CHECKLIST GASTROINTESTINAL MODULE PART II.

PANCREAS TOPICS Pancreas Position Parts of Pancreas Relations Surfaces Borders Ducts of pancreas Blood supply and lymphatic drainage Pancreas Exocrine pancreatic secretion Composition of pancreatic secretion Other constituents of pancreatic juice Effects of loss of pancreatic secretion Steatorrhea Regulation Of Exocrine Pancreatic Secretion Nervous regulation Hormonal regulation Diseases of Exocrine Pancreas Pancreatitis o Acute Pancreatitis o Chronic Pancratitis Tumors and tumors likke conditions o Non-neoplastic cysts - Congenital cysts - Von-Hippel- Lindau Disease - Pseudocysts o Neoplasms arising from exocrine pancreas - Cystic tumor Microcyst adenoma Mucinous cyst adenoma Mucinous cyst adenocarcinoma - Carcinoma of exocrine pancreas Disease of Peritoneum Peritonitis o Sterile peritonitis o Septic or bacterial peritonitis o Sclerosing peritonitis Mesentric cysts Tumors o Primary malignant tumor o Secondary malignant tumor

SUBJECTS Anatomy

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REMARKS

Histology Physiology

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Pathology

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SUBJECTS Anatomy

LOWER GASTROINTESTINAL TRACT TOPICS Small Intestine Duodenum o Position o Part of duodenum o Relations o Blood supply o Peritoneal recesses of duodenum o Duodenal ulceration Jejunum and Ileum o Table of differences Mesentry of small intestine o Borders o Contents of mesentry o Mickels diveticulum Small Intestine The Mucosa o Intestinal epithelium o Lamina Propria o Types of cells lining the intestinal mucosa 1- The intestinal villi - Absorptive columnar cells - Goblet cells - Enteroendocrine cells - M-cells 2- The intestinal glands - Undifferentiated Columnar Cells (Stem Cells) - Few absorptive cells - Goblet cells - Paneth cells - Enteroendocrine cells Submucosa Musculosa and serosa Small Intestine Intestinal secretions o Mucus - Brunners gland - Goblet cells - Mucus cells o Digestive juices Digestion in small intestine o Protein digestion o Carbohydrate digestion o Lipid digestion o Digestion of nucleic acids 2

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REMARKS

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Histology

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Physiology

Regulation of intestinal ssecretions o Nervous control o Hormonal control Part II, 43

Biochemistry

Intestinal Motility Types of intestinal movement o Segmenting movement o Peristaltic movement o Tonic contraction o Antiperistalsis o Motor Migrating Complex (MMC) Regulation of intestinal movements o Nervous control o Hormonal control Iliocecal sphinchter Ileocecal valve Absorption Factors for absorbing power of intestine The intestinal villi Movement of villi Villikinin Factors affecting rate of intestinal absorption Digestion and absorption of carbohydrate Digestion and Absorption of Lipid Digestion and Absorption of Protein Large Intestine Length Small vs large intestine Parts o Ceacum - Position - Relations - Communications of ceacum - Peritoneal recesses related to ceacum - Blood supply o Vermiform Appendix - Position of appendix - Blood supply - Surface anatomy of base of appendix - Clinical note o Ascending Colon - Peritoneal covering - Relations - Blood supply o Transverse Colon - Relations - Transverse mesocolon, contents - Blood supply 3

