ambirnba's version from 2015-04-13 14:39

Section 1

Question Answer
Gastroschisis. due to malformation of _______congenital malformation of the anterior abdominal wall leading to exposure of abdominal contents (
OMPHALOCELEpersistence of herniation of abdominal contents into umbilical cord, sealed by peritoneum
OMPHALOCELE mneumonicsealed by peritoneum
Atresia =complete lumen occlusion
stenosis =lumen narrowing
DUODENAL ATRESIA. def. associationcongenital failure of duodenum to canalize; associated with Down syndrome
DUODENAL ATRESIA. 3 clinical features1. polyhydramnios (impairs the ability of the fetus to swallow (the fetus normally swallows the amniotic fluid)) 2. distension of stomach and blind loop of duodenum ('double bubble' sign 3. Bilious vomiting
Polyhydramnios = excess of amniotic fluid in the amniotic sac
Oligohydramnios= ; associated withdeficiency in amniotic fluid. associate with renal agenesis (absent kidney formation)
Umbilical hernia. what week in embryology?Intestines return into the abdomen in the 10th week, but the umbilicus is not perfectly closed. Hernia (greater omentum and part of small intestine) protrude during coughing, crying etc. and can easily be repositioned, often disappears by age 3-5
MECKEL DIVERTICULUM. what?Arises due Persistence of the ______A. Outpouching of all three layers of the bowel wall (true diverticulum, Fig. 10.16) B. Persistence of the vitelline duct.
MECKEL DIVERTICULUM: rule of 2s1. Seen in 2% of the population (most common congenital anomaly of the GI tract) 2. 2 inches long and located in the small bowel within 2 feet of the ileocecal valve 3. Can present during the first 2 years of life with bleeding (due to heterotopic gastric mucosa), volvulus, intussusception, or obstruction (mimics appendicitis); however, most cases are asymptomatic.
above pectinate line. epithelium. embyological origin. artery. nervescolumnar epithelium. endoderm. superior rectal artery. inferior hypogastric plexus
below pectinate line. epithelium. embyological origin. artery. nervesstratified squamous epithelium, non-keratinized (until Hilton's white line). ectoderm. middle and inferior rectal arteries. inferior rectal nerves.
Hirschsprung’s disease. definition. associated with...defective relaxation and peristalsis of rectum and distal sigmoid colon. ssociated with Down syndrome
Hirschsprung’s disease. due to (embryology + gene) Congenital megacolon characterized by lack of ganglion cells/enteric nervous plexuses (Auerbach and Meissner plexuses) in segment of colon. Due to failure of neural crest cell migration. Associated with mutations in the RET gene.
Hirschsprung’s disease. 4 clinical features1. failure to pass meconium 2. massive dilation (megacolon) 3. bilious emesis 4. abdominal distention
Hirschsprung’s disease. treatmentresection

Section 2

Question Answer
The pancreas and major salivary glands are ____compound exocrine glands— specialized secretory organs that contain a branching ductular system through which they release their secretory products.
acinar cells are specialized protein-synthesizing cells
pancreatic acinar cells are stimulated by ___ and _____ to release ______ ACh and CCk to release zymogen granules (digestive enzymes)
The pancreatic duct cell secretes− HCO3-rich fluid that alkalinizes and hydrates the protein-rich primary secretions of − the acinar cell
_____ and ______ stimulate the pancreatic duct cells to secrete ______secretin and ACh ... bicarbonate
CCK from ____ stimulates enzyme secretion by the aciniduodenal I cells
_____ from ____ stimulates bicarbonate and fluid secretion by the ductssecretin from S cells stimulates HCO3 and fluid secretion by the ducts
The gallbladder is a concentrative and storage reservoir that can deliver ______ in high concentration and in a controlled manner to the _______ for the _______ of dietary _______The gallbladder is a concentrative and storage reservoir that can deliver bile acid in high concentration and in a controlled manner to the duodenum for the solubilization of dietary lipid
ampulla of vater (aka hepatopancreatic duct). is formed by the union of _____. it marks the transition from _________the pancreatic duct and the common bile duct. foregut to midgut
secretin 4 actionsStimulates pancreatic bicarbonate secretion Stimulates hepatic bicarbonate secretion Inhibits gastric acid secretion Slows gastric emptying
CCK actionsStimulates gallbladder contraction Stimulates pancreatic enzyme release Delays gastric emptying (satiety factor) Interacts with hypothalamic satiety center via vagal innervation
bile is produced in the liver
what determines whether bile is released to the small intestine? Whether or not bile is released into the small intestine depends upon the activity of the sphincter of Oddi (also known as the hepatopancreatic sphincter).
what happens to bile during the interdigestive period?During the interdigestive period, the sphincter of Oddi is contracted, preventing bile from flowing out into the duodenum. As a consequence, pressure increases in the common bile duct, and bile flows into the gallbladder. In the gallbladder, epithelial cells reabsorb water and electrolytes, causing the bile to become more concentrated.

