Pathology- Small And Large Intestine

Front 1

what marks the entry of the small intestine into the peritoneal cavity?

Back 1

jejunum

Front 2

what does the superior mesenteric artery supply?

Back 2

proximal jejunum to hepatic flexure

Front 3

what does the inferior mesenteric artery supply?

Back 3

hepatic flexure to the rectum

Front 4

what supplies the lower portion of the rectum?

Back 4

hemorrhoidal branch of internal iliac or pudendal

Front 5

where are the stem cells of the small intestine located?

Back 5

crypts of Lieberkuhn

Front 6

where are Brunner's glands and what is there function?

Back 6

duodenum and secretion of bicar., glycoproteins, and pepsinogen II

Front 7

where are secretary granules released from endocrine cells in the gut?

Back 7

at or near the basal surface

Front 8

function of M cells?

Back 8

move antigenic macromolecules from the lumen to under the surface epithelium

Front 9

function of plasma cells?

Back 9

secrete IgA,IgG,IgM

Front 10

where is Meissner's plexus located?

Back 10

base of the submucosa

Front 11

where is Auerbach's plexus located?

Back 11

between the muscle layers of the muscle wall

Front 12

atresia

Back 12

complete closure of an opening

Front 13

defect in Meckel diverticulum?

Back 13

failure of involution of the vitelline duct (connects lumen of developing gut to the yolk sac), creates a blind pouch on the mesenteric side of the bowel

Front 14

defect in Hirschsprung disease?

Back 14

intestinal segment with missing ganglion cells (Meissner and Aurbach plexi)
obstruction and dilation proximal to defect

Front 15

mutation causing Hirschsprung disease?

Back 15

RET gene inactivating the kinase activity

Front 16

hallmark of malabsorption disease?

Back 16

steatorrhea

Front 17

defect in Celiac's disease?

Back 17

mucosal lesion of the small intestine and impaired nutrient absorption-T cell mediated inflammation due to intolerance to gluten

Front 18

what is necrotizing enterocolitis?

Back 18

acute, necrotizing inflammation of the intestines with necrosis of intestinal segments

Front 19

what do neonates with necrotizing enterocolitis present with?

Back 19

bloody stool, distended abdomen and gas in the intestinal wall

Front 20

dysentery

Back 20

low-volume, painful, bloody diarrhea

Front 21

what does rotavirus do?

Back 21

selectively destroys mature enterocytes in the small intestine-replaced by secretory cells

Front 22

where are antirotavirus antibodies located?

Back 22

mother's milk

Front 23

morphology of viral gastroenteritis?

Back 23

shortened villi, lymphocytes in the lamina propria, loss of brush border, hypertrophied crypts

Front 24

another name for bacterial enterocolitis?

Back 24

food poisoning

Front 25

main property of bacteria contributing to the pathogenesis of enterocolitis?

Back 25

ability to adhere to mucosal epithelial cells by plasmid-encoded adhesins

Front 26

what do staph enterotoxins do?

Back 26

proteins that bind to Ag receptors of T cells and stimulate cytokine secretion- intestinal motility and fluid secretion

Front 27

what does the cholera enterotoxin do?

Back 27

increases intracellular Ca, dysfunction of the fluid and electrolyte transport

Front 28

what does shigella do?

Back 28

invades intestinal mucosal cells and destroys them causing hemorrhaging

Front 29

what does salmonella do?

Back 29

invades intestinal epithelial cells and macro's, secretion increased by neural reflex pathways

Front 30

what characterizes pseudomembranous/antibiotic colitis?

Back 30

adherent layer of inflammatory cells and debris overlying sites of mucosal injury

Front 31

what causes antibiotic colitis?

Back 31

C. difficile

Front 32

characteristics of most bacterial infections of the GI?

Back 32

epithelial damage, decreased maturation, increased mitotic rate, hyperemia and edema of the lamina propria

Front 33

where does shigella primarily affect?

Back 33

distal colon

Front 34

where does salmonella primarily affect?

Back 34

ileum and colon

Front 35

what is the most common pathogenic parasitic infection in humans?

Back 35

giardia-protazoan

Front 36

what is important in resistance to giardia?

Back 36

Ab mediated immunity

Front 37

how does giardia work?

Back 37

trophozites adhere to but do not invade epithelial cells-diarrhea not dysentery

Front 38

what is primarily affected by T. whippelii?

Back 38

intestines, CNS and joints

Front 39

what does T. whippelii invade?

Back 39

macrophages without an immune reaction

Front 40

hallmark of Whipple disease?

Back 40

small-intestinal mucosa with distended macrophages in the lamina propria

Front 41

name the types of IBD

Back 41

ulcerative colitis
crohn's

Front 42

pathogenic abnormalities in IBD?

Back 42

immune response against intestinal flora
defect in epithelial barrier
genetic susceptibility

Front 43

GI affected by Crohn's?