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Anatomy

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Descending Colon - Peritoneal covering o Sigmoid colon - Relations - Blood supply - Sigmoid Mesocolon, its contents o Rectum - Course, beginning, termination. - Peritoneal covering - Lateral flexures and mucosal folds - Relations of rectum In male In female - Blood supply - Lymph drainage o Anal canal - Course, beginning, termination - Relations - Blood supply - Anal sphincter Internal anal sphincter External anal sphincter - Anal triangle Divisions of the Perineum Contents Boundaries Contents of ischeal fossa Pudendal canal and its contents Arterial supply of the alimentary canal Arterial supply of the foregut o Ceoliac trunk + branches - Left gastric artery - Splenic artery + branches - Hepatic artery + branches Arterial supply of the midgut o Superior mesentric artery + branches - Inferior pancreatico-duodenal artery - Jejunal artery - Ileal arteries - Ileo-colic artery + branches - Right colic artery - Middle colic artery Arterial supply of the hindgut o Inferior mesentric artery + branches - Left colic artery - Sigmoid artery Histology Large Intestine Vermiform Appendix 4

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Physiology

The Anal Canal The Sites of Junction Between Different Parts of the Digestive Tube Gastro-Esophageal junction Pyloro-Duodenal junction Recto-Anal junction Large Intestine Function of large intestine Innervation of muscles of large intestine Motility of large intestine Defecation Autonomic spinal mechanism Voluntary control of defecation Table of Enzymes of the Digestive Tract Enteric Viral Infections Viral gastroenteritis and diarrhoea o Rota Virus o Calciviridae o Enteric Adenovirus o Astrovirus o Enteric Coronavirus Enteroviruses o Polioviruses o Coxackieviruses o Echoviruses Enteric Bacterial Infection Salmonella o Salmonella food poisoning Shigella E.Coli Diarrhoea Vibrio o Vibrio Cholera Campylobacter o Campylobacter Jejuni Bacterial Toxin Associated Foof Poisoning Staph.Aureus food poisoning Botulism Infant Botulism Bacillus Cereus food poisoning Antibiotic-associated diarrhea-clostridium difficile Helmenthic Intestinal Infections Trematoda ( flat worm, 1 segment) o Heterophyes Heterophyes Cestoda ( flat worm, many segments) o Diphylobothrium Latum o Taenia Saginata ( Beef Tapeworm) o Taenia Solium ( Pork Tapeworm) 5

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Microbiology

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Parasitology

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o Hymenolepis Nana (Dwarf Tapeworm) Nematoda ( cylindrical worm, unsegmented) o Trichuris Trichiura ( Whipworm) o Enterobius Vermicularis o Capillaria Philipinensis ( Intestinal Capillariasis) o Ascaris Lumbricoides o Strongyloides Stercoralis o Ancylostomidae Duodenale ( Hookworm) Pharmacology Pharmacology of anti-helmenthic drugs Praziquantel Oxamniquine Niclosamide Bithionol Benzimidazoles (BZAS) o Thiabendazole o Mebendazole o Albendazole o Triclabendazole Pyrantel Pamoate Piperazine Ivermectin Parasitology Protozoal Intestinal Infections Pathogenic parasitic Ameoba o Entamoeba Histolytica Commensal Amoeba o Entamoeba Dispar o Entamoeba Hartmanni o Entamoeba Coli Giardia Lambria Balantidium Coli Isospora Belli Cryptospridia Pharmacology Chemotherapy of Common GIT Protozoal Infection Nitroimidazoles ( Metronidazole & Tinidazole) Diloxanide Furoate (Furamide) Paromomycin Sulfate Iodoquinol Nitazoxanide Furazolidone Treatment regimens of specific form of amebiasis Pathology Small Intestine and Colon Congenital abnormalities of small intestine o Atresia and stenosis o Duplication o Meckels diverticulum Congenital anomalies of colon o Malrotation 6