Section 3

Question Answer
6 risk factors of acute gastritissevere burn (hypovolemia leads to descreased blood supply), NSAIDS (decreased PGE2), heavy alcohol, chemotherapy, increased intracranial pressure (stimulation on vagus n. >> inc ACh >> inc acid production), shock
intestinal metaplasia is seen in what stomach pathology?. what can you see on histology?chronic gastritis. goblet cells and villi.
gastric mucosal atrophy can develop inchronic gastritis
1 risk factor for gastric adenocarcinomaGastric intestinal metaplasia
chronic autoimmune gastritis is due to autoimmune destruction of gastric parietal cells
chronic autoimmune gastritis hypersensitivitymediated by T cells (type IV hypersensitivity)
what type of anemia is associate with what type of gastritis?chronic autoimmune gastritis. Megaloblastic (pernicious) anemia due to lack of intrinsic factor
epigastric pain that improves with mealsduodenal ulcer (because duodenum secretes alkaline to prepare)
peptic ulcer diseaseproximal (anterior) duodenum (90%) or lesser curvature of antrum (10%)
presents with epigastric pain that worsens with mealsgastric ulcer (because stomach secretes acid to digest)
menetrier diseasegastric hyperplasia of mucosa in fundus and body. hypertrophied rugae. excess mucus production. parietal cell atrophy (decreased acid production).
Zollinger-Ellison syndromeGastrin-secreting tumor (gastrinoma) of pancreas or duodenum. recurrent ulcers in duodenum and jejunum, peptic ulcer disease
intestinal type of gastric carcinoma. morphology and location:presents as a large, irregular ulcer with heaped up margins; most commonly involves the lesser curvature of the antrum (similar to gastric ulcer)
what pathology is associated with ntestinal metaplasia (e.g., due to H pylori and autoimmune gastritis), nitrosamines in smoked foods (Japan), and blood type A?intestinal type of gastric carcinoma
diffuse type of gastric carcinoma. histologysignet ring cells that diffusely infiltrate the gastric wall (Fig. 10.14B); desmoplasia results in thickening of stomach wall (linitis plastica,
______ ulcers can be caused by NSAIDsgastric
_______ ulcers can be caused by Zollinger-Ellison syndromeduodenal
which type of ulcers are usually benign? which can be malignant?benign= duodenal. malignant= gastric
curling ulcer. definition and mneumonicburns. decr plasma volume. sloughing of gastric mucosa. Burned by the Curling iron.
cushing ulcer. definition and mneumonicbrain injury. inc vagal stimulation. inc ACh. inc H+.... Always Cushion the brain.

Section 4

Question Answer
osmotic diarrheaPoorly absorbable, osmotically active solutes draw fluid into intestine, which exceeds reabsorptive capacity
diarrhea that stops with fastingosmotic diarrhea
4 causes of osmotic diarrheaMagnesium containing antacids Health supplements Laxatives - measure Mg2+ or other laxative levels in the stool Carbohydrate malabsorption
2 carbohydrates that cause osmotic diarrhealactose, sorbitol (gum)
1 mineral that cause osmotid diarrheaMg
what enzyme turns starch>>> disaccharidespancreatic amylase
what enzyme turns disaccharides to monosaccharidesbrush border enzymes
where is lactase enzyme found?brush border of enterocytes