Term
| 80% of acute pancreatitis in Western countries is associated with what two underlying conditions? |
|
Definition
| Biliary tract disease and alcoholism |
|
|
Term
| In the absence of biliary tract disease or alcoholism, what are other potential causes of acute pancreatitis |
|
Definition
| Pancreatic carcinomas, Ascariasis or Clonorchis infection, congenital malformations of the pancreatic duct, drugs (thiazide diuretics, estrogens, lasix, others), mumps virus or coxsackivirus infection, ischemia, or trauma |
|
|
Term
| Regardless of different etiologies, what is the common precursor to acute pancreatitis? |
|
Definition
| Acinar cell injury, causing release of proenzymes and subsequent activation, especially proteases (trypsinogen->trypsin, other types) |
|
|
Term
| Trypsinogen is converted to trypsin by what enzyme, secreted by the duodenum? |
|
Definition
| Enteropeptidase, although trypsin has auto-catalytic properties as well, so once some trypsin is activated it can activate more trypsinogen |
|
|
Term
| In addition to auto-digestion, what other action of trypsin causes damage to pancreatic blood vessels and parenchymal tissue? |
|
Definition
| Conversion of prekallikrein to kallikrein and Hageman factor, both activating clotting and complement cascades that can lead to further inflammation and small vessel thromboses in the pancreas |
|
|
Term
| The pancreatic duct empties into the duodenum via this structure |
|
Definition
|
|
Term
| This type of necrosis seen in pancreatitis is a result of lipase activity, leading to deposition of fat in surrounding tissue |
|
Definition
|
|
Term
| True or false: IL1B, IL6, TNFa and substance P all play an important role in inflammation due to pancreatic duct obstruction |
|
Definition
| True, promotes edema formation from leaky microvasculature and ischemic injury to acinar cells |
|
|
Term
| This muscle controls the opening of the ampulla of vater |
|
Definition
|
|
Term
| True or false: normally, pancreatic zymogens and lysosomal enzymes are transported together and activated prior to entry into the duodenum |
|
Definition
| False, they are typically transported through the duct and into the small bowel in separate vesicles, then interact, in aberrant processes they join before, activation occurs causing pancreatic damage |
|
|
Term
| What is the difference in prognosis of chronic vs. acute pancreatitis? |
|
Definition
| the parenchymal damage is permanent in chronic pancreatitis, reversible in acute pancreatitis |
|
|
Term
| True or false: the primary symptom of acute pancreatitis is abdominal pain |
|
Definition
| True, it is a medical emergency, also can present with DIC, leukocytosis, hemolysis, ARDS and diffuse fat necrosis in the peritoneum |
|
|
Term
| What lab values are helpful during the first 24 hours and 72-96 hours respectively? |
|
Definition
|
|
Term
| True or false: "rest" is the recommended tx for acute pancreatitis |
|
Definition
| True, food and fluid rstriction with supportive therapy allows the pancreas to recover, sequelae include pancreatic pseudocysts or pancreatic abscesses that can cause subsequent attacks |
|
|
Term
| The most common cause of chronic pancreatitis is: |
|
Definition
| EtOH abuse, there are some hereditary causes but these are rare, resulting from mutations in the PRSS1 or SPINK1 genes that facilitate trypsin inactivation via a receptor and inhibitor, respectively, these can also cause acute pancreatitis |
|
|
Term
| In contrast to the hemhorrage and fat necrosis seen in acute pancreatitis, the most common pathologic finding in chronic pancreatitis is: |
|
Definition
| Parenchymal fibrosis, though pancreatic islets are spared |
|
|
Term
| True or false: Congenital diverticula are uncommon pathologies in the general population |
|
Definition
| False, in the ascending colon diverticula are not uncommon, most diverticular disease occurs in the sigmoid colon (95%) |
|
|
Term
| Unless otherwise specified, colonic diverticula contain only these two layers of the intestinal wall |
|
Definition
| Mucosa and sub mucosa, some may have an attenuated muscularis propria but it is commonly missing |
|
|
Term
| What two factors are implicated in the pathogenesis of diverticular disease? |
|
Definition
| Increased (bowel) luminal pressure and focal weakness in the large bowel |
|
|
Term
| Comparing the longitudinal muscle layer of the intestinal wall from the large bowel and the small bowel, what is the key difference? |
|
Definition
