10. GI Pathoma Flashcards
Tracheo-Esophageal Fistula
most common type?
Connection between Trach and the esophagus
- esophageal atresia w/ distal esophagus connecting to trach
- can cause polyhydramnios (cant swallow anything)
Plummer-Vinson syndrome
Esophageal webbing
Iron deficiency anemia
Beefy red tongue (atrophic glossitis)
Zenker Diverticulum
where does it outpouch?
how does it present-
Outpouching of the pharyngeal mucosa through a defect in the wall
- Killian Triangle
- halitosis, dysphagia
Mallory-Weiss syndrome
whos the main to get this
Lacerations at the gastroesophageal junction due to Severe vomiting
painful hematemesis (bloody vomit)
-alcoholics and bullemics
Boerhaave syndrome
Transmural, distal esophageal rupture due to violent retching
Achalasia
what causes this
Absence of relaxation of the LES (lower esophageal sphincter)
-loss of Myenteric (Auerbach) plexus
GERD
what anatomy fuck up can cause this?
reflux of acid from the stomach due to Decr. LES tone
-sliding hiatal hernia
Gastroschisis
abdominal contents coming thru abdominal folds
(Not covered by peritoneum)
Omphalocele
Herniation of abdominal contents
Covered by peritoneum (silver cap)
Pyloric Stenosis
when does it happen/ what does the mass look like/ how is the vomit?
Hypertrophy of the pyloric smooth muscle
- doesnt present at birth. usually in 2-6 weeks.
- olive shaped mass
-non billious vomiting
Barrett esophagus
whats it caused by?
Metaplasia of
nonkeratinized stratified squamos cells ->
nonciliated columnar /goblet cells
- chronic GERD
- increased risk of esophageal adenocarcinoma
What are the two types of Esophageal cancers?
where are they/how do you get them?
Squamos Cell - upper 2/3. alc, hot liquids, strictures, smoking, achalasia (more common world wide
Adenocarcinoma - lower 1/3. chronic GERD, Barrett, obesity (common in America)
Acute gastritis
Main causes/ common among who?
- Too much acid/ too little mucosa protection
- alcoholics or NSAID users
Chronic Gastritis
Increase risk of gastric cnacer
-H. Pylori (MALToma)/ Autoimmune (antibodies to parietal cells and intr
What are parietal cells?
What receptors are on it?
where are they located?
Secretes acid in the stomach
Ach, Gastrin, Histamine receptors
-body and the fundus
where is gastrin produced?
G cells (in the antrum and duodenum)
Peptic Ulcer Dz
Duodenal ulcer
what other things can cause it?
where is perforation most common?
what can happen with posterior ulcers
- Pain Decreases with meals (when you eat, the duodenum secretes protective coat (Brunners glands) cuz it knows food/acid is bout to come in)
- decr. mucsoal protection/incr. gastric acid (h. pylori)
- -Zollinger-Ellison syndrome* (Gastrinoma)
- anterior wall of stomach
- rupture of Gastroduodenal artery/ acute pancreatits
Peptic Ulcer Dz
Gastric Ulcers
whats a main cause?
where is the rupture? what would bleed.
pain becomes Greater with meals (stomach knows food is coming down so it secretes more acid)
-NSAIDS
-lesser curvature of stomach (bleeding from Left gastric artery)
Gastric Cancer (Adenocarcinoma)
Intestinal Vs Diffues type
what do they look like/where are they found/risk factors
-how does gastric carcinoma present (the rare signs)
malignant proliferation of surface epithelial cells in the stomach
Intestinal: irregular ulcer with f’d up margins. lesser curvature. rf: H.pylori, nitrosamines (smoked food), gastritis, Blood type A
Diffuse: Signet ring cells (mucin filled cells with periph nuclei) that infiltrate gastric wall. Stomach wall grossly thickens
-Acanthosis Nigrans (skin thickening in axilla) / Leser-Trelat (morgan freemans all over their skin- sub keratosis)
