Gastro pt 1
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Questions and Answers

Which condition is characterized by the congenital malformation leading to exposure of abdominal contents?

  • Gastroschisis (correct)
  • Esophageal carcinoma
  • Pyloric stenosis
  • Omphalocele

What are the common major risk factors associated with squamous cell carcinoma of the esophagus?

  • Viral infections and genetics
  • Obesity and sedentary lifestyle
  • Exposure to sunlight
  • Alcohol and tobacco (correct)

Which of the following symptoms is NOT typically associated with esophageal carcinoma?

  • Projectile vomiting (correct)
  • Progressive dysphagia
  • Hematemeisis
  • Weight loss

In which location of the esophagus would lymph node spread primarily occur to the cervical nodes?

<p>Upper 1/3 (C)</p> Signup and view all the answers

What is the classical presentation of pyloric stenosis occurring two weeks after birth?

<p>Nonbilious projectile vomiting and visible peristalsis (D)</p> Signup and view all the answers

What is the most common presentation of tracheoesophageal fistula?

<p>Proximal esophageal atresia with the distal esophagus arising from the trachea (A)</p> Signup and view all the answers

Which condition is associated with increased risk of esophageal squamous cell carcinoma?

<p>Esophageal web (B)</p> Signup and view all the answers

What is a key symptom of Zenker diverticulum?

<p>Halitosis (C)</p> Signup and view all the answers

What typically causes Mallory-Weiss syndrome?

<p>Severe vomiting (D)</p> Signup and view all the answers

What occurs as a result of portal hypertension in esophageal varices?

<p>Dilated submucosal veins in the esophagus (B)</p> Signup and view all the answers

Which of the following is a symptom of tracheoesophageal fistula?

<p>Polyhydramnios (A)</p> Signup and view all the answers

Which of the following characteristics is associated with Plummer-Vinson syndrome?

<p>Iron deficiency anemia and beefy-red tongue (B)</p> Signup and view all the answers

What is the primary risk associated with esophageal varices?

<p>Rupture leading to painless hematemesis (C)</p> Signup and view all the answers

What is the most common cause of unilateral sialadenitis?

<p>Obstructing stone (sialolithiasis) (D)</p> Signup and view all the answers

Which of the following complications is least likely to occur with a mumps virus infection?

<p>Mucoepidermoid carcinoma (A)</p> Signup and view all the answers

What is a distinguishing feature of a pleomorphic adenoma?

<p>It consists of both stromal and epithelial tissue (A)</p> Signup and view all the answers

Which of the following statements about Warthin tumor is incorrect?

<p>It typically presents in the submandibular gland. (C)</p> Signup and view all the answers

Which type of salivary gland tumor is characterized as the most common malignant tumor?

<p>Mucoepidermoid carcinoma (C)</p> Signup and view all the answers

What is the primary clinical feature associated with duodenal atresia?

<p>Polyhydramnios (B)</p> Signup and view all the answers

Which statement regarding Meckel diverticulum is correct?

<p>It is identified in 2% of the general population. (D)</p> Signup and view all the answers

In adults, intussusception is most commonly caused by what?

<p>Tumors (D)</p> Signup and view all the answers

Which of the following describes volvulus?

<p>A twisting of the bowel along its mesentery (D)</p> Signup and view all the answers

The 'double bubble' sign is characteristic of which condition?

<p>Duodenal atresia (B)</p> Signup and view all the answers

Which age group is primarily affected by intussusception due to lymphoid hyperplasia?

<p>Infants and toddlers (B)</p> Signup and view all the answers

What is the likely consequence of small bowel infarction?

<p>Ischemic injury (C)</p> Signup and view all the answers

Which of the following statements about Meckel diverticulum is incorrect?

<p>It is common in the elderly. (A)</p> Signup and view all the answers

What is the primary location of damage in Tropical Sprue?

<p>Jejunum and ileum (A)</p> Signup and view all the answers

Which process contributes to malabsorption in Whipple Disease?

<p>Compression of lacteals by macrophages (C)</p> Signup and view all the answers

What characterizes the deficiency seen in Abetalipoproteinemia?