| The longitudinal muscle of the large bowel is organized into three equidistant but independent bands the taenia coli, where nerves and arteries enter adjacent to the taenia coli it creates focal weakness to allow outpouchings to occur |
|
|
Term
| Epidemiologic studies suggest what as a cause of diverticular disease? |
|
Definition
| Western diets low in fiber and higher in processed foods, which decreases stool bulk and increases the work the muscles of the large bowel must complete to move stool along, increasing luminal pressure |
|
|
Term
| Diverticular disease is rare in persons <60 years old except in what acquired conditions? |
|
Definition
| Marfan's syndrome and Ehlers-Danlos syndrome |
|
|
Term
| When does diverticulosis become diverticulitis? |
|
Definition
| Impacted stool in the diverticula cause local ischemia and inflammation, presenting with LLQ pain, leukocytosis and fever, sometimes with frank blood in the stool, rarely the diverticula can rupture and cause hemhorrage |
|
|
Term
| True or false: CT scan is the gold standard of dx for diverticular disease |
|
Definition
| True, barium contrast enema can be used too but may not be as sensitive |
|
|
Term
| This congenital disease accounts for about 5-10% of causes of renal failure and hemodialysis |
|
Definition
| Autosomal dominant polycystic kidney disease, AD inheritance with high penetrance |
|
|
Term
| True or false: ADPKD is almost always bilateral |
|
Definition
| True, unilateral cases may represent other diseases |
|
|
Term
| These genes, involved in polycystic kidney disease, have different prognostic properties depending on which mutation occurs |
|
Definition
| PKD1 and PKD2, PKD1 mutations have an average life expectancy of 53 years compared to 69 years in PKD2 |
|
|
Term
| True or false: PKD1 encodes a large transmembrane protein without a well described function, found mostly on distal tubular cells |
|
Definition
|
|
Term
| This protein, implicated in ADPKD, is found in all tubular cells and outside the kidney, and is involved in controlling intracellular calcium concentration |
|
Definition
| polycystin 2, it may also form a complex with polycystin 1 |
|
|
Term
| What are the implications of excessive intracellular calcium with regards to cell function? |
|
Definition
| Increased cellular proliferation and growth and increased intracellular volume |
|
|
Term
| How are cysts in ADPKD diagnosed? |
|
Definition
| MRI, bright parenchyma surrounding dark cystic fluid, reversed on T2 waiting |
|
|
Term
| Where else in the body do abnormalities appear with ADPKD? |
|
Definition
| Berry aneurysms in brain, diverticula in the colon, hepatic cysts |
|
|
Term
| True or false: The vast majority of gallstones are "silent," about 80% |
|
Definition
| True, up to 20% of Americans have gall stones, common in Western developed countries |
|
|
Term
Select the proper order of flow of bile:
1) Common bile duct, hepatic duct, r&l hepatic ducts, cystic duct
2)hepatic duct, cystic duct, r&l hepatic ducts, common bile duct
3)cystic duct, R&l hepatic duct, hepatic duct, common bile duct
4) r&l hepatic ducts, hepatic duct, cystic duct, common bile duct |
|
Definition
| 4, the cystic and hepatic ducts fuse to form the common bile duct |
|
|
Term
| This type of stone accounts for 80% of all gall stones |
|
Definition
| Cholesterol stones, the other 20% are pigment stones of calcium bilirubinate or other pigment products |
|
|
Term
| What are some established risk factors for cholelithiasis? |
|
Definition
| Pregnancy, female over 40 years old, rapid weight loss, obesity, oral contraceptive use and Native American ancestry |
|
|
Term
| True or false: 25% of gallstone sufferers have a first degree relative with a similar problem |
|
Definition
|
|
Term
| True or false: CT scan is the gold standard of gallstone dx |
|
Definition
| False, ultrasound is effective at identifying gallstones |
|
|
Term
| Where does the achy epigastric pain of gallstones typically radiate? |
|
Definition
|
|
Term
| This hormone causes the gallbladder to contract |
|
Definition
|
|
Term
| This clinical exam technique elicits the peritonitis occuring with bacterial infection of a cholecystitis |
|
Definition
| Murphy's sign, presses the gallbladder against the inflamed peritoneum overlying the liver |
|
|
Term
| Why is morphine contra-indicated in pain management of acute cholecystitis? |
|
Definition
| It increases sphincter of Oddi contractility, which worsens pain of the bile duct |
|
|
Term
| True or false: cholecystitis can occur in the absence of stones |
|
Definition
| True, 5-10% of cholecystitis occurs without stones, often associated with infection, trauma or surgical intervention |
