, poor wound healing, impaired taste and appetite, and delayed development
lead poisoning and iron def
decresed intellectual ability
in utero effects on *growth congnition and morbidity from...
toxins, infection, and maternal diabetes
Vit A def
decreased tissue regeneration