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GI II > Ch. 17 Robbins GI Path Pt 1 > Flashcards

Ch. 17 Robbins GI Path Pt 1 Flashcards

1
Q

what are the organs of the Alimentary canal?

A 
mouth 
pharynx
esophagus 
stomach 
small intestine 
Large intestine
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2
Q

What are the 4 basic tissue layers of the Alimentary canal?

A

Mucosa, submucosa, muscularis, serosa

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3
Q

why should presence of congenital GI disorders prompt evaluation of other organs?

A

many organs develop simultaneously during embryogenesis

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4
Q

what is the incidence of tracheoesophageal fistula

A

1: 3500 Live births

- associated with cardiac defects

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5
Q

how to TEFs form?

A

abnormal separation of the caudal foregut during the fourth and fifth weeks of development.

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6
Q

What kind of diverticulum is Meckel’s?

A

true

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7
Q

What are the rules of 2s in meckel diverticulum

A 
2% 
within 2 feet of ilium 
2 in in length 
2X males 
present by age 2
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8
Q

What is the clinical presentation of pyloric stenosis

A

projectile non-bilious vomiting

M>F; XO and Edwards (18x3)

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9
Q

how do you treat pyloric stenosis?

A

myotomy

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10
Q

What causes hirschsprung disease?

A

abnormal migration or premature death of enteric ganglion cells

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11
Q

what is a functional cause of obstruction of the esophagus mean?

A

there is a problem with peristalsis

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12
Q

What kind of diverticulum is zenker’s diverticulum

A

false

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13
Q

What does a structural/mechanical obstruction of the esophagus mean?

A

Stricture or stenosis - NOT cancer

Webs
rings
achalasia

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14
Q

What does a bird beak sign signify?

A

achalasia

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15
Q

What disease and organism cause secondary achalasia

A

Chagas Disease

Trypanosoma cruzi

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16
Q

What is the difference between Mallory-Weiss Syndrome and Boerhaave’s syndrome

A

MW is a small tear with minimal bleeding

B - life threatening bleeding from tear in esophagus

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17
Q

What etiology are most esophageal varices due to?

A

chronic alcoholism

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18
Q

What denotes upper vs lower GI bleed?

A

Ligament of Treitz

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19
Q

Describe eosinophilic esophagitis

A

food impactions and dysphagia. Occurs in people with food or seasonal allergies. Gives ribbed like appearance to esophagus.

also associated with atopic dermatitis

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20
Q

What is the most common cause of esophagitis?

A

GERD

21
Q

What are some causes of LES relaxation problems?

A 
Vagal problems 
Alcohol/Tobacco 
Obesity
Hiatal Hernia
Gastroparesis 
Idiopathic
22
Q

What is a complication of untreated GERD

A

Barrett esophagus

squamous cell -> columnar cell metaplasia

23
Q

What are the most common tumors of the esophagus?

A

mesenchymal tumors, of those smooth muscle tumors

24
Q

What are the geographic distributions, highest risk group, and risk factors for developing adenocarcinoma of the esophagus

A

US, UK, Canada
White people 7X
Barrett esophagus, tobacco, H. pylori

25
Q

What are the geographic distributions, highest risk group, and risk factors for developing squamous cell carcinoma of the esophagus

A

Iran Central China
>45, Males, African-Americans 8X
Alcohol, tobacco, hot liquids, plummer vinson

26
Q

Where do squamous cell carcinomas of the esophagus present

A

middle 1/3 of esophagus

27
Q

In chronic gastritis, what neoplasm is H. pylori associated with

A

lymphoma

28
Q

In chronic autoimmune gastritis, what is the associated neoplasm

A

carcinoid tumor

29
Q

What do parietal cells secrete and what part of the stomach are they

A

HCL
Intrinsic factor

Body

30
Q

What do chief cells secrete and where are they located

A

pepsinogen

Body

31
Q

What do G cells secrete and where are they located

A

Gastrin

Antrum

32
Q

How do NSAIDs work to exacerbate ulcer formation in the stomach

A

COX inhibition which reduces the amount of gastric prostaglandin. Prostaglandin normally reduces acid production and stimulate mucus secretion `

33
Q

What are ulcers associated with trauma or severe burns called?

A

curling ulcers

34
Q

What causes type B gastritis

A

H. pylori

35
Q

What causes type A gastritis

A

autoimmune disorder

36
Q

What is the presentation of autoimmune gastritis?

A

atrophic gastritis
megaloblastosis of RBC - B12 deficiency
Peripheral neuropathies

37
Q

What three conditions are nearly all Peptic ulcer disease cases associated with

A

H. pylori
Smoking
NSAIDs

38
Q

If a peptic ulcer has “heaped up margins” what is that more indicative of?

A

cancer

39
Q

What are inflammatory and hyperplastic polyps associated with

A

H. Pylori

40
Q

Describe Gastric adenocarcinoma

A

High incidence (20X) in japan, chile, costa rica

Mets present at dx

Linked to chronic H. Pylori and dietary carcinogens

41
Q

What is the key step in the development of diffuse gastric cancer

A

Loss of E-Cadherin

42
Q

Describe the intestinal gastric cancer

A

Increased Wnt pathway signaling

loss of APC

gain of function B-catenin

43
Q

What are the most powerful indicators of prognosis in gastric cancer

A

depth of invasion

extent of nodal involvement

44
Q

Where are gastric cancers likely to metastasize?

A

Virchow node

45
Q

What are the translocations associated with MALT lymphoma

A

t(11;18)(p21;q21)

46
Q

what is the most important prognostic factor in carcinoid tumor

A

location

Most present in jejunum and ileum

47
Q

What are some clues you are dealing with carcinoid tumor

A

cutaneous flushing
sweating bronchospasm
diarrhea
+ synaptophysin

48
Q

What is the most common mesenchymal tumor of the abdomen

A

GIST

50% occur in stomach

arise from intestinal cells of cajal

49
Q

How does GIST present

A

Mass effect
Anemia/bleeding 50%
Incidental

prognosis based on size, mitotic index, and location

GI II (16 decks)

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