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Flashcards in this deck (149)

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  • What is the pathogenesis of intussusception?

    A segment of the intestine telescopes into the distal segment, leading to obstruction and potentially infarction due to mesenteric vessel compression.

    pathogenesis intussusception

  • What are the morphological features of intussusception?

    Involves an invaginated segment of the intestine, compressing its mesentery.

    morphology intussusception

  • What is the etiology of intussusception in children?

    Usually no underlying anatomical defect; may be associated with viral infections and rotavirus vaccines.

    etiology intussusception

  • What is the epidemiology of intussusception?

    Most common cause of intestinal obstruction in children under 2 years.

    epidemiology intussusception

  • What is the pathogenesis of Hirschsprung Disease?

    Congenital defect in colonic innervation due to disruption of neural crest cell migration.

    pathogenesis hirschsprung_disease

  • What is the morphology of Hirschsprung Disease?

    Aganglionic region may appear normal or contracted; proximal colon undergoes progressive dilation.

    morphology hirschsprung_disease

  • How is Hirschsprung Disease diagnosed microscopically?

    By histological confirmation of the absence of ganglion cells in the affected segment.

    microscopy hirschsprung_disease

  • What is the etiology of Hirschsprung Disease?

    Congenital defect involving neural crest cell migration; associated with genetic mutations and trisomy 21.

    etiology hirschsprung_disease

  • What is the epidemiology of Hirschsprung Disease?

    Occurs in approximately 1 in 5000 live births; more common in males.

    epidemiology hirschsprung_disease

  • What is the pathogenesis of abdominal hernia?

    Weakness in the peritoneal cavity wall allows protrusion of a serosa-lined pouch, leading to potential incarceration and strangulation.

    pathogenesis abdominal_hernia

  • What is the morphology of an abdominal hernia?

    A serosa-lined pouch protruding through a defect in the peritoneal cavity wall.

    morphology abdominal_hernia

  • What is the etiology of abdominal hernias?

    Commonly occur through inguinal and femoral canals, umbilicus, or surgical scars.

    etiology abdominal_hernia

  • What are the two major mechanical causes of intestinal obstruction?

    • Volvulus: Twisting of intestine
    • Adhesions: Abnormal fibrous bands between intestines
    pathology intestinal_obstruction

  • What is the pathogenesis of Ischemic Bowel Disease?

    • Acute obstruction: Thrombosis or embolism
    • Intestinal hypoperfusion: Without vascular obstruction
    • Reperfusion injury: Damage from restored blood supply
    pathology ischemic_disease

  • What are the vulnerable areas in Ischemic Bowel Disease?

    • Watershed zones: Splenic flexure, sigmoid colon, rectum
    • Surface epithelium
    pathology ischemic_disease

  • What is the morphology of Ischemic Bowel Disease?

    • Segmental and patchy involvement
    • Hemorrhagic and ulcerated mucosa
    • Thickened bowel wall due to edema
    pathology morphology

  • What characterizes acute ischemia microscopically?

    • Atrophy or sloughing of surface epithelium
    • Hyperproliferative crypts
    • Neutrophil recruitment upon reperfusion
    pathology microscopy

  • What leads to sigmoid diverticulitis?

    • Elevated intraluminal pressure in sigmoid colon
    • Obstruction and stasis of diverticula contents
    pathology diverticulitis

  • What is the morphology of diverticula in the sigmoid colon?

    • Small, flask-like outpouchings (0.5-1 cm)
    • Thin wall: flattened mucosa, compressed submucosa
    pathology morphology

  • What are diverticula?

    Pouches (0.5-1 cm) in the sigmoid colon with a thin wall.

    anatomy gastroenterology

  • What is the microscopic appearance of diverticula?

    Protrusion of mucosa and submucosa through muscularis propria.

    histology gastroenterology

  • What are the causes of diverticula?

    Elevated intraluminal pressure, Western diet, sedentary lifestyle.

    etiology gastroenterology

  • What is the epidemiology of diverticula?

    Rare under 30; 50% prevalence in adults over 60 in Western populations.

    epidemiology gastroenterology

  • What causes Cystic Fibrosis?

