this pathology lecture covered diarrhea and enterocolitis.
questions
developmental abnormalities...
1. what is a gastroschisis?
2. what is an omphalocele?
3. what is "heterotopia"?
4. what is meckel's diverticulum?
5. what is the "rule of 2's" in regards to meckel's diverticulum?
6. what is hirschsprung disease?
diarrhea...
7. how is diarrhea defined?
8. what is secretory diarrhea and what are the common triggers? what is the effect of fasting?
9. what is osmotic diarrhea and what are the common triggers? what is the effect of fasting?
10. what is exudative diarrhea? what is the effect of fasting?
11. what are some causes of "deranged motility" diarrhea?
celiac disease...
12. what are the genetic markers related to celiac disease?
13. gliadin is deaminated by...
14. what are some histomorphological features of celiac disease?
15. which sites are the best sites to biopsy in celiac?
16. what are some of the main symptoms of celiac?
17. what are some secondary manifestations of celiac?
18. what are the sequelae for celiac?
19. celiac might be associated with a lower risk for...
20. what are the tests used to diagnose celiacs?
other forms of enterocolitis...
21. tropical sprue may be associated with which microorganisms?
22. what is "whipple disease"?
23. what are some clinical features of whipple disease?
24. what type of diarrhea occurs in lactase deficiency?
25. what causes malabsorption in bacterial overgrowth syndrome?
26. how is bacterial overgrowth syndrome diagnosed?
27. what are the clinical features of bacterial overgrowth syndrome?
28. what is the etiology of enterocolitis due to pancreatic insufficiency?
29. what is the clinical presentation of enterocolitis due to pancreatic insufficiency?
infectious enterocolitis...
30. what is the most common cause of infectious enterocolitis in the world?
31. what is the morphology of the intestinal mucosa in infectious enterocolitis?
32. what are the three mechanisms for pathogenesis of infectious enterocolitis?
33. what is the most common caused of infectious enterocolitis caused by parasites?
34. pseudomembranous enterocolitis is mainly due to which microorganism?
35. what is the morphology of pseudomembranous enterocolitis in the colon?
36. what does the "pseudomembrane" refer to in pseudomembranous enterocolitis?
answers
1. failure of formation of some portion of the intestinal wall.
2. herniation of the abdominal viscera which results from failure of formation of a portion of the abdominal musculature.
3. 1-2 cm nodules of gastric or pancreatic mucosa.
4. a solitary diverticulum up to 6cm in diameter near the IC valve that results from failed involution of the vitelline duct.
5. 2% of the population affected
within 2 feet of IC valve
2 inches long
2 times as common in males
symptomatic by age 2
6. bowel obstruction from a congenital lack of enteric innervation of a portion of the distal intestine which can lead to megacolon.
7. more than 250g of stool/day composed of 70-95% water.
8. secretion of isotonic fluid and over 500g stool/day, commonly caused by v. cholera. can also be triggered by castor oil and other substances. persists with fasting.
9. output of fluid in the intestine due to increased osmotic pressure in the lumen. abated by fasting.
10. diarrhea with purulent, bloody stools; persists with fasting. can be caused by IBD, shigella, salmonella, etc.
11. diabetes
thyrotoxicosis
bacterial overgrowth
irritable bowel disease.
12. HLA DQ2 and DQ8.
13. TTG: tissue trans glutaminase.
14. villous atrophy
leukocytic infiltrates
crypt hyperplasia
15. duodenum, proximal jejunum.
16. diarrhea, flatulence, weight loss, fatigue, constipation.
17. ataxia
B12 deficiency
chronic anemia
dermatitis herpetiformis
osteoporosis
18. increased risk for GI cancers, bone fractures.
19. breast and lung cancer.
20. TTG, AGA, EMA.
21. e. coli, hemophilus.
22. a rare condition that involves tropheryma whippelii found in macrophages in the lamina propria of the SI, with no inflammation.
23. LA
hyperpigmentation
malabsorption
polyarthritis
CNS problems
24. osmotic.
25. bile deconjugation, mucosal damage by bacteria, and increased competition for nutrients.
26. by testing H2 and methane levels in breath.
27. diarrhea, abdominal pain, malabsorption, weight loss
28. cystic fibrosis
chronic pancreatitis
pancreatic adenocarcinoma
29. steatorrhea, gas, bloating, nutrient deficiency.
30. rotavirus.
31. increased mitosis, neutrophilic infiltrate, villi blunting, loss of microvilli.
32. preformed toxin, toxigenic (toxin formed in gut), enteroinvasive.
33. giardia.
34. c. difficile.
35. yellow, plaque like adhesions, looks like bad acne.
36. damaged crypts that have been filled with mucopurulent exudate. 37.
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