3rd Shifting - LQ1 part 1 Flashcards
mutation in FOXP3 gene
AUTOIMMUNE ENTEROPATHY
Clinical triad of Inflammatory polyp
o Rectal bleeding o Mucus discharge o Inflammatory lesion of anterior rectal wall
most common form of Esophageal Fistula
Blind upper segment with fistula b/w lower segment and trachea (Type B)
Characters of ulcers caused by HSV and CMV
HSV: punched-out ulcers CMV: shallower ulcerations
Most common pathogenic parasitic infection in humans
Giardia lamblia
Most common clinical symptoms of GERD/ Reflux Esophagitis
o Dysphagia o Heartburn o Noticeable regurgitation of sour-tasting gastric contents
antibiotic- assoc. colitis / antibiotic-assoc. diarrhea is caused by?
C. difficile (PSEUDOMEMBRANOUS COLITIS)
Incomplete closure of the abdominal musculature leading to herniation of abdominal viscera into ventral membranous sac
Omphalocele
Malformed submucosal and mucosal blood vessels
ANGIODYSPLASIA
most common Gastric malignancy from extranodal lymphoma
extra-nodal marginal zone B-cell
Lipid membrane defects in Abetalipoproteinemia
burr cells (presence of acanthocytic red cells)
Requirement for the diagnosis of Irritable Bowel Syndrome
o Abdominal pain or discomfort at least 3 days per month over 3 months o Improvement w/ defecation o Change in stool frequency or form
Examples of Hypertrophic gastropathies
Ménétrier disease Zollinger Ellison Syndrome
Triad Symptoms of Achalasia
o Incomplete LES relaxation o Increased LES tone o Aperistalsis of the esophagus
Inability to secrete triglyceride-rich lipoproteins
ABETALIPOPROTEINEMIA
Most common tumor of appendix
Carcinoid
two phases of Intestinal responses to ischemia
Initial hypoxic injury Reperfusion injury
Aka celiac sprue or gluten-sensitive enteropathy
CELIAC DISEASE
pain caused by minor pelvic bleeding at time of ovulation
Mittelschmerz
Meckel diverticulum occurs in the?
ileum
Meckel diverticulum occurs as a result of failed involution of the
Vitelline Ducts
congenital aganglionic megacolon
HIRSCHSPRUNG DISEASE
most frequent site of GI ectopia
Inlet Patch (upper 3rd of esophagus)
Present in tumors populated by immature cells derived from basal layer of transitional epithelium
Basaloid
Chronic condition of Inappropriate mucosal immune activation
INFLAMMATORY BOWEL DISEASE
upper esophageal webs accompanied by IDA, glossitis, and cheilosis
Paterson-Brown-Kelly or Plummer-Vinson syndrome
Acquired pseudo-diverticular outpouchings of colonic mucosa and submucosa
SIGMOID DIVERTICULITIS
Mutation in Abetalipoproteinemia
microsomal triglyceride transfer protein (MTP)
Susceptibility genes in Crohn disease
NOD2 (nucleotide oligomerization binding domain 2) ATG16L1 (autophagy-related 16-like) IRGM (immunity-related GTPase M)
Presents w/ multiple GI hamartomatous polyps and mucocutaneous hyperpigmentation
PEUTZ-JEGHERS SYNDROME
Autoantibodies to enterocytes and goblet cells
AUTOIMMUNE ENTEROPATHY
Hallmark of Crohn disease
Noncaseating granulomas
large numbers of superficial intraepithelial eosinophils
EOSINOPHILIC ESOPHAGITIS
Germline mutations in CDH1
Gastricadenocarcinoma
uncommon complication of Shigellosis
Reiter Syndrome
Most common tumors of the peritoneum
desmoplastic small round cell tumor
Exuberant reactive epithelial proliferation assoc. w/ entrapment of epithelial-lined cysts
Gastric Cystica
Morphologic alterations in celiac disease