    Mutations of the CFTR gene affecting ion transport.

    genetics pathogenesis

  • What is the pathogenesis of Cystic Fibrosis?

    Leads to inadequate luminal hydration and exocrine pancreatic insufficiency.

    pathogenesis gastroenterology

  • What is the microscopic appearance in Cystic Fibrosis?

    Duct obstruction and tissue damage in the pancreas.

    histology gastroenterology

  • What triggers Celiac Disease?

    Ingestion of gluten in genetically predisposed individuals.

    etiology gastroenterology

  • What are the morphological features of Celiac Disease?

    Crypt hyperplasia, villous atrophy, increased intraepithelial lymphocytes.

    morphology gastroenterology

  • What is the epidemiology of Celiac Disease?

    Worldwide prevalence of about 1%; manifests in childhood and adulthood.

    epidemiology gastroenterology

  • What is the onset age for Celiac Disease in children?

    Between 6 and 24 months after gluten introduction.

    health disease

  • What is the common age range for Celiac Disease onset in adults?

    Between 30 and 60 years of age.

    health disease

  • What is Environmental Enteric Dysfunction?

    A syndrome of impaired intestinal function.

    health disease

  • What causes malabsorption in Environmental Enteric Dysfunction?

    Small intestinal colonization by toxigenic coliform bacteria.

    health disease

  • What does a small intestinal biopsy show in Environmental Enteric Dysfunction?

    Blunted villi and chronic inflammation.

    health disease

  • What is a common microscopic finding in Environmental Enteric Dysfunction?

    Similar to celiac disease: blunted villi and chronic inflammation.

    health disease

  • Where is Environmental Enteric Dysfunction most prevalent?

    Sub-Saharan Africa, northern Australia, southern India, and poor areas in South America and Asia.

    health disease

  • What is Lactase Deficiency?

    Inability to digest lactose due to insufficient lactase enzyme.

    health disease

  • What causes osmotic diarrhea in Lactase Deficiency?

    Unabsorbed lactose exerts an osmotic force in the intestinal lumen.

    health disease

  • What is Congenital lactase deficiency?

    A rare autosomal recessive disorder caused by mutations in the lactase gene.

    health disease

  • What is the prevalence of acquired lactase deficiency?

    Affects roughly two-thirds of the worldโ€™s population.

    health disease

  • What is Abetalipoproteinemia?

    A rare autosomal recessive disease marked by inability to secrete triglyceride-rich chylomicrons.

    health disease

  • What is a characteristic finding in peripheral blood smears in Abetalipoproteinemia?

    Presence of acanthocytic red cells (spur cells).

    health disease

  • What are the two types of Microscopic Colitis?

    Collagenous colitis and lymphocytic colitis.

    health disease

  • What characterizes collagenous colitis?

    Presence of a dense subepithelial collagen layer.

    health disease

  • What is a symptom of both types of Microscopic Colitis?

    Chronic, nonbloody, watery diarrhea without weight loss.

    health disease

  • What is the histological difference between collagenous colitis and lymphocytic colitis?

    • Collagenous colitis: Dense subepithelial collagen layer
    • Lymphocytic colitis: Normal collagen layer, greater intraepithelial lymphocytes
    pathology colitis

  • What is the morphology of collagenous colitis?

    Typically normal radiologic and endoscopic studies.

    pathology colitis

  • What are the microscopic features of collagenous colitis?

    • Dense subepithelial collagen layer
    • Increased intraepithelial lymphocytes
    • Mixed inflammatory infiltrate
    pathology colitis

  • What is the etiology of lymphocytic colitis?

    Idiopathic, associated with celiac disease and autoimmune diseases.

    pathology colitis

  • Who is primarily affected by collagenous colitis?

    Middle-aged and older women.

    epidemiology colitis

  • What is the pathogenesis of graft-versus-host disease?

    Donor T cell-mediated damage to recipientโ€™s epithelial cells after transplantation.

    pathology graft

  • What is a common microscopic finding in graft-versus-host disease?

    Epithelial apoptosis, especially of crypt cells.

    pathology graft

  • What are the causes of infectious enterocolitis?

