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ETP Gastrointestinal System - HV
Anatomy of the gastrointestinal organs of the pelvis and perineum
Anatomy of the oral cavity (dentistry)
Anatomy of the pharynx and esophagus
Anatomy of the anterolateral abdominal wall
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Small intestine
Anatomy of the abdominal viscera: Large intestine
Anatomy clinical correlates: Anterior and posterior abdominal wall
Abdominal quadrants, regions and planes
Development of the digestive system and body cavities
Development of the gastrointestinal system
Development of the teeth
Development of the tongue
Small intestine histology
Gastrointestinal system anatomy and physiology
Anatomy and physiology of the teeth
Liver anatomy and physiology
Clostridium difficile (Pseudomembranous colitis)
Salmonella typhi (typhoid fever)
Vibrio cholerae (Cholera)
Bacillus cereus (Food poisoning)
Enteric nervous system
Chewing and swallowing
Carbohydrates and sugars
Fats and lipids
Vitamins and minerals
Intestinal fluid balance
Bile secretion and enterohepatic circulation
Prebiotics and probiotics
Cleft lip and palate
Dental caries disease
Gingivitis and periodontitis
Temporomandibular joint dysfunction
Nasal, oral and pharyngeal diseases: Pathology review
Esophageal disorders: Pathology review
Esophagitis: Clinical (To be retired)
Diffuse esophageal spasm
Esophageal disorders: Clinical (To be retired)
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Gastroesophageal reflux disease (GERD)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Gastric dumping syndrome
Small bowel bacterial overgrowth syndrome
Irritable bowel syndrome
Small bowel ischemia and infarction
Short bowel syndrome (NORD)
Malabsorption syndromes: Pathology review
Malabsorption: Clinical (To be retired)
Zinc deficiency and protein-energy malnutrition: Pathology review
Appendicitis: Pathology review
Appendicitis: Clinical (To be retired)
Protein losing enteropathy
Inflammatory bowel disease: Pathology review
Inflammatory bowel disease: Clinical (To be retired)
Bowel obstruction: Clinical (To be retired)
Familial adenomatous polyposis
Juvenile polyposis syndrome
Colorectal polyps and cancer: Pathology review
Colorectal cancer: Clinical (To be retired)
Diverticulosis and diverticulitis
Diverticular disease: Pathology review
Diverticular disease: Clinical (To be retired)
Cyclic vomiting syndrome
Hernias: Clinical (To be retired)
Congenital gastrointestinal disorders: Pathology review
Congenital diaphragmatic hernia
Anal conditions: Clinical (To be retired)
Jaundice: Pathology review
Cirrhosis: Pathology review
Cirrhosis: Clinical (To be retired)
Non-alcoholic fatty liver disease
Cholestatic liver disease
Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Primary biliary cirrhosis
Hepatitis A and Hepatitis E virus
Hepatitis B and Hepatitis D virus
Viral hepatitis: Pathology review
Viral hepatitis: Clinical (To be retired)
Primary sclerosing cholangitis
Benign liver tumors
Gallbladder disorders: Pathology review
Gallbladder disorders: Clinical (To be retired)
Pancreatitis: Clinical (To be retired)
Pancreatic neuroendocrine neoplasms
Pancreatitis: Pathology review
Abdominal trauma: Clinical (To be retired)
Gastrointestinal bleeding: Pathology review
Gastrointestinal bleeding: Clinical (To be retired)
Pediatric gastrointestinal bleeding: Clinical (To be retired)
Abdominal pain: Clinical (To be retired)
Disorders of carbohydrate metabolism: Pathology review
Glycogen storage disorders: Pathology review
Glycogen storage disease type I
Glycogen storage disease type II (NORD)
Environmental and chemical toxicities: Pathology review
Medication overdoses and toxicities: Pathology review
Laxatives and cathartics
Acid reducing medications
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Zollinger-Ellison syndrome p. 357
Zollinger-Ellison syndrome p. 359
Zollinger-Ellison syndrome p. 359
duodenal ulcers p. 389
gastrin in p. 380
MEN 1 syndrome p. 359
proton pump inhibitors for p. 408
Brittany Norton, MFA
Tanner Marshall, MS
Jahnavi Narayanan, MBBS
Zollinger-Ellison syndrome, named after Dr. Zollinger and Dr. Ellison - the two surgeons who first described it, is a rare endocrine disorder where there’s actually three interrelated pathologies.
First, there’s a gastrinoma, which is a gastrin-secreting tumor.
Second, the gastrinoma leads to increased gastric acid secretion from parietal cells.
Third, the excess gastric acid causes peptic ulcers.
Normally, the inner wall of the entire gastrointestinal tract is lined with mucosa, which consists of three cell layers.
The innermost layer is the epithelial layer and it absorbs and secretes mucus and digestive enzymes.
The middle layer is the lamina propria and it contains blood and lymph vessels.
The outermost layer of the mucosa is the muscularis mucosa, and it is a layer of smooth muscle that contracts and helps with the breakdown of food.
In the stomach, there are four regions - the cardia, the fundus, the body, and the pyloric antrum.
There’s also a pyloric sphincter, or valve, at the end of the stomach which closes while eating, keeping food inside for the stomach to digest.
The epithelial layer in different parts of the stomach contains different proportions of gastric glands which secrete a variety of substances.
Having said that, the cardia contains mostly foveolar cells that secrete mucus which is mostly made up of water and glycoproteins.
The fundus and the body have mostly parietal cells that secrete hydrochloric acid and chief cells that secrete pepsinogen, an enzyme that digests protein.
Finally, the antrum has mostly G cells that secrete gastrin in response to food entering the stomach.
These G cells are also found in the duodenum and the pancreas, which is an accessory organ of the gastrointestinal tract.
Gastrin stimulates the parietal cells to secrete hydrochloric acid, and also stimulates the growth of glands in the epithelial layer.
Zollinger-Ellison syndrome is a rare endocrine disorder characterized by a triad of one or more gastrinomas, increased gastric acid secretion, and peptic ulcers. The main symptom is epigastric pain from peptic ulcers, but also includes steatorrhea, weight loss, gastrointestinal bleeding, and diarrhea due to incomplete digestion and absorption. Zollinger-Ellison syndrome can be treated with acid-lowering medications and surgery to remove solitary tumors. Treatment involves reducing the production of stomach acid with medications, removing the tumor through surgery.
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