Term
|
Definition
Terminal Digestion
Transepithelial Transport |
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Term
|
Definition
Distal Small Intestine
Transepithelial Transport
Thought to be caused by Cyclospora or enterotoxigenic bacteria
Reminiscent of pernicious anemia |
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Term
| Cystic Fibrosis Pancreatitis |
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Definition
Intraluminal Digestion
Low-grade chronic auto digestion of the pancreas and exocrine pancreatic insufficiency |
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Term
| Celiac Disease (Celiac Sprue or Gluten sensitive enteropathy) |
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Definition
Genetic predisposition
Gliaden
Intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy |
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Term
|
Definition
Ages 30-60
Anemia, chronic, diarrhea, bloating, or CHRONIC FATIGUE
2-3 fold more in women |
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Term
| Classical Symptoms (Pediatric Celiac Disease) |
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Definition
6-24 months
Irritability, abdominal distention, anorexia, failure to thrive |
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Term
| Nonclassical Symptoms (Pediatric Celiac Disease) |
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Definition
Older children
Abdominal pain, nausea, vomiting, bloating, arthritis/joint pain, PUBERTAL DELAY and SHORT STATURE |
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Term
| Enteropathy-associated T-cell lymphoma |
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Definition
| Most common celiac disease-associated cancer |
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Term
| Mucosal and Mural Infection |
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Definition
Any level of the gut
More often segmented and patchy
May be ulcerated or dark red or purple due to hemorrhage |
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Term
|
Definition
Due to acute arterial obstruction
Splenic flexure is at greatest risk
Coagulative necrosis within 1-4 days, with possible perforation of bowel
Can lead to superinfection and enter toxin release with pseudomembranes |
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Term
|
Definition
Malformed submucosal and mucosal blood vessels
Dilation and tortuosity
Most often in the CECUM or R. COLON
6th decade
Can lead to significant hemorrhage |
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Term
|
Definition
| Isotonic stool and persists during fasting |
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Term
|
Definition
Ex: Lactase deficiency
Due to large amounts of unabsorbed luminal solutes
Abates with fasting |
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Term
|
Definition
Failure of nutrient absorption
Associated with steatorrhea
Relieved by fasting |
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Term
|
Definition
Purulent, bloody stool
Continues during fasting |
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Term
| Cholera (Vibrio cholerae) |
|
Definition
Comma shaped, G-
Transmitted through shell-fish and contaminated drinking water
NON-INVASIVE
Small-intestines |
|
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Term
|
Definition
| Most common cause of seafood associated gastroenteritis in North America |
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Term
| Campylobacter jejuni (enterocolitis) |
|
Definition
Comma-shaped, flagellated, G-
Improperly cooked chicken or unpasteurized milk or contaminated water
Dysentery or watery diarrhea |
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Term
|
Definition
| Occurs when bacteria proliferate within lamina propria |
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Term
| Campylobacter Enterocolitis |
|
Definition
Can result in:
Reactive arthritis
Erythema nodosum
Guillain-Barre (due to molecular mimicry) |
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Term
|
Definition
Enteric fever
INVASIVE
Colon |
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Term
|
Definition
Ingestion of 500 organisms
8 day incubation
May shed for 1 month post clinical resolution
ANTIBIOTICS ARE NOT REQUIRED |
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Term
| Campylobacter jejuni virulence |
|
Definition
1) Motility (flagella)
2)Adherence
3)Cytotoxins (bloody) and Cholera-like enterotoxin (watery)
4)Invasion |
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Term
| Vibrio cholerae virulence |
|
Definition
|
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Term
|
Definition
Watery diarrhea
Incubation of 1-5 days
Most deaths occur within the first 24 hours |
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Term
|
Definition
Children of developing countries
Left-colon and Ileum
Bloody diarrhea (6 days), fever, and abdominal pain
Mucosa is hemorrhagic and ulcerated, POSSIBLE PSEUDOMEMBRANE
Complications: Reiter syndrome, hemolytic-uremic syndrome |
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Term
|
Definition
G- bacilli
Unencapsulated
NON-MOTILE
Facultative anaerobes
Fecal-Oral transmission
Only a few hundred organisms needed
Humans are the only known reservoir
DO NOT USE ANTI-DIARRHEA MEDS |
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Term
|
Definition
1)Resistent to harsh acids
2)Taken up by M cells (INVASIVE), escape into the lamina propria, and cause apoptosis of Macrophages
3)TYPE III SECRETION SYSTEM that directly injects into host cells