<p>Lack of apolipoprotein B-48 and B-100 (A)</p> Signup and view all the answers

What substance is secreted by carcinoid tumors that can lead to systemic effects?

<p>Serotonin (C)</p> Signup and view all the answers

What is a common site of metastasis for carcinoid tumors?

<p>Liver (C)</p> Signup and view all the answers

How does Whipple Disease primarily affect fat absorption?

<p>By compressing lymphatics with macrophages (A)</p> Signup and view all the answers

What deficiency can result from damage in Tropical Sprue?

<p>Vitamin B12 and folate deficiency (D)</p> Signup and view all the answers

What histological characteristic is associated with Whipple Disease?

<p>Macrophages loaded with <em>Tropheryma whipplei</em> organisms (C)</p> Signup and view all the answers

What is a primary cause of acidic damage to the stomach mucosa in acute gastritis?

<p>Imbalance between mucosal defenses and acidic environment (A)</p> Signup and view all the answers

Which risk factor is associated with Curling ulcers in patients?

<p>Hypovolemia from severe burns (D)</p> Signup and view all the answers

What clinical feature is indicative of chronic autoimmune gastritis?

<p>Atrophy of the mucosa with intestinal metaplasia (B)</p> Signup and view all the answers

What is the mechanism by which H. pylori contributes to chronic gastritis?

<p>It weakens mucosal defenses through ureases and proteases. (D)</p> Signup and view all the answers

Which type of gastritis is primarily associated with a lack of hydrochloric acid production?

<p>Chronic autoimmune gastritis (C)</p> Signup and view all the answers

What is a typical treatment for H. pylori-induced chronic gastritis?

<p>Triple therapy (A)</p> Signup and view all the answers

Which statement about chronic gastritis caused by H. pylori is true?

<p>It is the most common form of chronic gastritis. (A)</p> Signup and view all the answers

In chronic autoimmune gastritis, what might lead to megaloblastic anemia?

<p>Lack of intrinsic factor production (C)</p> Signup and view all the answers

What is one potential outcome of untreated chronic H. pylori gastritis?

<p>Increased risk of gastric adenocarcinoma (B)</p> Signup and view all the answers

What is a contributing factor to increased intracranial pressure leading to Cushing ulcers?

<p>Increased vagus nerve stimulation (B)</p> Signup and view all the answers

What causes achalasia?

<p>Idiopathic damage to ganglion cells in the myenteric plexus (C)</p> Signup and view all the answers

What is the clinical feature that is notably associated with achalasia?

<p>Dysphagia for both solids and liquids (C)</p> Signup and view all the answers

Which imaging study is indicative of achalasia?

<p>Barium swallow study revealing a (D)</p> Signup and view all the answers

Which of the following is a known risk factor for gastroesophageal reflux disease (GERD)?

<p>Hiatal hernia (A)</p> Signup and view all the answers

What mechanism underlies Barrett esophagus?

<p>Metaplasia from stratified squamous to nonciliated columnar epithelium (B)</p> Signup and view all the answers

Which type of esophageal cancer is most commonly associated with Barrett esophagus?

<p>Adenocarcinoma (C)</p> Signup and view all the answers

What is a potential late complication of GERD?

<p>Barrett esophagus (A)</p> Signup and view all the answers

What symptom might mimic cardiac chest pain in patients with GERD?

<p>Heartburn (D)</p> Signup and view all the answers

What is the primary cause of solitary mucosal ulcers in the proximal duodenum?

<p>H pylori infection (B)</p> Signup and view all the answers

In which location do gastric ulcers most commonly form?

<p>Lesser curvature of the antrum (D)</p> Signup and view all the answers

What potential complication is associated with a rupture of a posterior duodenal ulcer?

<p>Bleeding from the gastroduodenal artery (A)</p> Signup and view all the answers

Which statement about the differential diagnosis of ulcers is true?

<p>Gastric carcinoma can cause gastric ulcers. (B)</p> Signup and view all the answers

What symptom typically characterizes gastric ulcers as opposed to duodenal ulcers?

<p>Epigastric pain that worsens with meals (B)</p> Signup and view all the answers

What is a common characteristic of both cleft lip and palate?