Back 43

any part

Front 44

presentation of Crohn's?

Back 44

abdominal pain, anemia, mild diarrhea, fever

Front 45

fistula

Back 45

abnormal communication between organs

Front 46

gross features of Crohn's?

Back 46

discontinuous
thickened wall with stricture and fissures
fistulas and perforations
cobblestoning of the mucosa
creeping fat

Front 47

microscopic features of Crohn's?

Back 47

patchy inflammation
aphthous-shallow ulcers above lymph nodules
cryptitis
occasional granulomas

Front 48

presentation of ulcerative colitis?

Back 48

recurring bloody mucoid diarrhea
waxes and wanes

Front 49

what is preventative of UC?

Back 49

smoking

Front 50

gross features of UC?

Back 50

continuous disease starting in the rectum and moving proximally
only colon
no thickening
inflammatory pseudopolyps
occasion megacolong

Front 51

microscopic features of UC?

Back 51

diffuse mucosal inflammation
cryptitis
little ulceration
polyps
risk of colon carcinoma

Front 52

the two diseases requiring prophylactic colectomy?

Back 52

UC and FAP

Front 53

extraintestinal manifestations of IBD?

Back 53

liver-primary sclerosing cholangitis
polyarthritis
uveitis-eye
skin
pulmonary inflammatory fibrosis

Front 54

three levels of severity in GI vascular disorders?

Back 54

mucosal infarction
mural infarction
transmural infarction

Front 55

is the superior or inferior mesenteric artery more affected by ischemia?

Back 55

inferior

Front 56

two phases of injury in ischemic bowel disease?

Back 56

initial hypoxic injury
secondary re-perfusion injury

Front 57

major causes of vascular obstruction?

Back 57

arterial/venous thrombosis
arterial embolism
nonocclusive ischemia
physical

Front 58

uveitis?

Back 58

inflammation of the uveal tract, behind the cornea

Front 59

diverticulum?

Back 59

outpouching or invagination of the mucosa into the wall of the bowel

Front 60

true diverticuli?

Back 60

includes the mucosa plus the entire wall

Front 61

pseudodiverticuli?

Back 61

only the mucosa

Front 62

cause of diverticular disease?

Back 62

increased intraluminal pressure, weakness in the wall

Front 63

where is the most common site of diverticulum?

Back 63

left colon

Front 64

common types of intestinal obstruction?

Back 64

hernia
adhesions
volvulus
intussusception

Front 65

volvulus

Back 65

contortion of a loop of intestine causing obstruction

Front 66

intussusception?

Back 66

enfolding of one part of the intestine into another

Front 67

what is a hyperplastic polyp?

Back 67

small, single polyp with no dysplasia

Front 68

what is a Peutz-Jeghers polyp?

Back 68

tumor-like growth

Front 69

most common location for small intestine tumors?

Back 69

duodenal ampulla

Front 70

what disease is associated with small intestine tumors?

Back 70

FAP

Front 71

what increases the chances of cancer in an polyp?

Back 71

high number
increased size
sessile- less stalk
high grade dysplasia

Front 72

defect in FAP?

Back 72

autosomal dominant germline mutation of APC gene

Front 73

presentation of FAP?

Back 73

hundreds of colonic polyps
other tumors and lesions

Front 74

association of FAP and cancer?

Back 74

100%

Front 75

defect in HNPCC

Back 75

autosomal dominant mutations in DNA repair genes

Front 76

where are HNPCC polyps more likely to appear?

Back 76

right side of colon

Front 77

two pathways of colorectal carcinogenesis?

Back 77

APC gene pathway
MMR gene pathway

Front 78

mechanism in APC gene pathway to colon cancer?

Back 78

most are somatic mutations
at least seven mutations leading to metastasis

Front 79

what pathway occurs in FAP?

Back 79

ACP gene pathway

Front 80

what pathway occurs in most of HNPCC?

Back 80

MMR gene pathway

Front 81

mechanism in MMR gene pathway to colon cancer?

Back 81

mutation in any DNA repair of MMR genes- produces DNA fragments or microsatellites

Front 82

presentation in right-sided colon cancer?

Back 82

slow blood loss leading to anemia, weakness

Front 83

presentation in left-sided colon tumors?

Back 83

altered bowel function, bleeding

Front 84

location of most tumors in colorectal carcinoma?

Back 84

left side

Front 85

gross presentation of carcinoid tumor?

Back 85

ball in the wall of the intestines protruding into the lumen with a dimple

Front 86

which has the better prognosis: carcinoid or carcinoma?

Back 86

carcinoid

Front 87

is prognosis of B or T cell GI lymphoma better?

Back 87

B

Front 88

mechanism of acute appendicitis?

Back 88

obstruction by lymphoid,hyperplasia,tumor or fecal stone
elevated WBC's
risk of perforation, abscess and peritonitis(inflammation)