|
|
Term
| Two thirds of colorectal cancers arise from this type, beginning as benign glandular polyps and progressing to tumors |
|
Definition
|
|
Term
| What is the difference between the FOBT and colonoscopy/barium contrast enema? |
|
Definition
| FOBT detects early cancers that can still be treated, while endoscopic or radiologic tests can detect non-cancerous polyps that may progress to cancer |
|
|
Term
| When should screening for colorectal begin and end for US residents? |
|
Definition
| Begin at age 50, end at age 75 |
|
|
Term
| What are the 5 general tissue responses to liver injury? |
|
Definition
| Necrosis->apoptosis, degeneration and intracellular accumulation, inflammation, regeneration and fibrosis |
|
|
Term
| Wilson disease, hemochromatosis, and fatty liver disease can lead to this type of liver injury? |
|
Definition
| Intracellular accumulation, fatty depositions can be microvesicular ( no nuclear displacement: pregnancy and valproic acid toxicity), or macrovesicular (AFLD, obesity, HCV, DM) with nuclear displacement by one large fat droplet |
|
|
Term
| Irregularly clumped organelles in the cytoplasm and large clear intracellular spaces are a hallmark of this type of hepatocyte degeneration (seen in alcoholic hepatitis, for instance) |
|
Definition
| Ballooning degeneration, where cholestatic injury causes "feathery degeneration," with a feathery appearance and yellow discoloration |
|
|
Term
| This region of liver parenchyma, adjacent to hepatic veins, is the most common site of liver necrosis due to ischemia, drug or toxic injury |
|
Definition
| Centrilobular, furthest from hepatic arteries and portal veins, poorest blood supply, zone 2 and 3 are uncommon injury sites but pre-eclampsia can cause periportal (zone 3) injury and necrosis |
|
|
Term
| In contrast to this type of necrosis, zonal necrosis typically occurs in the centrilobular area, furthest from the arterial blood supply making it vulnerable to ischemic injury |
|
Definition
| Diffuse necrosis, which can be located in the periportal parenchyma (interface hepatitis), contiguous hepatocyte necrosis that spans different lobules (bridging necrosis), scattered cells within a lobule (focal/spotty necrosis), and necrosis of the entire liver or entire lobules (massive/submassive necrosis) |
|
|
Term
| Ballooning degeneration can lead to this type of necrosis from cell swelling and lysis |
|
Definition
|
|
Term
| Describe the pathologic appearance of apoptotic hepatocyte death |
|
Definition
| Shrunken, pyknotic, eosinophilic hepatocytes with fragmented nuclei |
|
|
Term
| What three routes can lead to inflammation of liver parenchyma (hepatitis)? |
|
Definition
| Direct toxic injury, ischemia, and CD8+ mediated hepatocyte destruction with scavenger macrophage recruitment, all processes increase number of inflammatory immune cells and cytokines present in liver, can be acute or chronic |
|
|
Term
| True or false: as long as the connective tissue structure of the liver is intact, the liver can recover from any parenchymal injury or biliary obstruction |
|
Definition
| True, exceptions are severe cirrhosis where CT framework is destroyed or fulminant liver disease |
|
|
Term
| Though inflammation and toxic injury can cause necrosis in the liver, what process involves the deposition of collagen in the liver tissue, changing blood flow and hepatocyte perfusion? |
|
Definition
|
|
Term
|
Definition
| The sequestration of proliferating hepatocytes into nodules surrounded by scar tissue (collagen) |
|
|
Term
| What are some characteristic signs of liver dysfunction? |
|
Definition
| Jaundice, hypoalbunimeia, hyperammonemia, hypoglycemia, spider angiomata, palmar erythema, hypogonadism, gynecomastia, weight loss and wasting |
|
|
Term
| True or false: In the West, the most common cause of cirrhosis is chronic viral hepatitis |
|
Definition
| False, EtOH abuse, followed by viral hepatitis or biliary disease, unknown etiologies or metabolic diseases like Wilson, hemachromatosis, others |
|
|
Term
| Other than nodules surrounded by collagen, what are two pathologic features of cirrhosis? |
|
Definition
| Bridging fibrous septae linking portal tracts to one another and hepatic veins, also re-organization of vascular architecture that bypass hepatocytes and formation of anastomses between portal and caval circulation |
|
|
Term
| These cells secrete the collagen that builds up in cirrhosis, and are stimulated by cytokines from Kuppfer cells, endothelial cells, hepatocytes and bile duct epithelium, as well as non-inflammatory triggers |