<p>They usually occur together rather than separately. (A)</p> Signup and view all the answers

What triggers the recurrence of aphthous ulcers?

<p>Psychological stress and nutritional deficiencies. (B)</p> Signup and view all the answers

Which of the following is the primary characteristic of Behçet Syndrome?

<p>Recurrent oral and genital ulcers along with uveitis. (D)</p> Signup and view all the answers

What is the primary cause of oral herpes lesions?

<p>Primary infection with herpes simplex virus type 1. (B)</p> Signup and view all the answers

Which statement regarding squamous cell carcinoma is true?

<p>The floor of the mouth is a frequently affected area. (B)</p> Signup and view all the answers

What does erythroplakia indicate in the context of oral pathology?

<p>Highly vascularized leukoplakia suggestive of dysplasia. (D)</p> Signup and view all the answers

Which condition is characterized by white plaques that cannot be scraped away?

<p>Leukoplakia. (C)</p> Signup and view all the answers

Which of the following factors is NOT associated with squamous cell carcinoma?

<p>Genetic abnormalities. (C)</p> Signup and view all the answers

What is the primary function of the lactase enzyme in the gastrointestinal system?

<p>To break down lactose into glucose and galactose. (B)</p> Signup and view all the answers

Which of the following clinical symptoms is characteristic of lactose intolerance?

<p>Diarrhea after consuming milk products. (D)</p> Signup and view all the answers

What severe complication can arise in patients with celiac disease if dietary restrictions are not followed?

<p>Small bowel carcinoma. (C)</p> Signup and view all the answers

Which antibody is typically used for diagnosis in individuals with suspected IgA deficiency related to celiac disease?

<p>IgG against endomysium. (B)</p> Signup and view all the answers

What role do helper T cells play in celiac disease?

<p>They mediate tissue damage upon gluten exposure. (C)</p> Signup and view all the answers

What changes are observed in a duodenal biopsy of a patient with celiac disease?

<p>Flattening of intestinal villi and hyperplasia of crypts. (C)</p> Signup and view all the answers

What is the pathogenic component of gluten associated with celiac disease?

<p>Gliadin. (D)</p> Signup and view all the answers

Which symptom is classically seen in children with celiac disease?

<p>Failure to thrive. (A)</p> Signup and view all the answers

Flashcards

Duodenal Atresia

A congenital condition where the duodenum fails to develop properly, often associated with Down syndrome.

Meckel Diverticulum

An outpouching of the small intestine wall, often harmless, and possibly bleeding.

Small Bowel Volvulus

Twisting of the small intestine, leading to blockage or blood vessel damage.

Intussusception

One part of the intestine slides into another, causing blockage.

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Small Bowel Infarction

Loss of blood supply to a section of the small intestine, serious condition.

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Duodenal Atresia Symptoms

Polyhydramnios, distended stomach and duodenum (double bubble), and bilious vomiting.

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Intussusception Cause (Children)

Often caused by lymphoid hyperplasia, especially in the terminal ileum, and subsequently moving into the cecum.

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Intussusception Cause (Adults)

Most commonly caused by a tumor.

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Tropical Sprue:

Small bowel villi damage, often post-diarrhea, common tropical regions, leading to malabsorption.

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Whipple Disease:

Systemic disease with macrophages packed with bacteria, causing small bowel damage and malabsorption, affecting other areas.

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Abetalipoproteinemia:

Genetic deficiency in proteins involved in fat transport, causing fat malabsorption.

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Carcinoid Tumor:

Malignant gut tumor secreting serotonin, potentially metastasizing to liver, leading to carcinoid syndrome, heart disease.

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Small bowel villi damage:

Damage to the finger-like projections lining the small intestine, disrupting nutrient absorption.

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Macrophages in Whipple Disease:

Immune cells in Whipple Disease are packed with bacteria causing tissue damage.

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Chylomicron transport:

Transportation of fat from the intestines to the blood stream.

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Portal circulation and metabolism

Blood circulation through the liver for metabolism. Carcinoid tumors bypassing liver affected.

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Tracheoesophageal Fistula

A birth defect connecting the esophagus and trachea.

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Esophageal Web

Thin protrusion of esophageal lining, often upper.

