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Path 17 Gastro/Intes


X linked severe persistent diarrhea and autoimmune disease that occurs most often in young children o IPEX = immune dysregulation, polyendocrinopathy, enteropathy and X linkage; d/t germline mutation in FOXP3-->defective T regulatory func Autoimmune enteropathy
whipworms. Heavy infect--> bloody d and rectal prolapse Trichiura
traveler’s diarrhea. Oocysts killed by freezing, but resist Cl. Activated by stomach acid. Cryptosporidium
trauma induced prolif w/ entrapment of epthel lined cysts Gastritis Cystica
small icosahedral single strand RNA. Causes lots of gastroenteritis. Cruise ships Norovirus
traveler’s diarrhea, contam food/water, heat labile toxin (LT) and heat stable toxin (ST) induce Cl and water secretion while inhibiting intestinal fluid absorption. Etoxigenic EC
pork, raw milk, contam water. Likes iron. Ileum, appendix, right colon. o Extra intest symps = pharyngitis, arthralgia, erythema nodosum Yersinia
pin worms live in lumen, deposit eggs at butthole-->pruritus contaminates fingers. Tapebut Vermicularis
O157:H7, undercooked ground beef. Shiga-like toxins-->dysentery and HUS - Einvasive EC: similar to shigella Ehemorrhagic EC
most often associated w/ H. pylori. Most common in gastric antrum and prox duod. o Round to oval sharply punched out ulcer. o Pain 1 to 3 hrs after meals, worse at night , relieved by alkali or food PUD
most common pathogenic parasitic infect in humans. Cysts resist Cl. Pear shaped and owl eyes. Giardia lamblia
most common mesenchymal tumor of the abdomen, many in stomach. Large. o Carney triad: young females have GIST, paraganglioma, and pulm chondromas o Also increased GIST w neurofibromatosis type 1 o Oncogenic gain of func muts of gene encoding c-KIT GI stromal tumor (GIST)
most common malig of stomach. Symp: weight loss, altered bowels, anemia, hemorrh. Loss of func Mut CDH1, encodes E-cadherin. o Diffuse rugal flattening and a rigid, thick wall = leather bottle appearance linitis plastica Gastric Adenocarcinoma o Metastases: to supraclavicular sentinel lymph node = Virchow’s node, periumbilical = Sister Mary Joseph nodule o Intestinal: bulky tumors w/ glands o Diffuse infilt: signet-ring cells
malabsorption diarrhea (d/t impaired lymph transport), lymphadenopathy, arthritis w foamy macrophages and many argyrophilic rods in lymph nodes, shaggy appearance of mucosal surface. Gram pos actinomycete – Tropheryma whippelii. Whipple disease
Lynch synd. Young. Right colon. Mutant MSH2 and MLH1. Hereditary Non-Polyposis Colorectal Cancer
cant secrete TG rich lipoprots. Mut microsomal TG transfer prot (MTP)->TGs accumulate w/in epithel cells. Presents in infancy w/ failure to thrive, diarrhea, steatorrhea. Complete absence of apolipoprotein B. Have Acanthocytic RBCs (Burr cells). Abetalipoproteinemia
gram neg. Nontyphoid usually d/t S. enteritidis infects young and old in summer and fall. Raw or undercooked meat. Bacterial growth w/in phagosomes. Antibiotics not recommended Salmonellosis
gram neg facultative anaerobes. L colon children in daycare, travelers and nursing home most commonly infected. 6 days diarrhea, fever and ab pain o Resistant gastric acid, low infective dose o Shiga toxin inhib eukaryotic protein synth->host cell death Shigellosis Can lead to HUS and Reiters
foveolar hyperplasia, gland regen changes, and mucosal edema. o Gastric antral trauma induces lesion called gastric antral vascular ectasia (GAVE), watermelon stomach Reactive gastropathy
excessive iron absorption and accumulation. Micronodular cirrhosis, DM, skin pigmentation. 50-60 y/o men. Lack of hepcidin d/t mutant hepcidin (HAMP) and HJV (juvenile), TfR2, HFE (most common). Brown fibrous organs slate-gray skin. 200 x risk for HCC. Hemochromatosis o Hemosiderosis: acquired hemochromatosis d/t ineffective erythropoiesis (thalassemias and myelodysplastic synd)
Can survive in gastric acid and gallblad o Peyer’s patches terminal ileum plateau elevations, oval ulcers. o Rose spots on chest and abdomen. Sickle cell susceptible to osteomyelitis. Typhoid Anorexia, ab pain, bloating, N/V, dysentery, followed by short asymp phase, then bacteremia w fever and flu-like symptoms.
