Systems path 2 exam 1 pg 146-end

itchy small blisters on arms, elbows, legs and buttocks which is found in about 10% of celiac disease patients

dermatitis herpetiformis

disease of the small intestine characterized by mucosal injury, malnutrition and inflammation

environmental enteropathy (Whipple's disease)

signs/symptoms of environmental enteropathy

fever, malaise, weight loss, stunted growth

who is most likely to get environmental enteropathy

children (2-3 years) living in tropics

reduce/absent lactase which causes the body to not be able to digest lactose

lactose intolerance

signs/symptoms of lactose intolerance

bloating, cramps, gas, diarrhea (30 min postprandial)

acquired lactose intolerance

acquired in young adulthood

congenital lactose intolerance

rare, autosomal recessive, severe

a deficiency of lactase will result in malabsorption of lactose which results in...

osmotic diarrhea

microbial infections causing inflammation and diarrhea leading to abdominal pain, urgency/incontinence, perianal discomfort, or hemorrhage

infectious enterocolitis

gram-negative bacteria from caused by contaminated H2O and is 70% lethal

cholera

signs/symptoms of cholera

vomiting and "rice water" diarrhea

cholera toxin opens the _______

CFTR (causes massive chloride ion secretion)

>3 unformed or "loose" stools within 24 hours caused by the consumption of contaminated food or water

traveler's diarrhea

Traveler's diarrhea causative agent

E. coli

MC bacterial enteric pathogen in US which comes from contaminated H2O, raw or undercooked chicken or unpasteurized milk

campylobacter jejuni

Campylobacter enterocolitis signs and symptoms

frequent and bloody diarrhea (10+/day x 7-10 days)

Campylobacter Enterocolitis may initiate....

reactive arthritis or GBS

causes of acute self-limited colitis

campylobacter, shigella, E.coli, salmonella

signs/symptoms of acute self-limited colitis

abdominal pain, watery or bloody diarrhea, sudden onset, early fever,

how long does acute self-limited colitis last?

<1 month

MC bacterial cause of food poisoning, usually from contaminated eggs, poultry or inadequately

salmonella food poisoning (acute bacterial gastroenteritis)

signs/symptoms of salmonella food poisoning

nonbloody diarrhea, n/v, fever, myalgia, headache, abdominal cramps

swelling or inflammation of large intestine due to over-growth of clostridioides difficile bacteria

clostridium difficile colitis (pseudomembranous colitis)

pseudomembranous colitis is a common cause of diarrhea after ________ use

antibiotic

signs/symptoms of pseudomembranous colitis

pseudomembranes (cellular debris + WBC), diarrhea

1/2 of all gastroenteritis caused by infection leading to inflammation and then diarrhea

viral gastroenteritis (stomach flu)

location of viral gastroenteritis

stomach or SI

signs/symptoms of viral gastroenteritis

n/v, diarrhea, cramps, malabsorption

causes of viral gastroenteritis

rotovirus (children) and norovirus (adults)

common waterborne disease in US caused by Giardia intestinalis (g. duodenal, g. lambda) which resists cold and chlorine

parasitic disease

signs and symptoms of parasitic disease

giardiasis (beaver fever), water diarrhea, bloating, rotten egg smelling stool, malabsorption

altered bowel habits with no inflammation characterized by chronic and relapsing abdominal pain and altered BM habits, bloating, diarrhea, and constipation

irritable bowel syndrome (IBS)

risk factors associated with developing IBS

20-40 years, females, caucasians

treatment for IBS

fiber, decrease carbs, stress management

types of IBD

crohn's and UC

regional inflammation and fissues/strictures which are transmural and found throughout the entire GI tract, MC in ileum

Crohn's disease (regional enteritis)

signs and symptoms of Crohn's disease

melena, skip lesions, granulomas, creeping fat, cobblestone appearance

Crohn's disease and UC increases risk for...

G.I. adenocarcinoma

superficial inflammation causing mucosal ulcerations which always begin in the rectum then moves proximally

ulcerative colitis

signs/symptoms of UC

pseudopolyps, relapsing episodes, stool is grossly bloody and mucoid, lower abdominal cramps, tenesmus

most common type of polyp in children

hamartomatous polyps in GI tract

what type of polyp follows inflammation (IBD) and is low risk?

inflammatory

MC colon polyp

adenomatous

what type of polyp is considered malignant (until proven otherwise) and is onset usually around age 40

colonic adenoma

colonic adenoma signs and symptoms

occult blood (FOB), possible anemia

cancer is in 50% of cases if polyp is around how many cm?

2 or more

Familial adenomatous polyposis diagnostic criteria

> 100 adenomas (MC 500-2,500)

Autosomal dominant mutation of APC gene on chromosome 5 which has a teenage onset of numerous adenomas and 100% develops colon cancer (MC before age 30)

Familial adenomatous polyposis

signs/symptoms of familial adenomatous polyposis

fecal occult blood -> anemia

hereditary cancer syndrome of inherited mutations that alter DNA mismatch repair

Lynch syndrome (HNPCC)

MC location of Lynch syndrome

endometrial

5% of patients develop what type of CA?

colorectal

Types of colorectal cancer

adenocarcinomas (MC), carcinoid tumors

MC malignancy of G.I. tract which is usually diagnosed between ages 50-70r

colorectal adenocarcinoma

risks associated with developing colorectal adenocarcinoma

age, males, IBD, highly processed diet

dietary risk factors of colorectal adenocarcinoma

low fiber, high refined carbs, high fat

colorectal adenocarcinoma signs and symptoms

altered bowel habits, occult blood in stool, anemia-> fatigue (iron-deficiency anemia in elderly)

colorectal adenocarcinoma metastizises MC to....

liver

6 ways to reduce risk of colorectal cancer

eat less processed food, healthy weight, more fiber, less alcohol, don't smoke, stay active

1/2 of SI cancer are _________ while the other 1/2 are _________

adenocarcinomas ; carcinoids

where is SI cancer most common?

duodenum

features of SI cancer (late)

abdominal pain/cramping, n/v, weight loss

lack of neurologic ganglia in rectum (may involve sigmoid colon) causing defective neural crest cell migration and bowel obstruction

Hirschsprung disease