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Questions and Answers

¿Cuál de las siguientes características es típica del esófago de Barrett?

  • Inflamación por H.pylori
  • Mucosa columnar metaplásica por encima de la unión gastroesofágica (correct)
  • Presencia de células epiteliales escamosas sanas
  • Formación de úlceras duodenales

    • La infección por H.pylori se asocia comúnmente con qué tipo de gastritis?

  • Gastritis eosinofílica
  • Gastritis crónica (correct)
  • Gastritis aguda
  • Gastritis autoinmune

    • ¿Cuál es el principal mecanismo de transmisión de H.pylori?

  • Transmisión a través de alimentos contaminados
  • Transmisión sexual
  • Transmisión fecal-oral (correct)
  • Transmisión por aire

    • ¿Qué características histológicas se encuentran en el esófago de Barrett?

    <p>Células con características de tipo intestinal y células en forma de copa</p> Signup and view all the answers

    ¿Cuál de las siguientes afirmaciones sobre la gastritis crónica es correcta?

    <p>Puede llevar a la formación de linfomas</p> Signup and view all the answers

    ¿Cuál de las siguientes condiciones se presenta típicamente con un incremento en la producción de ácido estomacal?

    <p>Infección por H.pylori en la mucosa antral</p> Signup and view all the answers

    ¿Qué tipo de metaplasia se asocia con el diagnóstico de esófago de Barrett?

    <p>Metaplasia intestinal</p> Signup and view all the answers

    ¿Qué hallazgos se pueden observar en la mucosa antral infectada por H.pylori?

    <p>Mucosa con apariencia eritematosa y nódulos</p> Signup and view all the answers

    ¿Cuál es la principal causa de la infarcción transmural en el intestino?

    <p>Obstrucción vascular aguda</p> Signup and view all the answers

    En el caso de la isquemia intestinal aguda, ¿qué característica histológica se observa?

    <p>Atrofia del epitelio superficial</p> Signup and view all the answers

    ¿Cuál de las siguientes estructuras es particularmente vulnerable a lesiones isquémicas debido a su disposición capilar?

    <p>Epitelio de superficie</p> Signup and view all the answers

    La malabsorción se presenta comúnmente como:

    <p>Diarrea crónica</p> Signup and view all the answers

    En la isquemia intestinal, ¿qué tipo de infarto puede ser causado por la hipotensión generalizada?

    <p>Infarto mural</p> Signup and view all the answers

    ¿Qué proceso ocurre tras la reperfusión después de una isquemia intestinal?

    <p>Reclutamiento de neutrófilos</p> Signup and view all the answers

    ¿Cuál de las siguientes condiciones podría simular la formación de pseudomembranas en el intestino?

    <p>Colitis asociada a Clostridium difficile</p> Signup and view all the answers

    ¿Qué tipo de vitaminas se ven afectadas durante la malabsorción?

    <p>Vitaminas liposolubles y hidrosolubles</p> Signup and view all the answers

    ¿Cuál de los siguientes es un síntoma frecuente asociado con la enfermedad de reflujo gastroesofágico (GERD)?

    <p>Regurgitación de contenido gástrico agrio</p> Signup and view all the answers

    La achalasia secundaria puede originarse de qué enfermedad parasitaria?

    <p>Enfermedad de Chagas</p> Signup and view all the answers

    ¿Cuál es el tratamiento más común para la achalasia primaria y secundaria?

    <p>Dilatación con globo neumático</p> Signup and view all the answers

    ¿Qué condición clínica está asociada con laceraciones en el esófago debido a vómitos severos?

    <p>Síndrome de Mallory-Weiss</p> Signup and view all the answers

    ¿Qué función tienen las glándulas submucosas en el esófago?

    <p>Contribuir a la protección mucosa</p> Signup and view all the answers

    ¿Qué caracteriza a la metaplasia en el esófago en relación con el esófago de Barrett?

    <p>Transformación de un epitelio estratificado a uno cilíndrico</p> Signup and view all the answers

    ¿Cuál es la causa más común de esofagitis?

    <p>Reflujo de contenido gástrico</p> Signup and view all the answers

    ¿Qué acción provoca la relajación transitoria del esfínter esofágico inferior, contribuyendo al reflujo?

    <p>Consumo de alimentos grasos</p> Signup and view all the answers

    Study Notes

    DIGESTIVE DISORDERS

    • Esophageal Atresia and Tracheoesophageal Fistula: A congenital condition discovered shortly after birth, typically due to feeding difficulties. Esophageal atresia involves a non-canalized esophagus segment, leading to a mechanical obstruction. Often associated with a fistula connecting esophageal pouches to a bronchus or trachea. Can cause aspiration, suffocation, pneumonia, and fluid/electrolyte imbalances.

    DIAPHRAGMATIC HERNIA

    • Definition: Occurs when the diaphragm doesn't develop completely, allowing abdominal organs to enter the chest cavity.
    • Severity: Severe cases cause pulmonary hypoplasia (underdevelopment of the lungs), which is often incompatible with life.

    OMPHALOCELE

    • Definition: A congenital defect where abdominal organs (mostly intestines) protrude through a membrane sac at the navel.
    • Location: Centered.
    • Content: Contains intestines, colon, bladder, and gonads (occasionally).
    • Association: Often associated with other congenital anomalies.

    GASTROSCHISIS

    • Definition: Similar to omphalocele, but the abdominal organs protrude outside the body, outside a sac, with all the layers of the abdominal wall, from peritoneum to skin are involved.
    • Location: Right side.
    • Content: Contains intestines, liver (often), and sometimes spleen, colon, and bladder.
    • Association: Frequently associated with other congenital anomalies.

