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36 Cards in this Set
- Front
- Back
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Achalasia
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Failure to relax chch by :
aperistalsis incomplete relaxation of the LES with swallowing increased resting tone of the LES |
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Secondary achalasia
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Chagas disease (trypanosome cruzi
- destruction of the myenteric plexus |
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Hiatal Hernia
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Two patterns:
1. axial or sliding hernia (95%) -- protusion of the stomach above the diaphragm (bell shaped) 2. paraesophageal hiatal hernia -- portion of the stomach along the greater curvature |
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Hiatal Hernia Complications
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Ulceration leading to bleeding and perforation
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Hiatal Hernias are Characterized by:
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heartburn or
regurgitation of gastric juices into the mouth that is accentuated by positions and obesity |
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Esophageal Varices
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extremely dilated sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension, commonly due to cirrhosis
90% from alcoholic cirrhosis then schistosomiasis |
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Complication of Esophageal varices
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rupture that leads to massive hematemesis (vomiting blood)
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GERD - Reflux Esophagitis caused by
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1. decreased antireflux mechanisms: alcohol, tobacco, hypothyroidism, pregnancy
2. sliding hiatal hernia 3. gastric juice - hyperacicdity |
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GERD histologic features
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Inflammatory Cells (EOS, neutrophils, lymphocytes)
Basal Zone hyperplasia Capillary congestion |
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GERD - Reflux Esophagitis Clinical presentation
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dysphagia and heartburn
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Barrett Esophagus
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In 10% of people with long standing GERD
Risk factor for adenocarcinoma RED VELVETY MUCOSA in esophageal and gastric mucosa GOBLET CELLS metaplasia --- gives definitive diagnosis 40-60 yo white males |
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Adenocarcinoma
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Majority from Barrett Mucosa - tobacco and obesity
Distal esophagus raised patches, large nodularmasses |
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Parietal Cells
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Secrete intrinsic factor
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Chief Cells
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proenzymes pepsinogen I and II
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Congenital Hypertrophic Pyloric Stenosis
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Turner syndrome, trisomy 18, esophageal atresia
Regurgitation and persisten projectile nonbilious vomiting in 2nd, 3rd week of life FIRM PALPABLE MASS IN THE REGION OF THE PYLORUS BIG PYLORIC SPHINCTER WHEN BORN |
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Acute Gastritis
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one of the most common things seen in NSAID users
Major cause of massive hematemesis |
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Acute Gastritis
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transient inflammatory process
neutrophils are present above the basement membrane erosion (loss of superficial epithelium) |
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Chronic Gastritis
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mainly caused by H. Pylori
Occurs in 2 patterns: 1. antral type with high acid 2. pangastritis (autoimmune, 10%) - atrophic gastritis |
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Peptic Ulcer Disease
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breach of mucosa into the submucosa or deeper
usually solitary |
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Peptic Ulcers are located....
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duodenum or stomach
gastroesophageal junction Zollinger Ellison Syndrome |
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Peptic Ulcers are caused by
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recurrent H. Pylori Infection
acid imbalances |
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Gastric Ulcers usually located
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Lesser Curvature
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Peptic Ulcer Complications
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Bleeding
perforation obstruction from edema or scarring |
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Gastric Carcinoma
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90-95% of malignant tumors of the stomach
H. Pylori infection increases incidence 5-6x |
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Gastrointestinal Stromal Tumor (GISTs)
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Originate from the interstitial cells of Cajal (control GI peristalsis)
Can be solitary or multiple Positive for c-KIT (CD 117) and CD34 |
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Meckel Diverticulum
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failure of the viteline duct produces it
lies on the antimesenteric side of the bowel within 2 feet of the ileocecal valve |
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Causes of Secretory Diarrhea
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infections (rotavirus, calciviruses, enteric adenoviruses)
enterotoxin mediated neoplastic |
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Osmotic Diarrhea
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Disaccharidase definiencies
lactulose therapy |
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Exudative Disease
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Shigella, slamonella, campylobacter, Entamoeba hisotlytica
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Viral Enterocolitis
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Acute
self limiting major cause of morbidity in Children |
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Bacterial Enterocolitis
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Ingestion of preformed toxin - develops within hours
toxigenic organisms prolifeate within the gut >> traveler's diarrhea Enteroinvasive organisms >> invade and destroy mucosa (dysentery) |
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Antibiotic Associated Colitis (pseudomembranous Colitis)
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pseudomembran formation (inflammatory cells and debris over sites of mucosal injury)
Caused by Clostridium difficile after antibiotics Dramatic potentially lethal diarrhea may occur |
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Amebiasis
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Entamoeba histolytica (ameba) causes dysentery spread by fecal-oral route
in 40% parasites penetrate the splanchnic vessels and embolize to the liver and produce abscesses |
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Giardiasis
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MOST COMMON PATHOGENIC PARASITIC INFECTION IN HUMANS
spread by contaminated water/food pear shaped and binucleate cells on stool smear acute/chronic diarrhea, steatorrhea or constipation |
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collagenous collitis
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chronic watery diarrhea
patches of bandlike collagen deposits directly under the surface epithelium |
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Lymphocytic colitis
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intraepithelial infiltrate of lymphocytes
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