4)"Stx" (toxin) that inhibits eukaryotic protein synthesis |
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Term
|
Definition
Typhoid Fever and Non-typhoid
G- bacilli; reservoir is poultry, farms animals, and reptiles
Contaminated food; raw, undercooked meat, poultry, eggs, and milk
Loose stools, dysentery, or watery diarrhea
Fever (resolves in 2 days)
NO ANTIBIOTICS (Disease is self-limited) |
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|
Term
Salmonella typhi
Salmonella paratyphi |
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Definition
|
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Term
|
Definition
|
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Term
| Salmonella virulence factors |
|
Definition
1)Very few viable organisms needed to cause infection
2)Flagella
3)TYPE III SECRETION SYSTEM (transfers into M-cells that activate Rho GTPases)
4)Molecule that causes epithelial cells to secrete hepoxillin A3, that draws neutrophils into the intestinal lumen |
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Term
|
Definition
Peyer's patches and mesenteric nodes are enlarged
Oval ulcers that may perforate
Liver shows random parenchymal necrosis, filled with macrophage aggregates
Anorexia, bloating, vomitting, dysentery |
|
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Term
|
Definition
2 weeks of not being treated causes:
Rose spots: small erythematous maculopapular lesions on chest and abdomen
High fevers and abdominal tenderness |
|
|
Term
Yersinia enterolytica
Yersinia pseudotuberculosis |
|
Definition
G-
Urease +
Transmitted through pork, milk, and cont. water
Human reservoir |
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Term
|
Definition
Abdominal pain, with or without fever and diarrhea
Enteritis and colitis predominate in younger children
Ileum, Appendix, and R. Colon
Can mimic acute appendicitis
Lymph node and Peyer's patch hyperplasia, bowel wall thickening
Extra-intestinal symptoms:
Pharyngitis, arthralgia, and erythema nodosum |
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Term
|
Definition
1)Invade M-cells
2)Adhesins (bind to B1-integrins)
3)IRON UPTAKE SYSTEM |
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Term
| Enterotoxicgenic E. coli (ETEC) |
|
Definition
G- bacilli
2> year olds, and in underdeveloped regions
Traveler's diarrhea
Contaminated food or drink
Limited infection
Secretory/non-inflammatory diarrhea, dehydration, and shock (severe) |
|
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Term
|
Definition
1)Heat labile toxin (LT): increases host intracellular cAMP
2)Heat stabile toxin (ST): increases host intracellular cGMP |
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|
Term
| Enterohemorrhagic E. coli (EHEC) |
|
Definition
G- bacilli
Famous 0157:H7 strain caused Jack-in-the-Box epidemic
Contaminated meat, milk, and vegetables
Large outbreaks, dysentery, and hemolytic-uremic syndrome |
|
|
Term
|
Definition
Shiga-like toxin
0157:H7 strain |
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Term
| Enteroinvasive E. coli (EIEC) |
|
Definition
G- bacilli
Transmitted from person-to-person, food, and water
Most common among children in developing countries
NO TOXINS
Invades epithelial cells and cause acute self-limited colitis |
|
|
Term
| Enteroaggregative E. coli (EAEC) |
|
Definition
G- bacilli
Diarrhea in children and adults (non-bloody)
Histologic damage is minimal
Can cause travelers diarrhea
In both developed and developing countries |
|
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Term
|
Definition
1)Adherence fimbriae: unique adherence
2)Disperins: assist adherence and neutralize (-) charge on LPS
3)Enterotoxin related to Shigella enterotoxin
4)ETEC ST |
|
|
Term
| Pseudomembranous colitis (Antibiotic-associated colitis ir antibiotic associated diarrhea) |
|
Definition
May be due to Clostridium difficult, Salmonella, Clostridium perfringens Type A, or Staphylococcus aureus
PSEUDOMEMBRANES; surface epithelium is denuded; "eruptions reminiscent of volcanos"
Fever, cramps, hypoalbuminemia, watery diarrhea, and dehydration
Treated with 3rd-generation cephalosporins, METRONIDAZOLE OR VANCOMYCIN |
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Term
|
Definition
Multivisceral chronic disease
Triad: Diarrhea, malabsorption, and weight loss
Foamy macrophages in the lymph nodes and small intestines with VILLOUS EXPANSION
G+ bacteria bacilli implicated (Trphpheryma whippelii)
Impaired fat lymphatic transport leads to diarrhea |
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Term
|
Definition
Small icosahedral with SS-RNA
Causes ~50% of all gastroenteritis outbreaks worldwide
Contaminated food or water and by person-to-person transmission
Common signs of GI distress w/ mild villous shortening and loss of the microvillus brush border
Self limited |
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Term
|
Definition
Encapsulated virus with segmented DS-RNA
Most common cause of severe childhood diarrhea (6-24 months)
Destroys mature enterocytes
Vomiting and watery diarrhea that is self-limited
VACCINE |
|
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Term
|
Definition
2nd most common cause of pediatric diarrhea
Non-specific villous atrophy and crypt hyperplasia
Incubation 1 week |
|
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Term
|
Definition
Infects over 1 BILLION PEOPLE WORLDWIDE
Fecal oral transmission
Disease is caused by the larval migration from the splanchnic circulation to the systemic and cause liver abscesses. They also migrate up the trachea and are swallowed to mature into adult worms.
