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WHich IBD has transmural inflammation?
Crohns
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Which IBD has bowel wall thickening? Why
/?
Crohns--bc of transmural inflammation which causes edema
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Which IBD involves the rectum and has continous colonic involvement up to the transverse colon?
UC
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Which IBD has creeping fat?
Crohns
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Which IBD has granulomas?
Crohns
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Which IBD has skip lesions and rectal sparing?
Crohns
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Which IBD has pseudopolypps?
UC
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Which IBD has Lead pipe mophology?
UC
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Which IBD has cobblestone appearance of the mucosa?
Crohns
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What is sclerosing cholangitis?
inflammation and ulceration of bilducts inside and outside the liver
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Pyoderma gangrenosum and sclerosing cholangitis are extra-intestinal manifestations of what IBD?
UC
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Most common congenital anamoly of the GI tract?
Meckels diverticulum
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Meckels diverticulum is a remnant of what fetal structure?
vitelline duct
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Why is the mecke's diverticulum a "TRUE" diverticulum?
- because it contains all three layers of the wall i.e
- mucosa
- submucoa
- muscularis propria
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What kind of ectopic tissue might be present at a Meckel's Diverticulum?
gastric or pancreatic mucosa secreting gastric acid and causing ulceration and bleeding giving rise to anemia and occult stools
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What are the rules of 2 for Meckel's Diverticulum?
- 2% of population has it
- 2 feet away from the ileocecal valve
- 2 inches long
- 2% are symptomatic
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What connects the lumen of the developing gut to the yolk sac?
vitelline duct
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What is halithosis?
bad breath
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What is Zenker's diverticulum?
false diverticulum at the junction of pharynx and esophagus causing halithosis, dysphagia, obstruction
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What is a false vs true diverticulum?
- true--3 layers--mucosa, submucosa, muscularis externa
- false--2 layers--mucosa, submucosa,
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Diverticulosis occurs where?
sigmoid colon
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What is the physiology of the Diverticulosis?
herniation of mucosa and submucosa thru the muscularis externa
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What is the common site for a false diverticulum?
where the vasa recta perforates the muscularis externa
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What is the etiological factor of diverticulosis?
low-fiber diet
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What embryological structure gives rise to enteric ganglionic Auerbach's and Meissner's Plexi?
Neural crest cells
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What structure is absent in Hirschsprung disease?
enterric nervous system--parasympathetic Myenteric and Meissner's plexi
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Hirschspurng disease is associated with what congenital syndrome?
Down syndrome
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WHat is the difference between diarrhea and dysentry?
- diarrhea--increase frequency, high volume
- Dysentry--low volume with mucus and blood
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Test done for Rotavirus in infants?
rota virus antigen test
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Tx for Pseudomembranous colitis?
metronidazole
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what antibiotic use precipitates Pseudomembraneous colitis?
-
The pseudomembrane in Pseudomembraneous colitis is made up of what?
neutrophils, fibrin, necrotic cells, mucin
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What 3 antibodies are present in Celiac sprue?
- anti-gliadin
- anti-endomysial
- anti-transglutaminase
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Dermatitis Herpetiforms is associated with what malabsorption Dz?
Celiac Sprue
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What happens to the villi in Celiac Sprue?
What cells are present in the Lamina Propria?
- Blunting of villi
- Plasma cells are present
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What is Tropical Sprue?
How is it different from Celiac Sprue
Malabsorptive disease similar to Celiac sprue but responds to vitamins and antibiotics
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In what region do people get Tropical Sprue?
Caribbean and Central America
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What causes Whipple's Disease?
Tropheryma Whippeli
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Tropheryma Whippeli is what kind of gram staining organism?
Gram +
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PAS staining gram positive organisms with macrophages in the lamina propria are indicative of what malabsorption disease?
Whipple's Disease
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A diarrhea presenting with multisystem symptoms e.g arthritis, liver, spleen, CNS is most likely what malabsorption disease?
Whipple
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WHat are the sites of a volvulus?
-
What is a volvulus?
twisting of a portion of a bowel around its mesentery
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What are the consequences of a volvulus?
- intestinal obstruction
- Infarction
-
Intussusception?
telescoping of a proximal segment into distal segment
-
What are the causes for intussusception?
- just a mass --preventing peristalsis --mass--polyp, tumor in adults, peyers patches hyperplasia
- in children--adenovirus infection
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Red currant jelly stools are indicative of what GI malformation?
intussusception
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what is an incarcerated hernia?
visceral segment protrudes thru the wall--may leade to infarction
-
What causes Intestinal Adhesions?
surgery, infections, endometriosis
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In which IBD do you seen Apthous Ulcers and Linear fissures?
Crohns
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Which IBD presents with bloody diarrhea?
UC
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Which IBD has Crypt abscess?
UC
-
Which IBD increases chances of colorectal adenocarcinoma?
UC
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Which IBD may present with toxic megacolon?
UC
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Which IBD has extraintestinal manifestations due to immune-complex like deposition such as erythema nodosum, migratory polyarthritis?
Crohns
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Which polyps have a higher risk of malignancy?
Tubular or Villous?
Villous
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Malignancy of polyps increases with what factors?
- Villous size
- Histology
- extent of dysplasia
-
Are hyperplasic polyps malignant?
NO
-
ARE juvenile polyps malignant?
no if they're single
-
Where do most hyperplasic polyps occur?
in the sigmoid region
-
WHIch tumors have a sawtooth appearance?
Hyperplastic Tumors
-
What is Peutz-Jegher Synrome?
- multiple Hamartomas in GI tract
- hyperpigmented lesions around the mouth, hands, genitalia
-
What is Juvenile Polyposis syndrome?
multiple juvenile polyps in GI tract
-
Whats Cronkhite-Canada Syndrome?
non-familial Polyps + anomalies of skin, nails alopecia
-
What is the treatment for FAP?
prophylactic colectomy
-
What is the first gene inactivated in FAP?
APC
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What is Gardner's Syndrome?
FAP + soft tissue tumors
-
What is Turcot's syndrome?
FAP + CNS tumors
-
hereditary non-polyposis colorectal cancer/LYNCH syndrome is caused by what?
Mismatch repair gene mutation
-
What are the sequential mutation of genes involved in CRC?
APC, K-ras, p53
-
What are the two molecular pathways leading to CRC?
- DNA mismatch repair genes
- Apc/beta catenin pathway
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How can colon cancer be differentiated from ascending colon and descending colon location?
- ascending--anemia
- descending--change in bowel movement
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