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88 Cards in this Set

  • Front
  • Back
what marks the entry of the small intestine into the peritoneal cavity?
what does the superior mesenteric artery supply?
proximal jejunum to hepatic flexure
what does the inferior mesenteric artery supply?
hepatic flexure to the rectum
what supplies the lower portion of the rectum?
hemorrhoidal branch of internal iliac or pudendal
where are the stem cells of the small intestine located?
crypts of Lieberkuhn
where are Brunner's glands and what is there function?
duodenum and secretion of bicar., glycoproteins, and pepsinogen II
where are secretary granules released from endocrine cells in the gut?
at or near the basal surface
function of M cells?
move antigenic macromolecules from the lumen to under the surface epithelium
function of plasma cells?
secrete IgA,IgG,IgM
where is Meissner's plexus located?
base of the submucosa
where is Auerbach's plexus located?
between the muscle layers of the muscle wall
complete closure of an opening
defect in Meckel diverticulum?
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
defect in Hirschsprung disease?
intestinal segment with missing ganglion cells (Meissner and Aurbach plexi)
obstruction and dilation proximal to defect
mutation causing Hirschsprung disease?
RET gene inactivating the kinase activity
hallmark of malabsorption disease?
defect in Celiac's disease?
mucosal lesion of the small intestine and impaired nutrient absorption-T cell mediated inflammation due to intolerance to gluten
what is necrotizing enterocolitis?
acute, necrotizing inflammation of the intestines with necrosis of intestinal segments
what do neonates with necrotizing enterocolitis present with?
bloody stool, distended abdomen and gas in the intestinal wall
low-volume, painful, bloody diarrhea
what does rotavirus do?
selectively destroys mature enterocytes in the small intestine-replaced by secretory cells
where are antirotavirus antibodies located?
mother's milk
morphology of viral gastroenteritis?
shortened villi, lymphocytes in the lamina propria, loss of brush border, hypertrophied crypts
another name for bacterial enterocolitis?
food poisoning
main property of bacteria contributing to the pathogenesis of enterocolitis?
ability to adhere to mucosal epithelial cells by plasmid-encoded adhesins
what do staph enterotoxins do?
proteins that bind to Ag receptors of T cells and stimulate cytokine secretion- intestinal motility and fluid secretion
what does the cholera enterotoxin do?
increases intracellular Ca, dysfunction of the fluid and electrolyte transport
what does shigella do?
invades intestinal mucosal cells and destroys them causing hemorrhaging
what does salmonella do?
invades intestinal epithelial cells and macro's, secretion increased by neural reflex pathways
what characterizes pseudomembranous/antibiotic colitis?
adherent layer of inflammatory cells and debris overlying sites of mucosal injury
what causes antibiotic colitis?
C. difficile
characteristics of most bacterial infections of the GI?
epithelial damage, decreased maturation, increased mitotic rate, hyperemia and edema of the lamina propria
where does shigella primarily affect?
distal colon
where does salmonella primarily affect?
ileum and colon
what is the most common pathogenic parasitic infection in humans?
what is important in resistance to giardia?
Ab mediated immunity
how does giardia work?
trophozites adhere to but do not invade epithelial cells-diarrhea not dysentery
what is primarily affected by T. whippelii?
intestines, CNS and joints
what does T. whippelii invade?
macrophages without an immune reaction
hallmark of Whipple disease?
small-intestinal mucosa with distended macrophages in the lamina propria
name the types of IBD
ulcerative colitis
pathogenic abnormalities in IBD?
immune response against intestinal flora
defect in epithelial barrier
genetic susceptibility
GI affected by Crohn's?
any part
presentation of Crohn's?
abdominal pain, anemia, mild diarrhea, fever
abnormal communication between organs
gross features of Crohn's?
thickened wall with stricture and fissures
fistulas and perforations
cobblestoning of the mucosa
creeping fat
microscopic features of Crohn's?
patchy inflammation
aphthous-shallow ulcers above lymph nodules
occasional granulomas
presentation of ulcerative colitis?
recurring bloody mucoid diarrhea
waxes and wanes
what is preventative of UC?
gross features of UC?
continuous disease starting in the rectum and moving proximally
only colon
no thickening
inflammatory pseudopolyps
occasion megacolong
microscopic features of UC?
diffuse mucosal inflammation
little ulceration
risk of colon carcinoma
the two diseases requiring prophylactic colectomy?
UC and FAP
extraintestinal manifestations of IBD?
liver-primary sclerosing cholangitis
pulmonary inflammatory fibrosis
three levels of severity in GI vascular disorders?
mucosal infarction
mural infarction
transmural infarction
is the superior or inferior mesenteric artery more affected by ischemia?
two phases of injury in ischemic bowel disease?
initial hypoxic injury
secondary re-perfusion injury
major causes of vascular obstruction?
arterial/venous thrombosis
arterial embolism
nonocclusive ischemia
inflammation of the uveal tract, behind the cornea
outpouching or invagination of the mucosa into the wall of the bowel
true diverticuli?
includes the mucosa plus the entire wall
only the mucosa
cause of diverticular disease?
increased intraluminal pressure, weakness in the wall
where is the most common site of diverticulum?
left colon
common types of intestinal obstruction?
contortion of a loop of intestine causing obstruction
enfolding of one part of the intestine into another
what is a hyperplastic polyp?
small, single polyp with no dysplasia
what is a Peutz-Jeghers polyp?
tumor-like growth
most common location for small intestine tumors?
duodenal ampulla
what disease is associated with small intestine tumors?
what increases the chances of cancer in an polyp?
high number
increased size
sessile- less stalk
high grade dysplasia
defect in FAP?
autosomal dominant germline mutation of APC gene
presentation of FAP?
hundreds of colonic polyps
other tumors and lesions
association of FAP and cancer?
defect in HNPCC
autosomal dominant mutations in DNA repair genes
where are HNPCC polyps more likely to appear?
right side of colon
two pathways of colorectal carcinogenesis?
APC gene pathway
MMR gene pathway
mechanism in APC gene pathway to colon cancer?
most are somatic mutations
at least seven mutations leading to metastasis
what pathway occurs in FAP?
ACP gene pathway
what pathway occurs in most of HNPCC?
MMR gene pathway
mechanism in MMR gene pathway to colon cancer?
mutation in any DNA repair of MMR genes- produces DNA fragments or microsatellites
presentation in right-sided colon cancer?
slow blood loss leading to anemia, weakness
presentation in left-sided colon tumors?
altered bowel function, bleeding
location of most tumors in colorectal carcinoma?
left side
gross presentation of carcinoid tumor?
ball in the wall of the intestines protruding into the lumen with a dimple
which has the better prognosis: carcinoid or carcinoma?
is prognosis of B or T cell GI lymphoma better?
mechanism of acute appendicitis?
obstruction by lymphoid,hyperplasia,tumor or fecal stone
elevated WBC's
risk of perforation, abscess and peritonitis(inflammation)