15. Gastrointestinal Tract Pathology Flashcards
What is a esophageal web?
Weblike protrusions of the esophageal mucosa into the lumen.
What is a Schatzki ring?
Weblike narrowing at gastroesophageal junction.
What are 4 clinical presentations of Plummer-Vinson syndrome?
- Middle age women.
- Esophageal webs.
- Iron deficiency anemia.
- Increased risk of carcinoma.
What is achalasia?
Failure of the lower esophageal sphincter (LES) to relax with swalling.
What do we see in barium swallow of someone with achalasia?
“Bird-beak” sign.
What is the treatment for achalasia?
LES ballon dilation or myotomy.
What is Mallory-Weiss syndrome?
Laceration at the gastroesophageal junction producesd by severe prolonged vomiting.
What is the most common cause of Mallory-Weiss syndrome?
Alcoholism.
What is Boerhaave syndrome?
Esophageal rupture.
What is the main cause of esophageal varices?
Portal hypertension due to cirrhosis.
What are esophageal varices?
Dilated submucosal veins in the lower third of the esophagus, usually secondary to portal hypertension.
What is the treatment for esophageal varices?
Band ligation, sclerotherapy or ballon tamponade.
What is a Barrett esophagus?
Metaplasia of the squamous esophageal mucosa to a more protective columnar type because of chronic exposure to gastric secretions.
What is the most common type of esophageal cancer in the world, but not in the USA?
Squamous cell carcinoma (SCC).
What is tylosis and what is so surprising about the disease?
A genetic disorder characterized by thickening (hyperkeratosis) of the palms and soles, white patches in the mouth (oral leukoplakia), and a very high risk of esophageal cancer. This is the only genetic syndrome known to predispose to squamous cell carcinoma of the esophagus.
What is the most common type of esophageal cancer in the USA?
Adenocarcinoma.
What is pyloric stenosis?
Congenital stenosis of the pylorus due to marked muscular hypertrophy of the pyloric sphincter, resulting in gastric outlet obstruction.
What is the presentation of pyloric stenosis?
Onset of regurgitation and vomiting (projectile) in the second week of life. There is a palpable oval (olive) abdominal mass and waves of peristalsis are visible on the abdomen.
What is Congenital diaphragmatic hernia?
Congenital defect in the diaphragm, resulting in herniation of the abdominal organs into the thoracic cavity.
What is the most common organ herniated in congenital diaphragmatic hernia?
The stomach.
What is Ménétrier disease?
A type of hypertrophic gastropathy characterized by enlarged rugal folds in the body and fundus of the stomach.
What micro changes do we see in Ménétrier disease?
Massive foveolar hyperplasia with replacement of the parietal and chief cells.
What are two clinical presentations of Ménétrier disease?
Protein losing enteropathy and decreased acid production.
What is the cause of Zollinger-Ellison syndrome?
Pancreatic gastrinoma producing gastrin.
What is the presentation of Zollinger-Ellison syndrome?
Multiple intractable peptic ulcers.
What is acute hemorrhagic gastritis?
Acute inflammation, erosion and hemorrhage of the gastric mucosa due to a breakdown of the mucosal barrier and acid-induced injury.
What is the gross presentation of gastric stress ulcers?
Multiple, small, round, superficial ulcers of the stomach and duodenum.
What are ulcers caused by severe burns called?
Curling ulcers.
What are ulcers caused by elevated intracranial pressure called?
Cushing ulcers.
What is another name for Fundinc type chronic gastritis?
Type A.
What is the cause of Fundic type chronic gastritis?
Autoantibodies to parietal cells and/or intrinsic factor.
Which parts of the stomach is affected by Type A chronic gastritis?
The body and fundus.
What is the gross presentation of Fundic type chronic gastritis?
Loss of rugal folds in the body and fundus.
What micro changes do we see in Fundic type chronic gastritis?
We see loss of parietal cells and hyperplasia of G cells (increased serum gastrin). We also see mucosal atrophy with loss of glands and parietal cells. Chronic lymphoplasmatic inflammation can be seen.
What is another name for Antral type chronic gastritis?
Type B.
What is the most common form of chronic gastritis in the USA?
Type B.
What is the main cause of Antral type chronic gastritis?
Helicobacter pylori.
What is the gold standard to diagnose H. pylori infection?
Biopsy; histological identification.
What is a peptic ulcer?
Ulcers of the distal stomach and proximal duodenum caused by gastric secretions (hydrochloric acid and pepsin) and impaired mucosal defenses.
What is the most common type of gastric ulcer?
Duodenal peptic ulcer.
What is the percentage association of duodenal ulcer and H. pylori?
~100%
Which blood group is associated with duodenal peptic ulcer?
Blood group 0.
Which 2 syndromes are related to duodenal gastric ulcer?
Multiple endocrine neoplasia (MEN) type 1 and Zollinger-Ellison syndrome.
What is the classic presentation of duodenal peptic ulcer?
Burining epigastric pain 1-3 hours after eating, whcih is relieved by food.
Where in the duodenum is duodenal peptic ulcer most found?
Anteriro wall of the proximal duodenum.
Where is the location of gastric peptic ulcer?
Lesser curvature of the antrum.
What is the gross presentation of gastric peptic ulcer?
Small (
What is the classic presentation of gastric peptic ulcer?
Burning epigastric pain, which worsens with eating.
Which type of blood group is associated with gastric carcinoma?
Blood type A.