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GI2- AM > Ch.17 > Flashcards

Ch.17 Flashcards

1
Q

Omphalocele vs Gastroschisis

A

Omphalocele: viscera herniates into the ventral membranous sac Gastroschisis: incomplete all layers of abdominal wall, doesnt herniate into sac, separate

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2
Q

Erythomycin exposure Projectile vomiting, non bilious Palpable mass

A

Pyloric stenosis

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3
Q

No meconium Bilious vomiting -mutation

A

Hirschsprung Megacolon -RET (RTK) mutation

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4
Q

Plummer-Vinson syn

A
  1. upper esophagus webs 2. Iron deficiency 3. Inflammation of tongue 4. Chilosis (cracked corner of mouth)
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5
Q

Longitudinal lacerations of mucosa at gastroesophageal junction

A

Mallory-weiss tears

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6
Q

Severe chest pain, tachypnea, and shock following severe vomiting

A

Boerhaave syndrome - transmural tearing and rupture of distal esophagus

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7
Q

Heart burn, dysphagia, sour taste PPI help

A

Reflux esophagitis (GERD)

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8
Q

Food impaction, dysphagia Atopic dermatitis PPI dont provide relief Furrow ridges

A

Eosinophilic esophagitis

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9
Q

Barretts esophagus is a precursor for what

A

Esophageal Adenocarcinoma

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10
Q

Helicobacter pylori gastritis is assoc with

A

Peptic ulcer disease Lymphoma

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11
Q

Mucosal atrophy and intestinal metaplasia is assoc with

A

Gastric adenocarcinoma

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12
Q

Gastric polyps and gastric adenoma are associated with

A

Gastric adenocarcinoma

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13
Q

Autoimmune gastritis is associated with

A

Carcinoid tumor

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14
Q

Zollinger-Ellison syndrome is associated iwth

A

Peptic ulcer disease

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15
Q

Parietal cells -location -secrete (2)

A

Body HCl Intrinsic factor

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16
Q

Chief cells -location -secrete

A

Body Pepsinogen

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17
Q

G cells -location -secrete

A

Antrum Gastrin

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18
Q

Mucous cells -location -secrete (2)

A

Antrum Mucus Pepsinogen

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19
Q

Longitudinal stripes of edematous erythematous mucosa alternating with less severly injured paler mucosa “watermelon stomach”

A

Gastric antral vascular ectasia (GAVE)

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20
Q

Warthrin-Starry stain

A

Helicobacter pylori

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21
Q

Helicobacter pylori gastritis -location -inflammatory -acid production -gastrin -other lesions -serology -sequelae -associations -characteristic -side effect -tests (2)

A

Antrum Neutrophils, subepithelial plasma cells Increased to slightly decreased Increased local gastrin production (normal to decreased) Hyperplastic/inflammatory polyps Ab to H. pylori Peptic ulcer, adenocarcinoma, MALToma Poverty Patchy mucosal atrophy Iron def Warthin starry stian Urea breath test

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22
Q

Autoimmune gastritis -location -inflammatory -acid production -gastrin -other lesions -serology -sequelae -associations -characteristic (3)

A

Body (spares antrum) Lymphocytes and macrophages decreased acid production Incrased gastrin production Neuroendocrine hyperplasia Antibodies to parietal cells & IF Atophy, pernicious anemia, adenocarcinoma, carcinoid tumor Autoimmune disease, Thyroiditis, DM, Graves Diffuse atrophy Hypergastrinemia (G cell hyperplasia) Achlorhydria (no acid secretion) Hypersegmented neutrophils Rugal folds lost

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23
Q

Rugal folds lost

A

Autoimmuen gastritis

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24
Q

Memory loss, behavorial changes, paresthesia and numbness Tongue becomes smooth and beefy red Megaloblastosis of RBC

A

Vit B12 def Subacute degeneration of spinal cord

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25
Q

Thickened folds of stomach covered by small nodulaes iwth central aphthous ulcerations

A

Lymphocytic (varioliform) gastritis

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26
Q

Gastritis cystica

A

exuberant epithelial proliferation with entrapment of epithelium lined cysts Body Mucous, cyst lining Neutrophils and lymphocytes Trauma, prior surgery No malignancy

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27
Q

DIffuse fovelar cell hyperplasia in body and fundus Get systemic hypoprotenemia Irregular enlarged rugae

A

Menetrier disease

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28
Q

Increased Gastrin levels 5x parietal cells Mucin production increase Duodenal ulcers

A

Zollinger-Ellison syndrome

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29
Q

Polyp associatedi wth H. pylori

A

Hyperplastic inflammatory polyps

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30
Q

Polyp associated with PPI

A

Fundic gland polyps

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31
Q

Polyp associated with FAP mutation

A

Fundic gland polyps Gastric adenoma

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32
Q

Malignant potential polyps

A

Gastric adenoma** Fundic gland polyps w/ syndromic FAP

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33
Q

50-60 Antrum Mucous Neutrophils/lymphcytes Risk: chronic gastritis, H. pylori

A

Hyperplastic and inflammatory polyps

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34
Q

50-60 Body/ Fundus Parietal/ chief cells No inflammatory Risk with PPI use and FAP mutation

A

Fundic gland polyp

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35
Q

50-60 Antrum Dysplatic intestional cells Risk: chronic gastritis, atrophy Malignancy potential FAP mutation