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Mallory-Weiss Syndrome

Tear in the esophagus lining from violent vomiting.

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Esophageal Varices

Swollen veins in the lower esophagus due to high blood pressure in the portal vein.

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Dysphagia

Difficulty swallowing.

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Hematemesis

Vomiting blood.

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Portal Hypertension

High blood pressure in the portal vein.

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Acute Gastritis Cause

Damage to the stomach lining caused by an imbalance between stomach acid and protective mucosal defenses.

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Chronic Autoimmune Gastritis Cause

Inflammation caused by the body's immune system attacking its own gastric parietal cells.

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Chronic Gastritis Type

Chronic inflammation of the stomach lining.

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Chronic Autoimmune Gastritis Symptoms

Includes stomach atrophy, loss of acid production, and increased gastrin, risk of certain cancers. Lack of intrinsic factor, and anemia.

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Chronic H. pylori Gastritis Cause

Infected by the bacteria, H. pylori, leading to chronic stomach inflammation.

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Risk Factors for Acute Gastritis

Conditions like severe burns, NSAID use, alcohol, chemotherapy, and increased intracranial pressure.

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H. Pylori Pathophysiology

H. pylori weakens mucosal protections via bacterial enzymes and inflammation. It commonly infects the antrum.

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Mucosal Defenses Stomach

The mucus layer, bicarbonate secretion, and blood supply that protect the stomach lining from the corrosive effects of acid.

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Acute Gastritis Pathophysiology

Impaired mucosal defenses allow stomach acid to damage the stomach lining.

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Chronic Autoimmune Gastritis Diagnosis

Often involves detecting antibodies against parietal cells and/or intrinsic factor.

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Salivary Glands

Exocrine glands that produce saliva, divided into major (parotid, submandibular, sublingual) and minor glands.

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Mumps

Viral infection causing swollen parotid glands, potentially affecting other organs like the testicles, pancreas, and brain.

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Sialadenitis

Inflammation of a salivary gland, often caused by a blocked duct (sialolithiasis) and bacterial infection.

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Pleomorphic Adenoma

A benign tumor common in the parotid gland, composed of both epithelial and stromal (cartilage) tissue.

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Warthin Tumor

A benign cystic tumor with abundant lymphocytes and germinal centers, second most common salivary gland tumor.

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Esophageal carcinoma symptoms

Late-stage esophageal cancer shows progressive difficulty swallowing (solids to liquids), weight loss, pain, and possible vomiting of blood.

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Squamous cell carcinoma (Esophagus)

Common esophageal cancer type; arises in upper/middle esophagus; linked to alcohol/tobacco, hot drinks, and other issues.

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Gastroschisis cause

A birth defect where abdominal organs are exposed, due to a defect in the abdominal wall.

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Pyloric stenosis symptoms

Vomiting and visible abdominal muscle contractions, projectile vomit; happens in babies a few weeks after birth.

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Omphalocele cause

Intestines don't return to the body cavity. Covered by amnion/peritoneum, located around the umbilical cord.

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Achalasia

A condition where the lower esophageal sphincter (LES) doesn't relax properly, causing difficulty swallowing.

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Esophageal Motility

The movement of food through the esophagus.

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GERD (Gastroesophageal Reflux Disease)

Stomach acid flowing back into the esophagus, causing heartburn.

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Barrett's Esophagus

A change in the lining of the esophagus due to acid reflux.

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Esophageal Adenocarcinoma

A cancer that starts in the glands of the esophagus.

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Lower Esophageal Sphincter (LES)

The muscle that prevents stomach acid from entering the esophagus.

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Squamous Cell Carcinoma

A type of cancer that typically originates on the surface of organs.

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Lactase Enzyme

An enzyme in the small intestine that breaks down lactose (milk sugar) into glucose and galactose, which the body can absorb.

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Lactose Intolerance

A condition caused by a lack of lactase enzyme, leading to undigested lactose in the gut, causing symptoms like bloating and diarrhea after consuming milk products.

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Celiac Disease

An autoimmune disorder triggered by gluten consumption, leading to damage of the small intestine's villi, impacting nutrient absorption.

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Gluten in Celiac

A protein found in wheat, barley, and rye that triggers an immune response in individuals with celiac disease.