    Bacteria, viruses, and parasites.

    pathology infectious

  • What are some bacterial causes of infectious enterocolitis?

    • Escherichia coli
    • Campylobacter jejuni
    • Shigella
    • Salmonella
    • Clostridioides difficile
    pathology infectious

  • What is the global impact of infectious enterocolitis?

    More than 1 million deaths annually, >10% in children under 5.

    epidemiology infectious

  • What is the pathogenesis of cholera?

    Vibrio cholerae produces cholera toxin, increasing cAMP and chloride ion outflow into the gut lumen.

    pathology cholera

  • What activates the cystic fibrosis transmembrane conductance regulator (CFTR)?

    Increased cAMP binds and activates CFTR.

    biochemistry cftr

  • What is the result of CFTR activation?

    Massive outflow of chloride ions into the gut lumen.

    biochemistry cftr

  • What does the outflow of chloride ions cause?

    Creates an osmotic gradient, leading to massive secretory diarrhea.

    biochemistry diarrhea

  • What is the morphology of mucosal biopsy specimens in cholera?

    Show only minimal morphologic alterations.

    morphology cholera

  • What bacteria causes cholera?

    Caused by Vibrio cholerae.

    etiology cholera

  • How is cholera primarily transmitted?

    Through contaminated drinking water.

    transmission cholera

  • What is a common symptom of severe cholera?

    Rapid dehydration, shock, and potential death.

    symptoms cholera

  • What causes Campylobacter Enterocolitis?

    Caused by Campylobacter jejuni.

    etiology campylobacter

  • What are the virulence factors of Campylobacter jejuni?

    Includes motility, adherence, toxin production, and invasion.

    virulence campylobacter

  • What is the microscopic appearance of Campylobacter Enterocolitis?

    Characterized by prominent lamina propria and intraepithelial neutrophil infiltrates.

    microscopy campylobacter

  • What is a common source of Campylobacter infections?

    Associated with ingestion of raw or undercooked meat.

    sources campylobacter

  • What is a major epidemiological fact about Campylobacter?

    A common cause of acute diarrhea worldwide.

    epidemiology campylobacter

  • What is the pathogenesis of Shigellosis?

    Shigella organisms resist stomach acid and infect epithelial cells.

    pathogenesis shigellosis

  • What does Shiga toxin do?

    Inhibits eukaryotic protein synthesis and causes host cell death.

    toxins shigella

  • What is the morphology of Shigellosis?

    Infections are most prominent in the rectosigmoid colon.

    morphology shigellosis

  • What is the etiology of Shigellosis?

    Caused by Shigella (gram-negative, nonmotile bacteria).

    etiology shigella

  • How is Shigellosis transmitted?

    Highly transmissible via the fecal-oral route.

    transmission shigella

  • What is a significant burden of Shigellosis?

    A common cause of bloody diarrhea (dysentery).

    symptoms shigella

  • What are the annual global cases of E. coli infections?

    Approximately 170 million cases

    bacteria epidemiology

  • What is the annual death toll from E. coli infections?

    About 160,000 deaths

    bacteria epidemiology

  • What syndrome can be caused by EHEC?

    Hemolytic uremic syndrome

    bacteria syndrome

  • What toxin does ETEC produce?

    Heat-labile toxin and heat-stable toxin

    bacteria toxin

  • What does EPEC cause in the intestines?

    Local loss (effacement) of microvilli

    bacteria pathogenesis

  • What type of diarrhea does EHEC cause?

    Can cause dysentery

    bacteria symptoms

  • What characterizes EIEC infection?

    Invasion of gut epithelial cells

    bacteria pathogenesis

  • How does EAEC cause symptoms?

    By producing heat-labile and Shiga-like toxins

    bacteria toxin

  • What is a principal cause of travelerโ€™s diarrhea?

    ETEC

    bacteria epidemiology

  • What is the main cause of nontyphoid salmonellosis?

    Salmonella enteritidis

    bacteria pathogenesis

  • What is a common symptom of Salmonellosis?