Villous atrophy Increased numbers of intraepithelial lymphocytes (IELs) Epithelial proliferation with crypt elongation
gastric, duodenal, and esophageal ulcers arising in persons with intracranial disease
Cushing ulcers
Blood supply of the GIT
o Celiac artery o Superior mesenteric artery o Inferior mesenteric artery
most common cause of seafood-associated gastroenteritis in N. America
V. parahaemolyticus
When present in the distal esophagus, above the gastroesophageal junction
A rings
Inherited mutations in genes that encode proteins responsible for the detection, excision, and repair of errors that occur during DNA replication
HEREDITARY NON-POLYPOSIS COLORECTAL CANCER (HNPCC) aka Lynch syndrome
Most common cause of Chronic Gastritis
H. pylori infection
Small patches of ectopic gastric mucosa in small bowel or colon
Gastric Heterotopia
Diagnostic requirements of GERD
- Endoscopic evidence of abnormal mucosa above the gastroesophageal junction 2. Histologically documented intestinal metaplasia (goblet cells)
Second most common cause of pediatric diarrhea
Adenovirus
Presence of hamartomatous polyps of stomach, s. intestine, and colorectum
CRONKHITE-CANADA SYNDROME
tumor that rises from Barrett esophagus and long- standing GERD
Adenocarcinoma
Hallmark of Malabsorption
Steatorrhea
Giant cerebriform enlargement of rugal folds d/t epithelial hyperplasia w/o inflammation linked to excessive growth factor release
Hypertrophic gastropathies
Intestinal segments at the end of their respective arterial supplies are particularly susceptible
watershed zones
Genetic cause of HIRSCHSPRUNG DISEASE (familial cases)
receptor tyrosine kinase RET
Caused by failure of distal esophageal inhibitory neurons
Primary Achalasia
Gastritis that may progress to involve gastric body and fundus
Pangastritis
Most common cause of atrophic gastritis / without H. pylori infection
Autoimmune gastritis
Chronic, relapsing abdominal pain, bloating, and changes in bowel habits
Irritable Bowel Syndrome
Phases of Nutrient Absorption disrupted by Malabsorption
- Intraluminal digestion 2. Terminal digestion 3. Transepithelial transport 4. Lymphatic transport of absorbed lipids
Most common bacterial enteric pathogen
C. jejuni
development of numerous mucosal lymphoid follicles is the characteristic of this disease
DIVERSION COLITIS
polyp that forms as part of solitary rectal ulcer syndrome
Inflammatory polyp
most common site of GI neoplasia
Colon
Distal esophageal rupture and mediastinitis (Catastrophic event)
Boerhaave syndrome
SMAD4 - Most common mutation
JUVENILE POLYPS
Morphologic signature of Ischemic Bowel Disease
Surface epithelial atrophy Normal or hyperproliferative crypts
result of epithelial or stromal cell hyperplasia, inflammation, ectopia, or neoplasia
Polyp
a cause of acquired megacolon disease
Chagas disease
Most common neoplastic polyp
Adenoma
Congenital Hypertrophic Pyloric Stenosis is also associated with what 2 diseases?
Turner syndrome and trisomy 18
Most common mesenchymal tumor of abdomen
GASTROINTESTINAL STROMAL TUMOR (GIST)
painful, bloody, small-volume diarrhea
Dysentery
part of stomach most commonly used for H. pylori biopsies
Antrum
name the 3 psuedodiverticulae associated at the esophagus
Zenker / Pharyngoesophageal Diverticulum Traction Diverticulum Epiphrenic Diverticulum
Whipple Disease caused by?