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o Congenital Megacolon (Hirschsprung disease) Vascular Disorders Ishemic bowel disease Hemorrhoids Inflammatory Bowel Disease Definition Etiology and pathogenesis Types o Crohn Disease(CD) o Ulcerative Colitis (UC) o Table of differences between UC nd CD Pharmacology Pharmacotherapy of Inflammatory Bowel Disease Background Aim of therapy General approach to treatment o Aminosalicylates - Sulfasalazine - Mesalamine - Olsalazine - Balsalazide o Corticosteroid o Immunosuppressive drugs - Azathioprine - Methotrexate - Cyclosporine o Antimicrobials - Metronidazole o Biological therapy @ Anti-Tumor Necrosis Factor- Treatment - Infliximab - Adalimumab Pharmacotherapy of Antidiarrheal Drugs Background Lines of treatments o Non-specific anti-diarrheal drugs - Maintainance of fluid and electrolyte balance (Rehydrane solution) - Antimotility drugs Anticholinergic drugs (Atropine, scopolamine) Diphenoxylate (Lomotil) Loperamide (Imodium) - Adsorbant Kaolin, Pectin, smecta, dietary fibers - Agents that modify fluid and electrolyte transport Bisthmuth subsalicylate o Anti-diarrheal for specific cause 7

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- Octreotide - Sulfasalazines and ASA derivatives - Antimicrobial agent - Metronidazole Laxative drugs Irritants and stimulants o Bisacodyl o Anthraquinone group o Castor oil Bulk forming agents Osmotic laxatives o Saline cathertics o Lactulose o Balance Polyethylene Glycol Stool softener o Emollient laxatives ( docusate) o Lubricants o Suppositories enemas Chloride channel activator (Lubiprostone) Opioid receptor antagonist o Methylnaltrexone bromide o Alvimopan Clinical indications for purgatives or laxatives Pathology Tumors of Lower GIT Polyps o Non-neoplastic polyps - Hyperplastic polyps - Hamartomatous polyps Juvenile polyps Peutz-Jegher polyps - Inflammatory polyps (Pseudopolyps) o Neoplastic epithelial lesions - Adenomatous polyps, Adenoma Tubular Adenoma Villouus adenomas Tubulovillous adenomas Familial Polyposis Syndromes o Familial Adenomatous Poluposis o Gardner Syndrome o Turcot Syndrome Colorectal carcinoma Tumors of Small Intestine Adenoma Adenocarcinoma Carcinoid tumors Carcinoid syndrome Gastrointestinal Lymphoma o Sporadic Lymphoma 8

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o Sprue-associated lymphoma o Mediterranean lymphoma Colonic Diverticulosis Bowel @ Intestinal Obtruction Mechanical obstruction Pseudo obstruction o Hernias o Adhesions o Intussusception o Volvulus o Paralytic Ileus Ulcers of the Intestine Clinical Menifestations of Intestinal Diseases Disease of Appendix Acute Appendicitis Chronic Appendicitis Mucocele of Appendix Tumors of the Appendix o Carcinoid o Mucinous Cystadenoma o Mucinous Cystadenocarcinoma o Adenocarcinoma and mesenchymal tumors Bilharziasis Helmenthic Granulomas Shistosomiasis (Bilharziasis) o Lesion caused by cercaria and schistosomules o Lesions caused b adult worms o Lesions caused by eggs - Nodular Granulomatous reaction (Bilharzioma) - Diffuse reaction ( Diffuse Bilharzial Granulation Tissue) Intestinal Bilharziasis o Gross lesion of intestinal bilharziaisis Bilharziasis of the liver o Course periportal fibrosis o Fine periportal fibrosis Bilharziasis of the spleen o Early stage o Late stage Urinary Bilharziasis Bilharziasis of the lung

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SUBJECT Embryology

DEVELOPMENTS TOPICS Development of Digestive System Origin Development of primitive gut tube Derivatives of the gut Development of Oesophagus Origin Development Congenital anomalies Development of stomach Origin Development Congenital anomalies Development of intestine Origin Stages of development o Pre-herniation stage o Herniation stage o Post-herniation stage Congenital anomalies Development of duodenum Origin Development Congenital anomalies Development of rectum and upper part of half of anal canal Origin Development Development of lower half of the anal canal Origin Development Congenital anomalies Development of the liver Origin Development Congenital Anomalies Development of pancreas Origin Development Congenital anomalies

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REMARKS

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