|
Definition
| Perisinusoidal stellate cells, differentiate to form myofibroblasts and divide rapidly, increasing the synthesis of EC matrix and connective tissue fibers |
|
|
Term
| Macrophages in this immune tissue degrade hemoglobin into globin and heme |
|
Definition
| Reticuloendothelial system |
|
|
Term
| The component parts of heme include ferric iron and this structure, a four-pyrrole straight chain |
|
Definition
| Biliverdin, is reduced to bilirubin in the blood (free/unconjugated bilirubin) which binds with albumin in the blood |
|
|
Term
| In the hepatocytes, bilirubin typically joins with what two organic compounds to become "conjugated"? |
|
Definition
| Glucuronic acid, 80% and sulfate, 10%. |
|
|
Term
| Most bile is excreted in the (), in the form of urobilinogen |
|
Definition
| feces, some is re-absorbed in the gut and re-excreted by the liver, while about 5% of urobilinogen leaves in the urine |
|
|
Term
| True or false: Urobilin is urobilinogen in urine, while stercobilin is urobilinogen in stool |
|
Definition
| True, they are both oxidized but differently, giving urine its characteristic color and stool its characteristic color |
|
|
Term
| At what level of serum bilirubin does jaundice become apparent? |
|
Definition
| 1.5 mg/dl, or three times the normal level |
|
|
Term
| What two pathways lead to jaundice, primarily? |
|
Definition
| Hemolysis or biliary obstruction/hepatocyte damage, the former elevating unconjugated bilirubin in the blood with the latter decreasing bilirubin excretion into the gut (post conjugation) |
|
|
Term
| True or false: Presence of antiHAV-IgG is indicative of chronic HAV infection |
|
Definition
| False, there is no chronic carriage of HAV, IgG indicates immunity from past infxn or immunization |
|
|
Term
| What is the characteristic pattern of liver aminotransferase elevation in viral hepatitis? |
|
Definition
|
|
Term
| After calculating an anion gap, and finding it to be elevated, what is the next step in eliciting the source of the acid-base disturbance? |
|
Definition
| gap-gap, the difference in HCO3 should equal the elevation in the anion gap, if it is larger then it suggests a super-imposed acidosis |
|
|
Term
| True or false: autoimmune hepatitis (AIH) is frequently associated with other autoimmune diseases like thyroid, rheumatoid and UC |
|
Definition
|
|
Term
| True or false: Type 1 AIH patients have serum positive for ANA and ASMA (smooth muscle), while Type 2 AIH patients have anti-LKM1 antibodies |
|
Definition
| True, Type 2 is rare in the US, more common in Europe among young children |
|
|
Term
| This is the simplified explanation for the development of self-antibodies |
|
Definition
| In the thymus, MHCII-CD4 interactions are regulated such that self-reactive CD4+ cells are culled when bound to MHC II antigens, in autoimmune disease a mutation in the HLA gene disrupts this process, so MHC II-CD4 interactions of self-peptides can occur, leading to the inflammation and self-antibodies seen in autoimmune disease |
|
|
Term
| This pathologic finding on biopsy is a hallmark of autoimmune liver disease |
|
Definition
| Though non-specific, the presence of inflammatory cells (PMNs, lymphocytes) in the portal tracts invades the surrounding liver parenchyma leading to apoptosis of the periportal hepatocytes |
|
|
Term
| These two drugs are recommended in treating AIH |
|
Definition
| Prednisone (low dose) with azathioprine, 80% of patients go into remission after three years, azathioprine is a purine-analog DNA synthesis inhibitor, and works mainly by suppressing mitosis of B and T cells, significantly it depresses bone marrow fxn leading to anemia, leukopenia and thrombocytopenia |
|
|
Term
| What three cell types make up an oxyntic gland? |
|
Definition
| Chief (peptic) cells which secrete pepsinogen, parietal cells that secrete HCl, and mucous neck cells that secrete mucous |
|
|
Term
| In the parietal cells, how does the cell create the negative potential in the lumen of the gland to draw in more KCl and NaCl into the cell? |
|
Definition
| Chloride ion is pumped actively from the cell into the lumen of the canaliculus, which creates a negative charge in the cannaliculus, drawing more salt into the canaliculus |
|
|
Term
| () and () are actively exchanged by an ATPase in parietal cells, which in results in the replacement of potassium and sodium with hydrogen in the canaliculus, forming HCl in the lumen |
|
Definition
| Hydrogen and potassium, hydrogen is exchanged in the lumen for potassium, and a separate sodium pump moves sodium back into the cell from the lumen to help form hydrochloric acid |