    Diarrhea, nausea, vomiting, fever

    bacteria symptoms

  • How is nontyphoid Salmonella typically transmitted?

    Through contaminated food

    bacteria transmission

  • What is the annual incidence of Salmonellosis in the U.S.?

    Over 1 million cases

    bacteria epidemiology

  • What causes Typhoid fever?

    Salmonella typhi and Salmonella paratyphi

    bacteria pathogenesis

  • What happens to Peyer patches in Typhoid fever?

    They enlarge into plateau-like elevations

    bacteria pathogenesis

  • What type of ulcers are formed in the ileum due to Typhoid fever?

    Oval ulcers oriented along the long axis

    bacteria symptoms

  • What are the causes of typhoid fever?

    • Salmonella typhi
    • Salmonella paratyphi
    microbiology etiology

  • What are the morphological features of typhoid fever?

    • Enlarged Peyer patches
    • Oval ulcers along the ileum
    morphology typhoid

  • What is the microscopic appearance in typhoid fever?

    • Reactive hyperplasia of lymph nodes
    • Typhoid nodules in liver and lymph nodes
    microscopy typhoid

  • What is the epidemiology of typhoid fever?

    • Affects up to 30 million yearly
    • More common in endemic areas
    epidemiology typhoid

  • What is the pathogenesis of pseudomembranous colitis?

    • Disruption of colonic microbiota by antibiotics
    • C. difficile overgrowth
    pathogenesis c.difficile

  • What are the morphological features of pseudomembranous colitis?

    • Formation of pseudomembranes at mucosal injury sites
    morphology c.difficile

  • What is the microscopic appearance of pseudomembranous colitis?

    • Pseudomembranes with neutrophils and debris
    • Distended crypts with exudate
    microscopy c.difficile

  • What causes mycobacterial infections in the GI tract?

    • M. tuberculosis
    • M. bovis
    • M. avium
    microbiology etiology

  • What is the morphology of mycobacterial infections?

    • Infection common in ileocecal region
    • Leads to fibrosis and ulceration
    morphology mycobacterial

  • What is the microscopic appearance in mycobacterial infections?

    • Granulomas with caseous necrosis
    • Expansion of macrophages in M. avium infection
    microscopy mycobacterial

  • What are the causes of granulomas with caseous necrosis?

    • Mycobacterium tuberculosis
    • Mycobacterium bovis
    • Mycobacterium avium
    microbiology pathology

  • What is the common presentation of M. avium in immunocompromised patients?

    Sheet-like expansion of macrophages in the lamina propria without granulomas

    microbiology pathology

  • What distinguishes M. avium from Whipple disease?

    M. avium is acid-fast

    microbiology pathology

  • What is the etiology of gastrointestinal tuberculosis?

    Caused by Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium avium

    microbiology etiology

  • Where is gastrointestinal tuberculosis endemic?

    Areas like India and Pakistan

    epidemiology geography

  • What is the pathogenesis of Norovirus?

    Involves ingestion or inhalation of as few as 10 viral particles

    microbiology pathogenesis

  • What is the etiology of gastroenteritis outbreaks?

    Caused by Norovirus (Norwalk virus)

    microbiology etiology

  • What is the common cause of severe childhood diarrhea?

    Rotavirus is the most common cause

    microbiology epidemiology

  • How does Rotavirus affect the intestine?

    Infects and destroys mature enterocytes, leading to loss of absorptive function

    microbiology pathogenesis

  • What is the pathogenesis of Ascaris lumbricoides?

    Ingested eggs hatch, larvae penetrate the mucosa, migrate to liver and lungs

    microbiology pathogenesis

  • How is Ascaris lumbricoides transmitted?

    Spread by human fecal-oral contamination

    microbiology transmission

  • What is the pathogenesis of Strongyloides?

    Larvae penetrate skin, travel to lungs, then to intestines where they mature

    microbiology pathogenesis

  • Where are Strongyloides commonly found?

    Widely found in tropical and subtropical regions

    microbiology geography

  • What causes Strongyloides infections?

    Strongyloides larvae

    etiology parasitology

  • Where are Strongyloides infections widely found?

