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Jaspie - Pathology > 16 - Gastrointestinal tract > Flashcards

16 - Gastrointestinal tract Flashcards

1
Q

most common form of congenital atresia

A

imperforate anus

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2
Q

Pathophysio of imperforate anus

A

failure of cloacal membrane involution

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3
Q

Enumerate (2): Clinical features of TEF

A
  • feeding abnormalities
  • frequent respiratory infections
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4
Q

-most common type of TEF? define

A

type C: distal TEF with proximal esophageal atresia

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5
Q

-Enumerate: 2 main types of diaphragmatic hernia and their corresponding locations. -Which is more common?

A

Bochdalek: posterolateral defect, usually on the left, more common

Morgagni: anteromedial defect

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6
Q

Identify: ventral wall defect with amniotic sac

A

omphalocoele

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7
Q

pathophysio of omphalocoele?

A

failure of bowel to return during physiological herniation

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8
Q

Identify: ventral wall defect without amniotic sac

A

gastroschisis

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9
Q

pathophysio of gastroschisis?

A

abnormal closure of body wall

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10
Q

Which is more morbid, omphalocoel vs gastroschisis?

A

gastroschisis

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11
Q
  • enumerate Rule of 2s;
  • what disease is this rule referring to?
A
  • 2% of population is affected
  • 2 feet from the ileoceccal valve
  • 2 years old at presentation (usually)
  • 2x more common in boys than in girls
  • 2 inches long
  • 2 types of common ectopic tissue: gastric and pancreatic

Meckel’s diverticulum

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12
Q

Pathophysiology of meckel’s diverticulum?

A

failed involution of vitteline/omphalomesenteric duct

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13
Q

Enumerate (2): conditions associated with pyloric stenosis

A
  • Turner syndrome (45XO)
  • Trisomy 18 (Edwards syndrome)
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14
Q

Enumarate: Triad of symptoms in achalasia:

A
  • incomplete LES relaxation
  • increased LES tone
  • esophageal aperistalsis
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15
Q

Most common form of chronic gastritis:

A

Helicobacter pylori gastritis

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16
Q

Most common cause of diffuse atrophic gastritis:

A

autoimmune gastritis

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17
Q

Most common form of gastritis in patients without H. pylori infection:

A

Autoimmune gastritis

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18
Q

Most common form of peptic ulcer disease:

A

duodenal ulcer (H. pylori)

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19
Q

Enumerate: triad of symptoms in Zollinger-Ellison syndrome

A
  • gastrinoma (pancreatic islet cell tumor)
  • gastric hypersecretion
  • peptic ulcer disease
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20
Q

Most common type of malignancy in GI tract:

A

adenocarcinoma

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21
Q

Most common site of extranodal lymphomas:

A

stomach

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22
Q

most common mesenchymal tumor of the abdomen:

A

GIST (gastrointestinal stromal tumor)

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23
Q

Most common site of gastric adenocarcinoma:

A

antrum, in the lesser curvature

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24
Q

Enumerate (2): most important prognostic factors in gastric adenocarcinoma

A
  • depth of invasion
  • nodal/distant metastases
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25
Q

Most common inducer of chronic inflammation in gastric lymphoma:

A

Helicobacter pylori

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26
Q

Most common site of GI carcinoids:

A

small intestines

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27
Q

Most important prognostic factor of GI carcinoid:

A

location (midgut carcinoids often multiple and aggressive)

28
Q

Most sensitive serologic test for celiac disease:

A

antibodies against translutaminase

29
Q

Most common type of malignancy associated with celiac disease:

A

enteropathy-associated T-cell lymphoma

30
Q

Most feared long-term complication of ulcerative colitis and Crohn’s disease:

A

Colitis-associated neoplasia

31
Q

Most common site of diverticular disease:

A

Sigmoid colon

32
Q

Single most important factor relating to malignancy risk in Adenomas: (specify)

A

size (>4 cm)

33
Q

Most common site of metastases of GI adenocarcinoma:

A

liver

34
Q

Enumerate (2): types of hypertrophic gastropathies:

A
  • Menetrier disease
  • Zollinger-Ellison syndrome
35
Q

this type of hypertrophic gastropathy causes hypoproteinemia due to protein-losing enteropathy

A

Menetrier disease

36
Q

this type of hypertrophic gastropathy arises from hypersecretion of gastrin:

A

Zollinger-Ellison syndrome

37
Q

Complication of long-standing GERD; characterized by intestinal metaplasia within the esophageal squamous mucosa; increased risk of esophageal adenocarcinoma.

A

Barrett esophagus

38
Q

Esophageal carcinoma associated with chronic GERD; usually occurs in the distal third of the esophagus; histologically characterized by gland formation and mucin production; premalignant lesion is Barrett esophagus.

A

Adenocarcinoma

39
Q

More common of the histologicpatterns of esophageal cancer; associated with smoking, alcohol, caustic injury, and frequent consumption of very hot beverages; usually occurs in the middle third of the esophagus; premalignant lesion is squamous dysplasia.

A

Squamous cell carcinoma

40
Q

Most common form of chronic gastritis; most common cause of multifocal atrophic gastritis; characterized by the following: predominantly antral, neutrophilic infiltrate with subepithelial plasma cells, serum gastrin normal to decreased; associated with hyperplastic/inflammatory polyps; (+) for H. pylori antibodies; sequelae includes gastric lymphoma.