|
|
Term
| True or false: Water is pumped actively into parietal cells of the stomach |
|
Definition
| False, the water moves by osmosis following the ions moving into the cell, the final HCl concentration is about 150 mEq/L, with a pH of 0.8, this process requires about 1500 calories per liter of gastric juice |
|
|
Term
| True or false: pyloric glands secrete pepsin |
|
Definition
| True, pepsin is secreted by the pyloric glands as pepsinogen, which is cleaved by HCl to pepsin, it is only active at a pH of about 1.8-3.5 |
|
|
Term
| In addition to HCl, parietal cells secrete this substance necessary for B12 absorption. Chronic gastritis can interrupt this process causing pernicious anemia |
|
Definition
|
|
Term
| What two substances do the pyloric glands primarily secrete? |
|
Definition
| Gastrin and mucous to protect the stomach mucosa |
|
|
Term
| These cells secrete a very viscid mucous, alkaline, that protects the mucosal lining of the stomach from the acidic environment of the interior |
|
Definition
|
|
Term
| These cells are the only ones that secrete HCl |
|
Definition
|
|
Term
| These cells secrete histamine in the stomach, stimulating HCl secretion by neighboring parietal cells |
|
Definition
| Entero-chromaffin like cells (ECL) |
|
|
Term
| True or false: the most important stimulator of histamine release from ECL cells is gastrin |
|
Definition
| True, gastrin is secreted by endocrine cells in the antrum of the stomach in response to increased numbers of proteins being digested in the stomach |
|
|
Term
| In addition to gastrin, ECL cells can be stimulated by () from the () nerve |
|
Definition
| Acetylcholine, vagus nerve |
|
|
Term
| Gastrin is secreted by () cells in the () glands, and is composed of two types, G34 and G17 |
|
Definition
| gastrin cells or G cells, pyloric glands |
|
|
Term
| Pepsinogen secretion can be stimulated by acetylcholine release from () nerve or () |
|
Definition
| Vagus, enteric nervous plexus, acid can also stimulate pepsinogen secretion |
|
|
Term
| In this phase of gastric secretion, appetite centers in the amygdyla and hypothalamus elicit a signal to the motor nuclei of the origin of the vagus nerve, which then stimulates gastrin secretion and histamine secretion in the stomach |
|
Definition
|
|
Term
| This phase occurs once food enters the stomach, stimulated by vagovagal reflexes and local enteric nervous plexus signals, accounting for about 70% of gastric secretions |
|
Definition
|
|
Term
| These substances can be secreted by the intestine in response to small bowel distention from food |
|
Definition
| Secretin, vasoactive intestinal peptide and somatostatin, which all inhibit gastric secretions |
|
|
Term
| Elimination of this organism is the most effective treatment for PUD, with a recurrence rate of PUD of 10-15% compared to 60-100% with anti-secretory therapy |
|
Definition
| H.pylori, a gram negative rod |
|
|
Term
| These substance, used in therapy for PUD, don't neutralize acid but increase the synthesis of mucus, preventing acid diffusion into the mucosa |
|
Definition
| Bismuth salts (pepto-bismol) |
|
|
Term
| Binding of this substance inhibits adenylyl cyclase and the synthesis of cAMP, working in opposition to histamine |
|
Definition
|
|
Term
| True or false: H2 blockers like cimetidine distribute widely in body tissues including breast milk and the placenta |
|
Definition
| True, cimetidine specifically is metabolized by microsomal oxygenase systems in the liver, and inhibits P450 cytochrome which potentiates the effects of drugs metabolized by these enzymes |
|
|
Term
| These drugs inhibit the K/H pump in parietal cells, irreversibly binding to the active site of the ATPase and preventing HCl formation |
|
Definition
| PPI, proton-pump inhibitors, more effective in treating PUD |
|
|
Term
| When is the best time to take a PPI? |
|
Definition
| 30 mins before breakfast or largest meal of the day |
|
|
Term
| What are some possible side fx of PPI use? |
|
Definition
| Bacterial overgrowth of the small bowel, animal models suggest increased risk of gastric carcinoid tumors but not in humans, low B12, omeprazole inhibits warfarin, phenytoin, diaepam and cyclosporine metabolism but not the other PPI |
|
|
Term
| This drug, a less effective tx for PUD, stimulates uterine contractions and is contraindicated during pregnancy |
|
Definition
| Misoprostol, usually used as prophylaxis for PUD caused principally by NSAID use |
|
|
Term