Induce eosinophil-rich inflammatory reactions |
|
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Term
|
Definition
Live in fecally contaminated ground soil and penetrate unbroken skin
Migrate to the lungs, and mature in the intestines
LAY LARVAE THAT PENETRATE THE MUCOSA, CAUSING AUTOINFECTION
Can persist for life |
|
|
Term
| Necator duodenale adn Ancylostoma duodenale |
|
Definition
Hook worms
Invade through the skin,develop in the lungs, swallowed, attach to the mucosa in the DUODENUM, where they suck blood
Multiple superficial erosions, hemorrhage, inflammatory infiltrates, and chronic iron deficiency |
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Term
|
Definition
Pinworms
Fecal-oral route; eggs are deposited on the perirectal mucosa
Intense irritation with rectal and perineal pruritis
USE CELLOPHANE TAPE stuck to the perianal skin, and examined under a microscope |
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|
Term
|
Definition
Whipworms
Young children
Same are Enterobius vermicularis but rarely serious |
|
|
Term
|
Definition
Adult worms reside within the mesenteric veins
Can cause bleeding and obstruction |
|
|
Term
Intestinal cestodes:
Diphullobothrium latum (fish tapeworms)
Taenia solium (pork tapeworms)
Hymenolepsis nana (dwarf tapeworms) |
|
Definition
Reside in the intestinal lumen
ENLARGES BY EGG FILLED SEGMENTS TERMED "PROGLOTTIDS"
DOES NOT ATTACH TO THE MUCOSA--> NO EOSINOPHILIA |
|
|
Term
| Entamoeba histolytica (amebiasis) |
|
Definition
Protozoan
Fecal oral transmission: chitin walls prevent damage by gastric acid
Release trophozoites
Dysentery and liver abscess
"Flask-shaped ulcers"
FERMENTERS OF GLUCOSE (inhibit with Metronidazole) |
|
|
Term
Giardia lamblia:
G. duodenalis
G. intestinalis |
|
Definition
Flagellated protozoans cause decreased expression of brush-border enzymes
Modify major surface proteins to evade the immune system
Fecal contaminated water and food
Resistant to chlorine |
|
|
Term
|
Definition
"Pear shaped" with 2 nuclei
Also: sickle cell profiles that are implanted/tightly bound to the brush border without invasion |
|
|
Term
Cryptosporidium:
C. hominis
C. parvum |
|
Definition
Can cause traveler's diarrhea
Oocyte is activated by stomach acid, releasing sporozoites
Sporozoites are motile and cause actin rearrangement in the brush border to form vacuoles around the organism
Terminal ileum (with villous atrophy in children)
Sodium malabsorption, chloride secretion, increased tight junction permeability, and watery diarrhea |
|
|
Term
|
Definition
Bleed and may prolapse
Usually in children less than 5
Usually solitary
<3cm, pedunculated, reddish |
|
|
Term
| Autosomal Dominant Syndrome of Juvenile Polyposis |
|
Definition
| From 3 to 100 hamartomatous polyps |
|
|
Term
|
Definition
Multiple hamartomatous polyps with mucous hyperpogmetation
Dark blue to brown macules around mouth, eyes, nostrils, palms, genitals, etc. |
|
|
Term
| Peutz-Jeghers Syndrome (Morph) |
|
Definition
Small intestine
Stomach and colon
Large and pedunculated
ARBORIZATION AND PRESENCE OF SMOOTH MUSCLE INTERMIXED WITH THE LAMINA PROPRIA |
|
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Term
|
Definition
Macrocephaly, hamartomatous polyps, benign skin tumors
PTEN mutation |
|
|
Term
| Bannayan-Ruvalcaba-Riley Syndrome |
|
Definition
Mental deficiencies and developmental delays
Same presentation as Cowden Syndrome |
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