    MECKEĽS DIVERTSICULUM

    • Definition: A small, congenital outpouching of the ileum (part of the small intestine). It's the most common true diverticulum.
    • Mechanism: Results from failed involution of the vitelline duct, which connects the developing gut to the yolk sac.
    • Location: Usually within 2 feet (60 cm) of the ileocecal valve, approximately 2 inches (5 cm) long.
    • Prevalence: Occurs in approximately 2% of the population.
    • Sex Predominance: Twice as common in males.
    • Symptom Onset: Often asymptomatic, often becoming symptomatic by age 2 (only ~4% are ever symptomatic).

    PYLORIC STENOSIS/PYLORIC OBTSTRUCTION

    • Definition: A narrowing of the opening between the stomach and small intestine (pylorus).
    • Cause: Congenital hypertrophy of the pyloric sphincter.
    • Symptoms/Presentation: Projectile vomiting following feeding, constantly hungry, voracious appetite, dehydration.
    • Age of onset: Infants generally affected between 2 and 12 weeks old, but presentation can be from 2 weeks to 2 months.

    HIRSCHSPRUNG'S DISEASE

    • Definition: Congenital aganglionic megacolon, a condition where the nerves necessary for gut movement are absent in a segment of the large intestine.
    • Mechanism: Lack of normal migration of neural crest cells from the cecum to rectum.
    • Characteristics: Results in paralysis of bowel segments below the affected area, leading to bowel obstruction.

    ACHALASIA

    • Definition: A condition causing the lower esophageal sphincter (LES) to remain contracted, obstructing the passage of food into the stomach.
    • Symptoms: Dysphagia (difficulty swallowing solids and liquids), difficulty belching, chest pain, and regurgitation of undigested food.

    MALLORY-WEISS SYNDROME

    • Definition: Longitudinal tears in the mucosa of the distal esophagus and proximal stomach, typically occurring after forceful vomiting or retching.
    • Causes: Prolonged and persistent vomiting (e.g., from illness, alcohol use, or bulimia).
    • Symptoms: Acute upper gastrointestinal bleeding (hematemesis).

    BOERHAAVE'S SYNDROME

    • Definition: A spontaneous rupture of the esophagus, usually in the lower thoracic area, after forceful vomiting.
    • Symptoms: Chest pain and shock, often accompanied by subcutaneous emphysema (air in subcutaneous tissues), which is audible during auscultation of the chest (Hamman's sign).

    REFLUX ESOPHOAGITIS

    • Definition: Inflammation of the esophageal lining (epithelium) due to frequent reflux of stomach acid.
    • Cause: Transient lower esophageal sphincter (LES) relaxation; associated with conditions like obesity, hiatal hernia, pregnancy.

    MISCELLANEOUS (HISTOLOGY)

    • Histological Findings in various disorders (e.g., Inflammatory cells, inflammatory infiltrates, crypt abscesses, mucosal atrophy, pseudopyloric epithelial metaplasia)

    INFECTIOUS ENTEROCOLITIS

    • Etiologies: Viral (Rotavirus, Calciviruses, Norwalk, Sapporo-like, Enteric adenoviruses, Astroviruses), Bacterial (E. coli, Salmonella, Shigella, Campylobacter, Yersinia, Vibrio, Clostridium difficile, Clostridium perfringens, TB - "overgrowth"), Parasitic (Ascaris, Strongyloides, Necator, Enterobius, Tricuris, Diphyllobothrium, Taenia, Hymenolepsis, Amebiasis, Giardia)
    • Symptoms: Diarrhea, abdominal pain, urgency, perianal discomfort, incontinence, hemorrhage.

    PSEUDOMEMBRANOUS COLITIS

    • Cause: Infection by Clostridium difficile.
    • Mechanism: Disruption of normal gut microbiota by antibiotics allows bacterial overgrowth.
    • Symptoms: Inflammation and formation of pseudomembranes in the colon (dense layer of inflammatory cells and debris at sites of colonic mucosal injury).

    WHIPPLE DISEASE

    • Cause: Infection by the bacterium Tropheryma whipplei.
    • Symptoms: Multivisceral disease, involving malabsorption, lymphadenopathy, and arthritis.

    INFLAMMATORY BOWEL DISEASE

    • Crohn's Disease: Often transmural inflammatory involvement that can affect any part of the gastrointestinal tract.
    • Ulcerative Colitis: Limited to the colon and rectum, involving only the mucosa and submucosa.

    MICROSCOPIC COLITIS

    • Collagenous Colitis: Thickened subepithelial collagen, inflammatory cells in the lamina propria.
    • Lymphocytic Colitis: Increased intraepithelial lymphocytes and lack of a thickened collagen layer.

    SIGMOID DIVERCTICULAR DISEASE

    • Definition: Acquired outpouchings of the mucosal or submucosal layers of the colon, usually in the sigmoid colon.
    • Cause: The unique structure of the colonic muscularis propria and the elevated intraluminal pressure in the sigmoid colon.
    • Symptoms: Usually asymptomatic initially but can lead to diverticulitis (inflammation) and potential complications like perforation.

    CELIAC DISEASE

    • Definition: A chronic autoimmune disorder triggered by gluten (a protein found in wheat, rye, and barley) ingestion.
    • Mechanism: Inflammatory response damages the intestinal villi, impairing nutrient absorption.
    • Symptoms: Weight loss, diarrhea, abdominal pain, fatigue, and other symptoms.

    MALABSORPTION

    • Definition: An inability to absorb sufficient nutrients from food. Often presents with diarrhea, characteristically bulky, frothy, greasy, and pale or clay-colored stool (steatorrhea).
    • Causes: Various causes include lymphatic obstruction (e.g., damage from surgery or inflammation), inflammatory conditions like celiac disease or IBD, or parasitic or bacterial infections obstructing the intestines, among others.

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