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YR2 - Clinical Pathology > 10. GI // stomach // pancreas > Flashcards

10. GI // stomach // pancreas Flashcards

1
Q

The majority function of the pancreas is in what?

A

Exocrine function

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2
Q

What special enzyme is a trypsin inhibitor found in the pancreas?

what cells is it found in?

A

SPINK-1

acinar + ductal cells

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3
Q

PRSS1 is what type of inheritance?

SPINK1 is what type of inheritance?

A

PRSS1 ==> Autosomal Dominant

SPINK1 ==> Autosomal Recessive

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4
Q

Amylase in blood is a sign of what?

A

Acute pancreatitis

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5
Q

What type of plug occurs in chronic pancreatitis?

A

Protein plugs

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6
Q

What order is destroyed first in chronic pancreatitis?

A

Exocrine => Endocrine

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7
Q

what is formed in chronic pancreatitis?

A

Fibrous tissue

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8
Q

most common type of pancreatic cancer

A

pancreatic ductal carcinoma

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9
Q

PanIN (pancreatic intraepithelial neoplasia) epi

A

Most common neoplastic precursor to invasive pancreatic cancer

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10
Q

what relatives are affected in a familial pancreatic cancer?

A

2x 1st degree relatives

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11
Q

Pancreatic carcinoma generally affects what part of the pancreas?

A

Head of pancreas

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12
Q

What syndrome is associated with pancreatic carcinoma?

A

Trousseau’s syndrome

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13
Q

What is a desmoplastic response?

A

intense non-neoplastic host reaction

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14
Q

What cells are responsible in desmoplastic response (30

A

Fibroblasts // Lymphocytes // ECM

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15
Q

Pancreatic neuroendocrine tumours originate from what cells?

A

islet cells

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16
Q

What disease has an increased risk of pancreatic neuroendocrine tumour?

A

MEN-1 pituitary adenoma

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17
Q

What is the most common type of neuroendocrine tumour?

A

Insulinoma

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18
Q

What happens to blood sugars in insulinoma?

A

Hypoglycaemia

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19
Q

Majority of acute pancreatitis are caused by what?

A

Gallstones

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20
Q

Peri-umbilical haemorrhage is associated with what sign?

A

Cullen’s sign

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21
Q

calculi are associated with what?

A

Chronic pancreatitis + excess alcohol

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22
Q

What is the most common form of oesophagitis?

A

Reflux oesophagitis

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23
Q

What is defective in reflux oesophagitis?

A

lower oesophageal sphincter

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24
Q

What type of metaplasia is present in Barrett’s oesophagus?

A

Glandular metaplasia

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25
Q

H pylori infects what part of the stomach to cause problems

A

Antrum

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26
Q

Most common type of gastric cancer?

A

Adenocarcinoma

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27
Q

In Coeliac disease, what component is there a reaction to?

A

Gliadin

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28
Q

What do epithelial cells express in Coeliac disease which activates CD8 (Intraepithelial lymphocytes)

A

IL-15

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29
Q

What is the diagnosis test used in Coeliac disease?

What does this AB bind to?

A

IgA

Tissue Transglutaminase (TTG)

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30
Q

Diverticulosis typically affects what part of the colon?

A

Sigmoid colon

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31
Q

Most common symptom presenting in ulcerative collitis?

A

Rectal bleeding

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32
Q

what is the most common area affected in Crohn’s disease?

A

Ileocolic region

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33
Q

What is the most common type of polyp?

A

Hyperplastic polyp

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34
Q

In Peutz-Jeghers syndrome, what chromosome is affected

What type of inheritance is it?

A

STK11 Ch.19

Autosomal dominant

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35
Q

DUKES stage is used in what diagnosis criteria

A

Adenocarcinoma of Colon

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36
Q

Von Meyenberg complex is a proliferation of what type of cells?

What are formed/

A

Bile duct cells ====> White nodules form

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37
Q

cholangiocarcinoma is what?

A

Malignant tumour of bile duct cells

38
Q

What is the main cause of cholangiocarcinoma (parasite)

A

Liver fluke => Clonorchis sinesis

39
Q

tumours of the liver are typically secondary and derive from what 4 areas/

A

lung

breast

colon

pancreas

40
Q

Pancreatic NENs can metastasise to bone (T/f)

A

t

41
Q

what is the normal epithelium lining of the oesophagus

A

stratified squamous layer

42
Q

formation of multiple colorectal polyps

A

FAP

Familial Adenomatous Polyposis

43
Q

What happens to intravascular fluids in physical trauma?

A

Intravascular fluid loss

44
Q

What happens to extravascular fluids in physical trauma?

A

Extravascular volume increase

45
Q

Shock post trauma occurs how many hours post onset

A

2-4

46
Q

Catabolic state post trauma occurs when?

What happens to glycolysis // lipolysis / proteolysis?

