Pathophys
Describe the risk factors, epidemiology, and genetic predisposition of celiac disease.
I totally agree.
Discuss the significance of the stool testing and the elevated fecal fat.
YASSSS
What are some common foods that contain gluten?
Dang...
The Ligament of Treitz is an anatomical landmark used to differentiate what?
Upper and Lower GI Bleeds.
Describe Crigler Najjar Syndrome Type I.
Absence of UDP-glucuronosyltransferase (converts unconj. bilirubin to conj. bilirubin). Presents with jaundice, kernicterus (unconj. bilirubin in the brain), elevation of unconj. bilirubin in the blood.
Outline the pathophysiology of non-celiac gluten/wheat sensitivity and compare it to celiac disease.
You're AMAZING!
What is the name of our patient in the case?
;)
Justify the use of an upper endoscopy and small bowel biopsy in patients with Celiac Disease.
Right on!
Name three differences between the jejunum and ileum (i.e. vasa recta, arterial arcades, color)
Jejunum: Red in color, thicker wall, greater vascularity, longer vasa recta, larger & fewer arterial arcades, less fat/transparent/presence of mesenteric windows, prominent circular folds.
Ileum: Pink in color, thinner wall, less vascularity, shorter vasa recta, smaller & fewer arterial arcades, more fat/mesentery reaches all the way to the ileum, sparse or absent circular folds.
Describe the role of secretin in the small intestine.
Secretin is secreted by S cells in the duodenum in response to H+ in the lumen of the small intestine. After secretion, secretin will activate adenylyl cyclase --> increasing cAMP--> stimulating protein kinase A --> phosphorylation of CFTR --> increase the shunting of Cl- ions into the lumen to be fed back into the Cl-/HCO3- exchanger to allow for more HCO3- in the lumen! Overall, secretin is a major stimulate of HCO3 secretion.
Outline the inflammatory adaptive immune response involved in celiac disease.
AWESOME SAUCE
Describe the typical clinical presentation and pertinent physical exam findings of adults & children diagnosed with celiac disease.
YAY YAY YAY
What is the difference between indirect and direct hernias?
Indirect: congenital; deep inguinal ring fails to close. Passes through both the deep and superficial inguinal rings. Located lateral to the inferior epigastric a.
Direct: weakness in the abdominal wall. Conjoint tendon is involved. Superficial inguinal ring involved. Medial to the inferior epigastric a.
Primary sclerosing cholangitis affects what parts of the liver/biliary tract? What is the antibody associated PSC? And, what does this look like histologically?
intrahepatic and extrahepatic ducts, PANCA, Onion-ring lesion
Explore the normal physiology of nutrient assimilation and water absorption.
i think you're pretty cool
Lets talk about LABS! Relate the laboratory findings to the pathophysiology of celiac disease.
I am so so proud of you.
Describe how adhering to a gluten-free diet helps in the management of celiac disease.
Do they have gluten free ice cream?
Outline the innervation pathway if sensation is sensed at the tail of the pancreas.
Dorsal pancreatic a. --> splenic a. --> celiac trunk --> synapse at celiac ganglion--> greater splanchnic nerve (T5-T9)--> paravertebral ganglion (sympathetic trunk)--> white rami communicans --> ventral primary rami --> spinal nerve --> dorsal root --> DRG (cell bodies found here) --> dorsal root --> dorsal rootlets--> dorsal horn (synapse here).
Identify the role of CCK in the gallbladder, pancreas, stomach, and sphincter of Oddi.
Gallbladder--> contraction
Pancreas--> acinar secretion
Stomach--> reduced gastric emptying
Sphincter of Oddi--> relaxation
Outline the pathophysiology of Celiac Disease.
GREAT JOB
Discuss the results of the upper endoscopy and small bowel biopsy--> relate to pathogenesis.
that was spectacular
Justify the use of vitamin and mineral supplementation with a probiotic.
You're so right.
Halfway through which structure, do visceral afferents follow parasympathetics in the hindgut?
sigmoid colon
Outline the innervation pathway of sensation from the gallbladder.
cystic a. --> right hepatic a. --> proper hepatic a. --> common hepatic a. --> celiac trunk --> synapse at celiac ganglion--> greater splanchnic nerve (T5-T9)--> paravertebral ganglion (sympathetic trunk)--> white rami communicans --> ventral primary rami --> spinal nerve --> dorsal root --> DRG (cell bodies found here) --> dorsal root --> dorsal rootlets--> dorsal horn (synapse here).