Tropheryma whippelii
Located at the squamocolumnar junction of the lower esophagus
B rings
Clinical Triad of Whipple Disease
diarrhea, weight loss, and malabsorption
Outer longitudinal layer of smooth muscle contracts before the inner circular layer causing periodic short-lived esophageal obstruction
nutcracker esophagus
Assoc. w/ loss-of-function mutations in PTEN
COWDEN SYNDROME AND BANNAYAN-RUVACALBA-RILEY SYNDROME
T. cruzi causes destruction of myenteric plexus, failure of peristalsis, and esophageal dilatation
Secondary Achalasia
COMPLICATIONS OF CHRONIC GASTRITIS
PEPTIC ULCER DISEASE (PUD) MUCOSAL ATROPHY AND INTESTINAL METAPLASIA DYSPLASIA GASTRITIS CYSTICA
Mutations of adenomatous polyposis coli (APC) gene; At least 100 polyps necessary for diagnosis
FAMILIAL ADENOMATOUS POLYPOSIS (FAP)
Dilated appendix filled w/ mucin
Mucocele
most common site of acquired diverticulae
sigmoid colon
Gastrin-secreting tumors (gastrinomas); Within stomach, most remarkable feature: doubling of oxyntic mucosal thickness d/t 5x increase in no. of parietal cells
Zollinger Ellison Syndrome
complications of fistulas
Aspiration Suffocation Pneumonia Severe Fluid & Electrolyte imbalances
Excessive secretion of TGF-α; hyperplasia of foveolar mucous cells
Ménétrier disease
Most common sites in Crohn Disease
terminal ileum, ileocecal valve, and cecum
Small patches of ectopic gastric mucosa in small bowel or colon that includes all three layers of the bowel wall
True Diverticulum
distinctive thickened folds covered by small nodules with central aphthous ulceration
Varioliform
Most common form of congenital intestinal atresia
Imperforate anus
Gastric cystica in Submucosa
gastritis cystica polyposa
Caused by gastric involvement by Crohn disease
Granulomatous Gastritis
Similar to webs, but circumferential and thicker
Esophageal/Schatzki rings
Result from dilation of superior hemorrhoidal plexus w/in distal rectum
Internal hemorrhoids
uncontrolled release of gastrin by a tumor and the resulting massive acid production causes multiple peptic ulcerations in stomach, duodenum, and jejunum
Zollinger Ellison Syndrome
Triad of sterile arthritis, urethritis, and conjunctivitis
Reiter Syndrome
Flaccid paralysis and Autoimmune-induced inflammation of peripheral nerves due to C. jejuni
Guillain-Barré syndrome (GBS)
Uncommon forms of Gastritis
Reactive Gastropathy Eosinophilic Gastritis Lymphocytic (Varioliform) Gastritis Granulomatous Gastritis
longitudinal stripes of edematous erythematous mucosa alternating with less severely injured mucosa
Watermelon stomach
One of the most feared long-term complications of IBD
COLITIS-ASSOCIATED NEOPLASIA
Principal cause of traveler’s diarrhea
ENTEROTOXIGENIC E. COLI (ETEC)
Malabsorption syndrome that occurs almost exclusively in people living in or visiting the tropics
TROPICAL SPRUE
Most useful diagnostic marker in GIST
c-KIT
o Alcohol-soluble fraction of gluten o Contains most of disease-producing components
Gliadin
Complication of chronic GERD
Barret’s Esophagus
Presence of neutrophils above basement membrane in direct contact w/ epithelial cells
Active inflammation
Gastric cystica in Deeper layers of gastric wall
gastritis cystica profunda
Most common cause of severe childhood diarrhea and diarrheal mortality worldwide
Rotavirus
Uncommon ledge-like protrusions of mucosa
Esophageal mucosal webs
Characteristics of Autoimmune Gastritis
o Antibodies to parietal cells o Reduced serum pepsinogen I concentration o Antral endocrine cell hyperplasia o Vitamin B12 deficiency o Achlorhydria
presence of foamy macrophages and large numbers of argyrophilic rods in lymph nodes
Whipple Disease
Tumors of the Esophagus
Adenocarcinoma Squamous cell carcinoma
Dense fibrosis that may extend to involve mesentery; Aka idiopathic retroperitoneal fibrosis/Ormond disease
SCLEROSING RETROPERITONITIS
Most common malignancy of GIT
Adenocarcinoma
mural thickening is not present, the serosal surface is normal, and strictures do not occur
Ulcerative colitis
Longitudinal tears in the esophagus near the gastroesophageal junction
Mallory-Weiss tears
Hepatocytes replaced by macrophage aggregates
Typhoid nodules
