Alimentary Flashcards
Tumors of salivary gland
Benign:
Pleomorphic adenoma
Warthin tumor
Oncocytoma
Basal cell adenoma
Canalicular adenoma
Ductal papilloma
Malignant
Sq cell carcinoma
Acinic cell carcinoma
Adenoid cystic carcinoma
Adenocarcinoma
Muco epidermoid carcinoma
Tumors of esophagus
Benign:
Epithelial-
sq cell papilloma
Condyloma
Mesenchymal-
Leiomyoma
Lipoma
Fibroma
Neurofibroma
Rhabdomyoma
Hemangioma
Malignant
Sq cell carcinoma
Adenocarcinoma
Carcinoid tumor
Define barett esophagus
Its a complication of chronic GERD which is characterised by intestinal metaplasia of oesophageal squamous mucosa
Which is an imp risk factor for adenocarcinoma
Distal sq epithelium is replaced by metastatic columnar epithelium as a response to prolonged injury.
It is a premalignant condition
Tumors and precancerous lesions of oral cavity
Leukoplakia
Erythroplakia
Squamous cell carcinoma
Gastric tumors who classification
Epithelial-
Benign: gastric adenoma
Malignant: gastric adenocarcinoma
Small cell carcinoma
Carcinoid tumor
Mesenchymal:
Benign- leiomyoma
Neurofibroma
Lipoma
Gastrointestinal stromal tumors
Malignant: malignant stromal tumors
Leiomyosarcoma
Kaposi sarcoma
Schwanoma
Others
Malignant: lymphoma
Diseases of stomach
1.Congenital anomalies
Ectopia
Diaphragmatic hernia
2.Gastritis
Acute and chronic
3.Pud
4.Gastric polyp and tumors
Gastric polyps
1.Non neoplastic polyps
Hyperplastic 90%
Inflammatory
Hamartomatous
2.neoplastic
Benign: tubular adenomatous polyp
Villous adenomatous polyp
Tubulo villous adenomatous polyp
Malignant: polypoid carcinoma
Eitiology of acute gastritis
- Age 3rd or 4th decade
- Sex males more than females
3.dietary or personal habits like smoking alcoholism spicy food
Malnutritikn
4.infection ie bacterial by h pylori and salmonellla or viral by ebv, hep virus etc - Drugs like nsaids
- Chemicals like kerosene and carbolic acid
7.chemotherapy. - Stress related ulcers in burns
Trauma shock
Eitiologuly of chronic gastritis
It is of 3 types
A- antral type
B - body type
Mixed AB- mixture of these two
A. Major factors
H pylori
Reflux disease
Autoimmunity
Association of previous disease of stomach
Minor factors like
Smoking
Alcoholism
Spicy food
Nsaid
Steroid
Irradiation
Ulcers of git
Ulcers of esophagus and stomach
1. Benign
Peptic ulcer
Curling ulcer
Cushing ulcer
Stress ulcer
2.malignant
Gastric carcinoma
Ulcers of small intestine
duodenal peptic ulcer
Typhoid ulcer
Tuberculous ulcer
Chrohns disease
Malignant ulcer
Ulcers of large intestine
Ameobic dysentry ulcer
Bacillary desentry ulcer
Typhoid ulcer
Tuberculous ulcer
Malignant ulcer
Diff btw benign and malignant ulcer
Benign younger age
Malignant older age
Benign marked male predominance
Malignant slight male predominance
Benign occurs in lesser curvature of pylorus and antrum
Malignant occurs in greater curvature of pylorus and antrum
Benign are small size regular shape with sharply demarcated punched out margins . Necrosis and hemorrhage are uncommon
Malignant large size irregular shape with rolled out margins
Necrosis and hemorrage are common
Benign: gastric acidity is normal or increased
Malignant: gastric acidity is normal or completely absent
Peptic ulcer
Chronic solitary ulcer at any point of gi tract exposed to aggressive action of acid peptic gastric juice with size less than 2 cm with punched out appearance
Common sites:
1st part of duodenum
Gastric antrum along the lesser curvature
Lower end of esophagus
Margin of gastrojejunostomy
Tip of meckels diverticulum
Throughout git
Risk factors of pud
Age: 5tg and 6th decade
Males >females
H pylori inf 90% duodenal ulcer
70% gastric ulcer
Cigarette smoking
Chronic ingestion of nsaids
Copd
High spicy diet
Alcoholism
Ch diseases like liver cirrhosis and Crf
Tumors of islets of langerhans like insulinoma and gastrinoma
Psychological stress
Complications of pud
Pyloric obstruction
Hemorrhage ie malaena and hematemesis
Duodenal perforation
Gastric carcinoma
Pathogenesis of pud
- Impaired defence mechanism
Dec mucous secretion
Dec hco3 secretion in mucous
Dec mucosal blood flow
Dec epithelial regenerative capacity
2.increased aggressive forces
Inc gastric hcl secretion
Inc pepsin secretion
Production of urease by h pylori
Duodenal gastric reflux
- Inflammatory cytokines
IL1, 6 ,8
TNF
Role of h pylori in pud
H pylori secretes urease enzyme which breaks down Urea and forms toxic compound ammonium chloride and monochloramine enhancing gastric hcl secretion impairs hco3 production. Bacterial proteases and phospholipases break down the glycoprotein lipid complexes in the gastric mucus thus weakens the first line of defence .
causes epithelial injury induced inflamation
Gastric carcinoma eitiology
Age 5th to 7th decade
Males more than females
Infection h pylori
Food habits
Smoked food
Pickled food
Salty food
Spicy diet
Canned food
Lack of vegetables
Smoking
Alcoholism
Reflux of bile
Genetic factors
Blood group A
Black ppl
Premalignant cond
Chronic atrophic gastritis
Chr gastric ulcer
Adenomatous polyp
Achlorhydria
Gastric adenoma
maltoma
ulcers causes
Stress ulcer: shock sepsis trauma
Most common
Curling ulcer
Proximal duodenum
Cause severe burn trauma
Cushing ulcer
Gastric or duodenal ulcer
Cause intracranial disease
Inflammatory bowel disease
Chronic inflammatory disease of unknown eitiology mostly confined to the gut
Its consists of ulcerative colitis and chrons disease
Diff btw chrohns disease and ulcerative colitis
Chrohns it occurs anywhere in git esp terminal part of ileum
UC confined to large gut in recto sigmoidal junction
CHROHNS lesion involves all 3 layers
UC only serous layer is involved
CROHNS skip lesions present
UC continuous lesions
CROHNS lesions result in fistula formation
UC fistula not formed
CROHNS pseudopolyp not formed
UC pseudopolyp formed btw 2 ulcers
CROHNS non caseating granuloma in 40% cases
UC granuloma not found
Chrohns. Crypt abscess
UC not found
Diseases of appendix
Inflammation: appendicitis
Early acute appendicitis
Acute suppurative appendicitis
Acute gangrenous appendicitis
Tumors: benign: adenoma
Mucinous cystadenoma
Hyperplastic polyp
Malignant
Carcinoid tumor
Adenocarcinoma
Mucinous cyst adenocarcinoma
Pathogenesis of acute appendicitis
Most commonly by
A small stone like mass of stool called fecolith
Or stricture
Less common
Gall stone
Tumor
Mass of worms