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Gliadin

The most pathogenic component of gluten, responsible for triggering the immune response in celiac disease.

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Celiac Symptoms

Symptoms include diarrhea, bloating, abdominal distension, and failure to thrive in children, and chronic diarrhea and bloating in adults.

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Celiac Antibodies

Specific antibodies against gliadin, tissue transglutaminase (tTG), and endomysium, indicating an autoimmune response to gluten.

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Celiac Diet

A strict gluten-free diet is the only treatment for managing celiac disease, allowing the gut to heal and prevent further damage.

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Peptic Ulcers are usually caused by?

Peptic ulcers are primarily caused by the bacterium Helicobacter pylori, which infects the lining of the stomach and duodenum. In rare cases, conditions like Zollinger-Ellison syndrome may cause these ulcers.

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How does a duodenal ulcer present?

Duodenal ulcers usually manifest with epigastric pain that gets better after eating. This happens as food neutralizes stomach acid, providing temporary relief.

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Where do gastric ulcers usually develop?

Gastric ulcers tend to form on the lesser curvature of the stomach's antrum. This is the area leading into the duodenum.

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What's the risky complication with a posterior duodenal ulcer?

A posterior duodenal ulcer can lead to bleeding from the gastroduodenal artery or even acute pancreatitis if it ruptures.

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Why are duodenal ulcers rarely malignant?

Duodenal ulcers are almost never cancerous because duodenal carcinoma is extremely rare. This means a duodenal ulcer is much more likely to be benign.

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Cleft Lip and Palate

A birth defect where the upper lip or roof of the mouth doesn't fully close during pregnancy.

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Aphthous Ulcer

A painful, small sore in the mouth that usually heals on its own.

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Behçet Syndrome

A condition with recurring mouth sores, genital sores, and eye inflammation.

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Oral Herpes

A viral infection causing blisters in the mouth that burst into shallow sores.

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Oral Leukoplakia

A white patch in the mouth that can't be scraped off, possibly representing precancerous cells.

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Oral Candidiasis (Thrush)

A white deposit on the tongue easily scraped off, seen in people with weakened immune systems.

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Hairy Leukoplakia

A white, rough patch on the tongue, often seen in people with weakened immune systems.

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Study Notes

Tropical Sprue

  • Damage to small bowel villi
  • Due to unknown organism
  • Similar to celiac disease, except
    • Occurs in tropical regions (e.g., Caribbean)
    • Responds to antibiotics
    • Damage most prominent in jejunum and ileum (secondary vitamin B12 or folate deficiency may ensue)
    • Duodenum less commonly involved

Whipple's Disease

  • Systemic tissue damage
  • Macrophages loaded with Tropheryma whipplei organisms
    • Partially destroyed organisms in macrophages
  • Classic site of involvement: small bowel lamina propria
  • Macrophages compress lacteals
  • Results in fat malabsorption and steatorrhea
  • Other common sites: synovium of joints (arthritis), cardiac valves, lymph nodes, CNS

Abetalipoproteinemia

  • Autosomal recessive deficiency of apolipoprotein B-48 and B-100
  • Clinical features
    • Malabsorption
    • Absent plasma VLDL and LDL (require B-100)

Carcinoid Tumor

  • Malignant proliferation of neuroendocrine cells; low-grade malignancy,
  • Tumor cells contain secretory granules that are positive for chromogranin.
  • Can arise anywhere along the gut; small bowel is the most common site
  • Grows as a submucosal polyp-like nodule
  • Often secretes serotonin
    • Serotonin is released into the portal circulation and metabolized by the liver
    • 5-HIAA is excreted in the urine
  • Metastasis of carcinoid tumor to the liver allows serotonin to bypass liver metabolism
    • Serotonin released into the hepatic vein and leaks into systemic circulation via hepatosystemic shunts, resulting in carcinoid syndrome and carcinoid heart disease

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Description

Test your knowledge on various gastrointestinal disorders, including congenital malformations and esophageal conditions. This quiz covers key symptoms, risk factors, and presentations of conditions such as pyloric stenosis and tracheoesophageal fistulae. Challenge yourself and validate your understanding of these crucial medical topics.

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