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47 Cards in this Set

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Diverticuli are blind pouches found in the:
alimentary tract
Diverticuli are lined by:
Mucosa, muscularis, and serosa
The 4 GI tract locations of diverticuli are:
esophagus, stomach, duodenum and colon
Why are most diverticuli termed false?
They lack or have an attenuated muscularis mucosa.
Percent of older patients likely to get diverticulosis (many diverticula):
50% of patients >60
The reasons for increasing number of diverticula with age are:
Increased intraluminal pressure and focal weaknes in the colonic wall.
What type of diet is diverticulosis associated with?
low-fiber
Sx of diverticulosis?
usually asymptomatic, sometimes vague discomfort.
Diverticulitis commonly presents with pain where?
LLQ
Complications of diverticulitis include:
perforation, peritonitis, abcess formation, bowel stenosis
What is intussuception?
telecoping of 1 bowel segment into distal segment.
Complication of intussusception is:
compromised blood supply.
What is volvulus?
Twisting of portion of the bowel around its mesentery.
What volvulus lead to?
obstruction.
What is the most common type of stomach cancer?
adenocarcinoma
Is this cancer aggresive?
Yes, it has early aggressive local spread and node/liver mets
Stomach Cancer is associated with what 3 etiologic factors?
dietary nitrosamines, achlorhydria, chronic gastritis
What is stomach cancer termed when it is diffusely infiltrative with thickened and rigid appearance?
Linitis plastica
What does Virchow's node signify?
involvement of supraclavicular node by stomach mets
What is Krukenberg's tumor?
bilateral stomach cancer mets to the ovary
What are characteristics of Krukenberg's tumor?
Abundant mucus, "signet ring" cells
What is Hirschprung's diease?
congential megacolon
What is missing?
enteric nerve plexus (both Auerbach's and Meissner's). Seen on biopsy
What is the cause of this disease?
failure of neural crest migration.
How does this disease present?
Chronic constipation early in life.
Which part of the colon is dilated?
That part proximal to the aganglionic segment - aganglionic portion is constricted.
The risk factors for colorectal cancer are:
colorectal villous adenoma, IBD, low-fiber diet, age, FAP, HNPCC, personal and family hx. of colon cancer.
What is Peutz-Jeghers, and does it lead to colorectal cancer?
It is a benign polyposis syndrome which is not a risk factor.
Who schould be screened for colorectal cancer and how?
People over age 50, screen with stool occult blood test.
Cirrho in Greek means:
tawny yellow
Cirrhosis is:
diffuse fibrosis of the liver with destruction of norml architecture, nodular regeneration.
Cause of micronodular cirrhosis (nodules <3mm, uniform in size) is:
metabolic insult
Causes of macronodular cirrhosis (nodules >3mm, varied in size) are?
Significant liver injury leading to hepatic necrosis (post-infectious, drug-induced hepatitis)
Cirrhosis is assocated with what type of cancer?
hepatocellular carcinoma
The effects of portal hypertension are:
esophageal varices (hemetemesis, melena), peptic ulceration (melena), splenomegaly, caput medusae, ascites, hemmorhoids, and testicular atrophy
Portal hypertension may be relieved by what method?
Portacaval shunt between splenic vein ad left renal vein.
What are the effects of liver cell failure?
Coma, scleral icterus, fetor hepaticus (breath smells like a freshly opened corpse), spider nevi, gynecomastia, jaundice, loss of sexual hair, asterixis, bleeding tendency, anemia, ankle edema
Hepatocytes in alcoholic hepatitis are:
swollen and necrotic
Other histologic changes seen in aloholic hepatitis are:
neutrophil infiltration, mallory bodies (hyaline), fatty change, and sclerosis areound central vein
SGOT (AST):SGPT (ALT) ratio in alcoholic hepatitis is:
usually more than 1.5 (A Scotch and Tonic: AST elevated)
What is Budd-Chiari Syndrome?
Occlusion of the IVC or hepatic veins with centrilobular congestion and necrosis, leading to congestive liver disease
The features of congestive liver disease are:
hepatomegaly, ascites, abdominal pain, and eventual liver failure
Budd-Chiari Syndrome is associated with what 3 conditions:
polycythemia vera, pregnancy, hepatocellular carcinoma
Wilson's disease is?
Copper accumulation, especially in liver, brain and cornea
It is due to what?
failure of copper to enter circulation in the form of ceruloplasmin
What is another name for Wilson's Disease?
Hepatolenticular degeneration
What are the symptoms of Wilson's Disease? (A,B,C-6,D)
Asterixis, basal ganglia degeneration (parkinsonian symptoms), Ceruloplasmin decrease, cirrhosis, corneal deposits (kayser-fleischer rings), copper accumulation, carcinoma (hepatocellular), choreiform movements, Dementia