encapsulated segmented 2x strand RNA. Most common cause of severe childhood diarrhea and diarrheal mortality worldwide. b/w 6 and 24 mos. 10 viral particles to infect Rotavirus
comma shaped, gram neg, improperly cooked chicken. Resists high temps. o Cholera-like toxin. Can cause watery di, dysentery, enteric fever, reactive arthritis, Guillan Barre Campylobacter jejuni
comma shaped, gram neg, contaminated drinking water and shellfish o cholera toxin (preformed) stimulates adenylate cyclaseincrease cAMPopen CFTR->Cl into lumen->secrete bicarb, NA and water->massive rice water diarrhea (fishy odor). Vibrio cholerae
chronic, watery diarrhea, w/o weight loss o Collagenous = older women, dense supbepi collagen layer, increased intraepi lymphocytes, mixed inflame infiltrate w/in lamina propria. o Lymphocytic=greater increase in intraepi lymphocytes. Strong ass w/ Celi Microscopic colitis
chronic, relapsing ab pain, bloating and changes in bowel habits. o Ab pain at least 3 days/mo over 3 mos, improve w/ defecation, change in stool freq or form. IBS
caused by excessive TGF-alpha->diffuse hyperplasia of foveolar (mucus) epithel of body and fundus (corkscrew like glands) and hypoproteinemia. Usually follows resp infect in kids. Increases risk of adenocarc. Menetrier disease
C. diff overgrowth d/t antibiotic suppression of normal flora, 3rd gen cephs and Clindamyacin Pseudomembranous Colitis
autosom dom, colorectal adenomas as teen. Mut APC gene, or MUTYH. Also, congen hypertrophy of retinal pigment epithel. o Gardner synd: osteomas, desmoids, skin cysts, dental abnorm o Turcot synd: CNS and intestinal tumors, meduloblastomas, glioblastoma Familial Adenomatous Polyposis
autoinfectious can persist for life Stongyloides
amebiasis and liver abscesses. Cause dysentery w flask shaped ulcers Entamoeba histolytica
adhere to epithel cells, traveler’s diarrhea. Nonbloody diarrhea prolonged w AIDS Eaggregative EC
>50 y/o, nonhereditary, hamartomatous polyps in stomach, small intestine and colorectum, nail atrophy and splitting, hair loss , and hypo and hyper pigmentation Cronkhite-Canada
<5 y/o, SMAD4 and BMPR1A, risk of GI adenocarcinoma, pulmonary arteriovenous malformations and digital clubbing Juvenile Polyposis
<15 y/o, PTEN, macrocephaly, intestinal hamartomatous polyps, benign skin tumors plus mental def and developmental delays Bannayan-Ruvalcaba-Riley
<15 y/o, PTEN, macrocephaly, intestinal hamartomatous polyps, benign skin tumors Cowden Syndrome
11 y/o, LKB1/STK11, arborizing polyps of small intestine, skin macules and increased risk of thyroid, breast, lung, other cancers Peutz-Jeghers
multiple peptic ulcerations in stomach, duod caused by gastrinoma->massive acid production and increase in parietal cells and mucin hyperproduction. Risk factor is MEN1 or 2 Zollinger-Ellison synd
Created by: Jakphooey