ALL THINGS GUT- FINAL

Question 1

different types of esophageal motility disorders

Answer 1

Achalasia
diffuse esophageal spasm
nutcracker esophagus
hypertensive lower esophageal spasm

Question 2

Achalasia is characterized by

Answer 2

increased tone and pressure at the lower esophageal sphincter (LES), diminished to absent peristalsis in the distal portion of the esophagus and lack of a coordinated LES relaxation in response to swallowing

Question 3

characteristic finding in achalasia following barium swallow is

Answer 3

“bird’s beak” appearance

Question 4

the underlying pathophysiology that results in achalasia is

Answer 4

lymphocytic infiltration of Auerbach’s plexus and destruction of ganglion cells

Question 5

Diffuse esophageal spasm is characterized by

Answer 5

uncoordinated contractions and several segments of the esophagus contract simultaneously

Question 6

Nutcracker esophagus is characterized by

Answer 6

contractions proceed in a coordinated manner but the amplitude is excessive

Question 7

barium swallow findings for nutcracker esophagus

Answer 7

corkscrew esophagus

Question 8

Mallory–Weiss tears refers to bleeding in the

Answer 8

mucosa at the junction of the stomach and esophagus,

The tear involves mucosa and submucosa but not the muscular layer (not a transmural tear).

Question 9

Boerhaave’s syndrome is a

Answer 9

full thickness tear or rupture of the esophageal wall

Question 10

Barrett’s esophagus is characterized by

Answer 10

transformation of cells at the lower end of the esophagus from normal squamous epithelium lining to columnar epithelium.
Micrograph of biopsy showing Barrett’s esophagus with characteristic goblet cells

Question 11

Hirshsprung’s disease is a disorder of the gut which is caused by

Answer 11

the failure of the neural crest cells (enteric ganglion cells) to migrate completely during fetal development of the intestine
Auerbach plexus involvement

Question 12

___________ is suspected in a baby who has not passed meconium within 48 hours of delivery.

Answer 12

Hirshsprung’s disease

Question 13

Intestinal volvulus is defined as

Answer 13

a complete twisting of a loop of intestine around its mesenteric attachment site.

Question 14

An intussusception occurs when

Answer 14

a part of the intestine has migrated into another section of intestine, similar to the way in which the parts of a collapsible telescope may slide into one another

Question 15

Celiac disease small intestine changes

Answer 15

There is blunting and flattening of villi with celiac disease, and in severe cases a loss of villi with flattening of the mucosa as seen here. Over 95% of affected patients will express the DQw2 histocompatibility antigen, which suggests a genetic basis for the condition

Question 16

Crohn’s vs Ulcerative Colitis in terms of location

Answer 16

Crohns- anywhere from mouth to anus

UC- restricted rectum and colon

Question 17

Microscopic findings of Crohn’s vs Ulcerative Colitis

Answer 17

Crohn’s- transmural lesions

UC- mucosal involvement, crypt abscess

Question 18

is Crohn’s or ulcerative colitis associated with increased risk of adenocarcinoma?

Answer 18

Ulcerative Colitis!!!!

Question 19

Across all age groups, what’s the most common cause of viral enteritis?

Answer 19

Norwalk virus

Question 20

Amongst children and infants what’s the most common cause of viral enteritis (diarrhea)?

Answer 20

Rotavirus

Question 21

What are the most common causes of food-borne illnesses world wide?

Answer 21

Norovirus- #1 cause
Salmonella- #1 cause in infants
Clostridium perfringens
Campylobacter- #1 cause of bloody diarrhea

Question 22

what’s associated with ‘picnic food poisoning’?

Answer 22

Staph aureus

Question 23

what’s associated with contaminated meat or rice from chinese restaurants?

Answer 23

Bacillus cereus

Question 24

what’s associated with contaminated shellfish?

Answer 24

Vibrio (cholera and non-cholera)

Question 25

what’s associated with improperly home canned fruits and veggies?

Answer 25

Clostridium botulinum

Question 26

a cause of antibiotic associated diarrhea (AAD)? AKA pseudomembranous enterocolitis

Answer 26

Clostridium difficile

Question 27

Benign small bowel tumors

Answer 27

Hyperplastic polyps
Adenomas
Leiomyomas- only one he talks about
Lipomas
Hamartomas

Question 28

Histologic findings of leiomyoma

Answer 28

the elongated spindle cells containing cigar-shaped nuclei and no evidence of increased mitotic activity is seen.

Question 29

Peutz-Jeghers syndrome is an autosomal dominant disorder characterized by

Answer 29

mucocutaneous pigmentation (i.e. lesions on the face, lips, and buccal mucosa) and benign GI hamartomas.

Question 30

Histologically the Peutz-Jeghers lesions appear

Answer 30

frond-like appearance

Question 31

the most common type of small bowel malignancy in the US is?

Answer 31

adenocarcinma

Question 32

less common types of small bowel malignancies

Answer 32

carcinoid tumors

lymphomas

Question 33

carcinoid tumors

Answer 33

Nests of carcinoid tumor have a typical endocrine appearance with collections of small round cells containing nuclei that are consistent in size and shape and surrounded by cytoplasm which stains pink to pale blue

Question 34

with Juvenile polyposis syndrome (the appearance of mutliple polyps in the GI tract esp in the young) there is an increased risk of developing what?

Answer 34

adenocarcinoma

Question 35

with Familial Adenomatous Polyposis (congenital condition marked by hundreds to thousands of polyps in the large intestines) there is an increased risk of developing what?

Answer 35

colon cancer

Question 36

The combination of polyposis, osteomas, fibromas and sebaceous cysts is termed

Answer 36

Gardener’s syndrom

Question 37

microscopically neoplastic glands of adenocarcinoma have

Answer 37

crowded nuclei with hyperchromatism and pleomorphism

Question 38

Atrophic gastritis is usually caused by

Answer 38

H. pylori

Question 39

In Atrophic gastritis, impairment in the secretion of hydrochloric acid, pepsin, and intrinsic factor can lead to

Answer 39

B12 deficiency

Question 40

The characteristic histologic findings of gastric adenocarcinoma is

Answer 40

singlet ring cell pattern

Question 41

carcinoid tumors are a class of neuroendocrine tumors that arise from

Answer 41

neuro-endocrine neoplasms that arise from enterochromaffin cells