Gastroenterology and Nutrition

• Upon completion of this problem, students should be able to describe the mechanism of swallowing and function of the stomach in digestion.
• Upon completion of this problem, students should have an understanding of fat, carbohydrate and protein requirements as well as the processes of digestion, absorption and metabolism of these macronutrients. The relationship between diet and growth and development in early childhood should be summarized.
• Upon completion of this case, students will be able to describe the normal structure and function of the liver, as well as changes to structure and function present in pathological states.
• Upon completion of this problem, students should be able to describe the approach to a patient presenting with acute abdominal pain, describe the basic anatomy and physiology of the pancreas and examine the pathophysiology of acute and chronic pancreatitis.
• Upon completion of this problem, students will be able to describe the physiology of the small intestine and discuss the pathophysiology of malabsorption.
• Upon completion of this problem, students will demonstrate an understanding of the physiology and pathophysiology of gastric acid secretion. The factors that support and disrupt gastroduodenal mucosal integrity should be identified and explained.
• Upon completion of this problem, students will be able to describe the anatomy and physiology of the biliary system and outline the pathophysiology of stone formation in various organs.
• Upon completion of this problem, students should be able to outline the anatomic structure and function of the colon (large intestine). Students will also be able to discuss the pathogenesis of gastroenteritis and the public health approaches to its control.
• Discuss the pathogenesis and common microbiology of gastroenteritis, including traveler's diarrhea.
• Describe the interaction between the immune system, especially mucosal immunity and ingested pathogens.
• Delineate the role of infection control practices in preventing communicable gastroenteritis.
• Describe the main steps in outbreak investigation, management and prevention.
• Describe the anatomy of each part of the alimentary tract from the mouth to the stomach.
• Describe the steps of digestion and absorption and roles of the key organs of the alimentary tract in these processes.
• Compare the innervation and function of the upper esophageal, lower esophageal (LES) and pyloric sphincters and describe the factors that might hinder motility.
• Describe the histology of gastric mucosa and the physiology of normal gastric secretions.
• With respect to the small intestine, summarize the relevant embryology, anatomy (including blood supply) and histology (including the function of villi and the cell cycle in the intestinal crypts).
• Outline the pathophysiology of celiac disease and the role of antibodies in its diagnosis.
• Review concepts of sensitivity and specificity as they relate to the diagnosis of Celiac disease.
• Review the protein, fat and energy requirements in infancy.
• Describe the digestion and absorption of protein, fat and carbohydrate in the diet.
• Describe the characteristics of growth and development and how they relate to feeding.
• Outline the processes of wasting and stunting.
• Describe the structure and function of the pancreas.
• Explain the acute and chronic complications of pancreatic disease.
• Describe the histology of the exocrine pancreas, and outline the feedback loops affecting pancreatic secretions.
• List the tests of liver synthetic function and compare these to tests of liver damage and inflammation.
• Interpret the patterns of liver enzyme abnormalities.
• Explain the difference between liver inflammation and liver fibrosis.
• Define portal hypertension and discuss its complications (ascites, varices, etc.)
• Explain the physiology of gastric acid secretion and factors that may alter gastric acid secretion.
• Examine the mechanisms by which the gastric barrier is maintained and describe mechanisms of injury of the gastroduodenal mucosa.
• Explain the mechanisms of iron absorption and iron homeostasis.
• Classify the complications of peptic ulcer disease.
• Describe the composition of bile and its function in digestion.
• Discuss the formation of gall bladder stones and diseases associated with them.
• Examine the indications for cholecystectomy and the differences in surgical approach.
• Describe the anatomy and histology of the large intestine (colon).
• Discuss the physiological role of the colon as it relates to water reabsorption.
• Define constipation.
• Compare and contrast the different causes of diarrhea: inflammatory vs non-inflammatory, acute vs chronic, functional vs organic, etiological causes (infectious, inflammatory, osmotic, secretory, malabsorption, motility disorders).
• Explore the role of stress and anxiety on gastrointestinal symptoms in Irritable Bowel Syndrome (IBS).
• Explain the consequences of short bowel syndrome (malabsorption) and outline its treatment with nutritional therapy.
• Calculate the risks to relatives of an individual with an autosomal recessive condition.
• Interpret a genetic test result of a variant of uncertain significance and how to apply this result to patient care.
• Describe the role of the small intestine in digestion and absorption.
• Explain the consequences of malabsorption of micronutrients and macronutrients.
• Explain the role of the pancreas in digestion and absorption.
• Describe the anatomy of the liver and the hepatic portal system.
• Describe the normal histology of the liver and biliary system.
• Describe the effects of gallstone impaction on the gall bladder and liver with reference to the pattern of liver enzymes typically observed.
• Upon completion of this problem, students should be able to describe the pathophysiology and consequences of chronic inflammation in the bowel, including the pathogenesis of short bowel syndrome in patients with Crohn’s disease.
• Define short bowel syndrome, and the mechanisms by which this condition can evolve in patients with Crohn’s disease.
• Describe normal gut flora and its role in health and disease.