A

H. pylori gastritis

41
Q

Most common form of gastritis in patients without H. pylori infection; most common cause of diffuse atrophic gastritis; characterized by the following: predominantly at the body, lymphocytic infiltrate with macrophages, serum gastrin increased; associated with neuroendocrine hyperplasia; (+) for antibodies against parietal cells (proton pump and intrinsic factor); clinically, patients present with achlorhydia (due to destruction of parietal cells), and megaloblastic anemia (due to Vitamin B12 deficiency).

A

Autoimmune gastritis

42
Q

Most common form of PUD.

A

Antral or duodenal (H. pylori)

43
Q

Histologic findings in PUD.

A

NIGS: N: necrosis, I: acute inflammation, G: granulation tissue, S: fibrous scar (from superficial to deep)

44
Q

Most common gastric polyp.

A

Inflammatory/ Hyperplastic (75%)

45
Q

The most common malignancy of the stomach (90%); has two types: intestinal (bulky tumors with gland-like structures histologically); and diffuse (intense desmoplasia leading to leather bottle stomach (linitis plastic) with signet ring cells containing mucin histologically. (Lauren classification of intestinal and diffuse is used); most common site: Antrum, on the lesser curvature.

A

Gastric adenocarcinoma

46
Q

Malignancy associated with H. pylori infection; most common site of occurrence is the stomach; eradication of H. pylori leads to tumor regression, except when it transforms to DLBCL.

A

Lymphoma/MALToma

47
Q

Tumors of neuroendocrine origin; common site is small intestine; may elaborate hormones that can lead to ZES (gastrin) or carcinoid syndrome (serotonin); most important prognostic factor is location i.e. midgut tumors are often multiple and aggressive; immunostains: Synaptophysin and Chromogranin A.

A

Carcinoid

48
Q

Most common mesenchymal tumor of the abdomen; more than half of cases occur in the stomach; cytogenetic origin is interstitial cells of Cajal (ICC); histologically composed of elongated spindle cells or plump epithelioid cells; Immunostains: KIT.

A

Gastrointestinal stromal tumor (GIST)

49
Q

Most common cause of intestinal obstruction.

A

Hernias

50
Q

Most common cause of intestinal obstruction in children <2 years old.

A

Intussusception

51
Q

Inflammatory bowel disease characterized by the following: continuous lesions usually limited up to submucosa, with rectal involvement but disease is limited to the colon only; associated with toxic megacolon and development of colonic adenocarcinoma.

A

Ulcerative colitis

52
Q

Most common site of diverticular disease.

A

Sigmoid (in areas penetrated by blood vessels)

53
Q

Type of diverticulum in sigmoid .diverticulosis.

A

False diverticulum

54
Q

Polyps common in the left colon; characterized by serrated architecture limited to the upper third of the crypt; no cytologic atypia and lateral growth; do not have malignant potential.

A

Hyperplastic polyp

55
Q

Polyps common in the right colon; characterized by serrated architecture throughout the whole length of the gland; no cytologic atypia but exhibits lateral growth (elephant-feet glands); has malignant potential like conventional adenomas.

A

Sessile serrated adenoma

56
Q

Autosomal dominant syndrome of hamartomatous polyps and mucocutaneous hyperpigmentation, associated with increased risk of visceral malignancies; histologically characterized by arborizing networks composed of smooth muscle intermixed with lamina propria.

A

Peutz-Jeghers syndrome

57
Q

Morphologic variants of colonic adenomas.

A

Tubular, Tubulovillous, Villous

58
Q

The single most important characteristic of adenomas that correlates with malignancy.

A

Size (>4cm) (others: architecture (villous), and severity of dysplasia

59
Q

Familial syndrome characterized by early onset development of numerous colonic polyps; main pathology is mutations on the APC gene (Ch5); criterion is the presence of at least 100 polyps.

A

Familial adenomatous polyposis (FAP)

60
Q

Familial syndrome characterized by early development of colon cancer and other visceral malignancies; main pathology is mutations in genes of DNA repair (MSH2 or MLH1) that leads to microsatellite instability and subsequent development of colonic adenocarcinoma.

A

Hereditary nonpolyposis colon cancer (HNPCC)/Lynch syndrome

61
Q

Most common malignancy of the gastrointestinal tract; two pathways are recognized; the adenoma carcinoma sequence involving APC among others; and the microsatellite instability pathway (sessile serrated adenoma-carcinoma sequence) involving MSH2 or MLH1; clinically characterized by different symptomatologies depending on location: (Right colon: usually anemia from bleeding from the bulky nonobstructive masses; Left colon: usually presents with change in bowel habits due to napkin-ring configuration of the lesion).

A

Colonic adenocarcinoma

62
Q

Two important prognostic factors in colonic adenocarcinoma.

A

Invasion and lymph node status

63
Q

Most common site of metastases of colonic adenocarcinoma.

A

Liver

64
Q

The most common cause of acute appendicitis in children and adults, respectively.

A

Lymphoid hyperplasia and Fecalith, respectively

65
Q

The most common tumor of the appendix.

A

Carcinoid

Jaspie - Pathology (29 decks)

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