| T or F: IBD is the result of an inappropriate response to normal gut microbial flora |
|
Definition
| True, pathogenesis involves the failure of immune regulation, genetic suceptibility and envioronmental triggers |
|
|
Term
| T or F: IBD exhibits Mendelian inheritance patterns |
|
Definition
| False, the disease is a complex multigenic trait and is not inherited in Mendelian fashion |
|
|
Term
| This gene, whose product is important for recognizing normal flora by binding microbes in the guy, is implicated in the etiology of what IBD? |
|
Definition
|
|
Term
| T or F: In both UC and CD the prime culprits for pathogenesis appear to be CD4+ T cells and injury is a result of T cells and their products |
|
Definition
|
|
Term
| T or F: CD is mediated by increased TH2 activation though IL4 has not been demonstrated in even though it's the usual signaling molecule for TH2 |
|
Definition
| False, UC has this characteristic, CD exhibits characteristic Th1 response to IFN-y |
|
|
Term
| What 3 pathologic classifications define Crohn's disease as compared to UC? |
|
Definition
| Sharply delimited and typically transmural involvement of the bowel by an inflammatory process with mucosal damage, presence of noncaseating granulomas and fissuring with formation of fistulae |
|
|
Term
| T or F: The incidence of Crohn disease in the US is around 30/100,000 yearly |
|
Definition
|
|
Term
| T or F: In UC, the intestinal wall is rubbery and thick, as a consequence of edema inflammation fibrosis and hypertrophy of the muscularis layer |
|
Definition
| False, that describes Crohn disease |
|
|
Term
| What term is used to describe sharp demarcation of diseased bowel segments from adjacent uninvolved bowel |
|
Definition
| Skip lesions, seen in Crohn disease |
|
|
Term
| Neutrophilic invasion of the crypts in Crohn typicall result in formation of these, which destroy the crypt |
|
Definition
|
|
Term
| T or F: Ulceration is the usual outcome of severe active Crohn disease |
|
Definition
|
|
Term
| T or F: The clinical manifestions of Crohn are extremely variable and usually more subtle than UC |
|
Definition
| True, including mild diarrhea, fever and abdominal pain with interceding asymptomatic periods lasting weeks-months |
|
|
Term
| T or F: Fecal blood loss in Crohn can lead to anemia over time |
|
Definition
|
|
Term
| T or F: Extensive involvement of the proximal jejeunum causes marked loss of albumin (protein losing enteropathy) generalized malabsorption and specific malabsorption of B12, and steatorrhea due to poor absorption of bile salts |
|
Definition
| False, involvement of the terminal ileum causes these problems, though protein losing enteropathy and poor bile salt absorption can occur anywhere |
|
|
Term
| T or F: Crohn disease confers a 20-30 fold increased risk of colorectal cancer over the lifetime |
|
Definition
| False, 5-6 fold risk of GI tract cancer |
|
|
Term
| T or F: In contrast to Crohn's disease, UC spares the rectum and extends distally from the ileum |
|
Definition
| False, extends proximally from the rectum without granulomata |
|
|
Term
| T or F: Crohn disease is slightly more common than UC |
|
Definition
| False, UC has an annual incidence of 4-12/100,000 |
|
|
Term
| T or F: Pancolitis describes the pattern of UC as it extends from the rectum to span the entire colon |
|
Definition
|
|
Term
| T or F: UC can lead to ulcerations in the mucosa of the colon, giving rise to pseudopolyps made up of regenerating mucosa |
|
Definition
|
|
Term
| T or F: Only in the most severe cases of UC or CD does toxic damage to the muscularis propria and neural plexus lead to complete shutdown of NM function, the colon progressively swells and becomes gangrenous leading to TOXIC MEGACOLON |
|
Definition
|
|
Term
| T or F: Non-specific changes in UC is the spectrum of epithelial changes signifying dysplasia and the progression to frank carcinoma |
|
Definition
| False, Particularly significant changes include all of the above |
|
|
Term
| Which disease presents as follows: bloody mucoid diarrhea that may persist for days weeks or months and then subside, recurring after an asymptomatic period of months, years or decades |
|
Definition
|
|
Term
| T or F: The associated carcinomas are often infiltrative without obvious exophytic masses, further underscoring the importance of early diagnosis in UC |
|
Definition
| True, risk of colon cancer is very high in UC |
|
|
Term
| T or F: In contrast to UC, Crohn disease exhibits early stricture formation but mild lymphoid aggregation and fibrosis |
|
Definition
| False, lots of lymphoid aggregates and fibrosis |
|
|