    In tropical and subtropical regions worldwide

    epidemiology geography

  • Who may develop overwhelming infections from Strongyloides?

    Immunocompromised individuals

    pathogenesis immunology

  • How is infection initiated by hookworms?

    By larval penetration of the skin

    pathogenesis hookworms

  • What do adult hookworms do in the duodenum?

    Suck blood and reproduce

    pathogenesis hookworms

  • How is hookworm infection diagnosed?

    By detecting the eggs in stool

    microscopic diagnosis

  • What are the two main species of hookworms?

    Necator americanus and Ancylostoma duodenale

    etiology hookworms

  • How many individuals are infected by hookworms worldwide?

    More than 500 million

    epidemiology hookworms

  • What is a leading cause of iron deficiency anemia?

    Hookworm infection in low-resource parts of the world

    epidemiology anemia

  • How does Giardia lamblia infect the host?

    By ingestion of cysts

    pathogenesis giardiasis

  • What do trophozoites of Giardia lamblia cause?

    Microvillous damage and apoptosis of small-intestinal epithelial cells

    pathogenesis giardiasis

  • What is the microscopic appearance of Giardia lamblia?

    Pear-shaped trophozoites

    microscopic giardiasis

  • How is Giardia lamblia spread?

    By fecally contaminated water or food

    etiology transmission

  • What is the most common pathogenic parasite in humans?

    Giardia lamblia

    epidemiology giardiasis

  • What does Cryptosporidium cause in the small bowel?

    Secretory diarrhea and malabsorption

    pathogenesis cryptosporidiosis

  • How are Cryptosporidium organisms diagnosed?

    By identifying organisms in stool preps

    microscopic diagnosis

  • What is a major source of Cryptosporidium infections?

    Contaminated public water supplies

    etiology epidemiology

  • How many deaths per year is Cryptosporidium responsible for?

    As many as 200,000 deaths

    epidemiology cryptosporidiosis

  • What type of ulcers do Entamoeba histolytica cause?

    Flask-shaped ulcers

    pathogenesis amebiasis

  • What do Entamoeba histolytica amebae do to the colonic epithelium?

    Induce apoptosis and invade crypts

    pathogenesis amebiasis

  • What can Entamoeba histolytica lead to in the liver?

    Liver abscesses

    pathogenesis amebiasis

  • What can be seen on a trichrome stain of Entamoeba histolytica?

    Amebae that have phagocytosed red cells

    microscopic amebiasis

  • What is the etiology of the inflammatory reaction described?

    Caused by the protozoan Entamoeba histolytica

    etiology protozoa

  • How is Entamoeba histolytica spread?

    By fecal-oral transmission

    transmission disease

  • Where is Entamoeba histolytica primarily found?

    In low-resource parts of the world with poor sanitation

    epidemiology geography

  • What are common symptoms of Entamoeba histolytica infection?

    Abdominal pain, bloody diarrhea, weight loss

    symptoms disease

  • What can Entamoeba histolytica lead to?

    Acute necrotizing colitis and megacolon

    complications disease

  • What characterizes Angiodysplasia?

    Malformed submucosal and mucosal blood vessels

    pathogenesis vascular

  • Where does Angiodysplasia most often occur?

    In the cecum or right colon

    epidemiology anatomy

  • What age group is most affected by Angiodysplasia?

    Usually presents after the sixth decade of life

    epidemiology age

  • What percentage of the adult population is affected by Angiodysplasia?

    Affects less than 1% of the adult population

    epidemiology statistics

  • What is the pathogenesis of hemorrhoids?

    Dilated anal and perianal collateral vessels

    pathogenesis vascular

  • What causes the development of hemorrhoids?

    Due to elevated venous pressure within the hemorrhoidal plexus

    etiology pressure

  • What are common predisposing factors for hemorrhoids?

    Constipation, straining, pregnancy, portal hypertension

    predisposing_factors etiology

  • What is the prevalence of hemorrhoids in the population?

    Affects about 5% of the population

    epidemiology statistics

  • What symptoms do hemorrhoids often manifest with?

    Pain and self-limited rectal bleeding (bright red blood)

    symptoms bleeding