A

24-48hr

Increase

47
Q

What are 2 key components responsible for activating the catabolic state // anabolic state

A

IL-1 // TNF-A

48
Q

How does adrenaline affect glycolysis

A

adrenaline = Increase Glycolysis => increase glucose

49
Q

Glutamine + Omega -3FA does what?

A

Reduce inflammatory cytokine IL-1 // TNF-a

50
Q

Why do patients die of pneumonia post trauma

A

Structural weakness => poor cough + retention of secretions

51
Q

What is produced as a biproduct of anaerobic metabolism that leads to hypoxia

A

Pyruvate ==> Lactate

52
Q

Protein // calorie undernutrition (starvation) is a type of what malnutrition?

A

Primary malnutrition

53
Q

appetite // absorption and utilisation inadequate are all type of what malnutrition

A

Secondary malnutrition

54
Q

What happens to phosphates during refeeding syndrome

A

hypophosphataemia => low phosphates after a starved state

55
Q

meconium ileus can occurs in babies with what type of disease

A

CFTR => CF

56
Q

Creon delayed release capsules can be given to patients with what?

What does it contain (3)

A

CF

Lipases // proteases // amylases

57
Q

Thiamine is a ….. for transketolase // PDH //a-KGDH

A

Co-factor

58
Q

Wernicke-Korsakoff is what type of def?

A

B1 def

59
Q

RBC are broken down where?

what does it release

A

Spleen

Bilirubin

60
Q

Where does conjugation of bilirubin occur?

What is it conjugated with?

A

Liver

Glycine // taurine

61
Q

What can bacteria do in the intestine to the bilirubin thats conjugated?

What is it absorbed as

A

Unconjugate it => Reabsorbed back into system

Absorbed as urobilinoigen

62
Q

Jaundice is first seen where?

A

Sclera

63
Q

Pre-hepatic causes of jaundice (2) that lead to too much bilirubin (unconjugated)

**included 1 syndrome

A

Haemolytic anaemia // Gilbert’s syndrome

64
Q

Bile duct obstruction is a form of what type of jaundice?

A

Post hepatic obstructive jaundice

65
Q

High ALK phosphatase would be indicative of what type of jaundice

A

Obstructive

66
Q

High ALT // AST would be indicative of what type of jaundice

A

Damage to hepatocytes

67
Q

What are the 3 stages of cirrhosis

A

Portal fibrosis –> Bridging fibrosis -> Cirrhosis

68
Q

Which type of viral hepatitis does not cause chronic hepatitis

A

Hep A

69
Q

Haemochromatosis is a failure of what?

What does it lead to

A

Failure of iron absorption

Excess iron stored in wrong places

70
Q

What 2 genes are responsible for haemochromatosis?

A

HFE + C282Y

71
Q

Wilsons disease =>

What transporter is affected

A

Copper deposited in wrong areas due to too little copper transporter

Caeruloplasmin

72
Q

Kayser-Fleischer rings are found in the eyes in what disease

A

Wilson’s disease

73
Q

What happens to urine // liver copper levels in Wilson’s disease

A

High Copper => Urine + liver

Low Copper => Serum

74
Q

Penicillamine is a treatment for what disease

A

Wilson’s => Copper

75
Q

PiZZ is the most common type of what?

A

Alpha 1 anti-trypsin deficiency

76
Q

Alpha 1 anti-trypsin is a type of what

A

Anti-protease

77
Q

Primary Biliary cholangitis (PBC) BT results (2)

A

Anti-mitochondrial AB + Raised ALP

PBC => Inc. ALP

78
Q

Primary sclerosing Cholangitis (PSC) BT results (1)

What disease is it associated with

A

High ALK

ulcerative colitis

PSC => Inc. ALK

79
Q

The ELF score is used in what?

A

Fibrosis marker

80
Q

2 inherited disorders of conjugation that would lead to increased unconjugated bilirubin

A

Gilberts // Crigler-Najjar

81
Q

2 inherited disorders of unconjugation that would lead to increased conjugated bilirubin

A

Dubin-Johnson // Rotor

82
Q

AST // ALT elevated + normal ALP

A

Hepatitis

83
Q

AST // ALT normal + High ALP

A

Obstructive Jaundice

84
Q

In chronic pancreatitis, what is there loss of (2)

A

Islet cells + acinar tissue

85
Q

Is ALT used in bilary tract damage?

A

No

Only used for damage to hepatocytes => hepatitis

86
Q

where does UC affect?

What about crohn’s

A

UC => Large bowel only

Crohn’s => Mouth -> anus

87
Q

presence of granulomas that are non-caseating epithelioid cell aggregates with Langhans’ giant cells.

A

Crohn’s

88
Q

Crypt abscesses and goblet cell depletion are common in ->

A

Ulcerative collitis

89
Q

p-ANCA negative

A

Crohn’s

90
Q

p-ANCA positive

A

UC

91
Q

what happens to albumin levels in trauma

A

reduced => Hypoalbuminaemia

YR2 - Clinical Pathology (10 decks)

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