A

Gastric adenoma

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36
Q

Left supraclavicular sentinel lymph node

A

Virchow node Gastric adenocarcioma

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37
Q

Periumbilical lymph nodes

A

Sister mary joseph nodule Gastric adenocarcinoma

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38
Q

Ovarian metastasis from intra-abdominal tumors

A

Krukenberg tumor Most likely stomach (pancreas or breast)

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39
Q

Linitis plastica

A

Leather bottle Diffuse type gastric adenocarcinoma

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40
Q

CDH1 mutation and loss of E-caderin

A

Diffuse gastric adenocarcinoma

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41
Q

Tumor in japan patient

A

Gastric adenocarcinoma

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42
Q

t(11;18)(q21;q21)

A

MALToma

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43
Q

Lymphoepithelial lesions

A

MALToma

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44
Q

Solitary well circumscribed, whorled appearance KIT marker

A

Gastrointestinal stromal tumor (GIST)

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45
Q

Yellow tan intramural or submucosa masses Firm, obstructs bowel

A

Carcinoid tumor

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46
Q

Carcinoid tumor in jejunum& ileum

A

Serotonin, Substance P, polypeptide YY Obstuction Metastatic disease AGGRESSIVE Throughout <3-5 cm

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47
Q

Carcinoid syndrome

A

Ileal tumors –> flushing and sweating Bronchospasm Diarrhea & collicky pain Due to secretion of 5HT into systemic circ Associated with metastic liver disease

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48
Q

Acute onset chest and back pain Preceded by burning epigastric pain History: chronic gastritis due to H. pylori COPD, smoking Air bubbles in chest xray

A

Perforated peptic ulcer

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49
Q

Disease associated w/ lacteals What is a lacteal

A

Whipples disease Lymphatic capillary that absorbs dietary fats in villi of small intestine

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50
Q

Can lead to toxic megacolon

A

Volvulus

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51
Q

Associated with Rota virus -causes

A

Intussception in children Reactive hyperplasia

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52
Q

LLQ pain, desire to defecate, bloody diarrhea Epithelial surface sloughs off

A

Ischemic bowel disease

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53
Q

Radiation fibroblasts Anorexia abdominal cramps Malabsorptive diarrhea

A

Radiation enterocolitis

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54
Q

Premature infant or low birth weight Oral feeding has just began Transmural necrosis of small and large intestine

A

Necrotizing Enterocolitis (NEC)

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55
Q

Ischemic bowel disease where

A

Splenic flexure -between superficial and inferior mesenteric artery

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56
Q

Significant bleeding Tortuous dilation of veins in mucosa and submucosa of cecum

A

Angiodysplasia

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57
Q

Hallmark of malabsorption

A

Steatorrhea Bulky, frothy, greasy yellow stools or Clay colored

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58
Q

Diarrhea that is isotonic to stool and persists w/ fasting

A

Secretory diarrhea

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59
Q

Diarrhea the is more concentrated than plasma and resides with fasting

A

Osmotic diarrhea

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60
Q

Osmotic diarrhea is assoc with what condition

A

Lactase deficiency

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61
Q

Diarrhea associated with steatorrhea

A

Malabsorptive diarrhea

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62
Q

Diarrhea that is purulent and bloody persists during fasting -due to

A

Exudative diarrhea Due to inflammatory disease

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63
Q

What are the 2 diseases that only have issues iwth intraluminal digestion

A

Chronic pancreatitis Cystic fibrosis (–> pancreatitis)

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64
Q

What is the disease that only has a problem with terminal digestion?

A

Lactase deficiency

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65
Q

What is the only disease that only has a problem with lymphatic transport?

A

Whipple disease

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66
Q

What is the only disease that only has a problem with transepithelial transport

A

Abetalipoproteinemia

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67
Q

HLADQ2, HLADQ8

A

Celiac disease

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68
Q

Increased CD8 cells Crypt hyperplasia Villous atrophy

A

Celiac disease

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69
Q

IgA antibodies ot tissue transglutaminase (tTG) ro anti-emdomysial (EMA)

A

Celiac disease

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70
Q

Condition associated with celiac disease

A

Dermatitis herpetiformis Microabscess Itchy blistering skin lesion

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71
Q

Patient presents with itchy skin blisters -condition? -assoc with

A

Dermatitis herpetiformis Celiac disease

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72
Q

Infant presents w/ failure to thrive, diarrhea and steatorrhea Presence of acanthocytic red cells (burr cells) Oil red o stain

A

Abetalipoprotenemia

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73
Q

Oil red o-stain

A

Abetalipoprotenemia

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74
Q

Abetalipoproteinemia is inherited how

75
Q

Acantocytic red cells aka

A

Burr cells Abetalipoprotenemia

76
Q

Young patient from Africa has repeat bouts of diarrhea starting around age 2. 50% percentile for height. Symptoms do not disappear with antibiotics. Cognitive deficits -severly affected area -caused by

A

Environmental enteropathy -distal bowel - defective intestinal barrier fxn, chronic exposure to fecal pathogens

77
Q

FOXP3 mutation

A

Autoimmune enteropathy

78
Q

Defective CD4 cells

A

Autoimmune enteropathy

79
Q

Autoimmune enteropathy has auto-Ab to what

A

Enterocytes and goblet cells

80
Q

Autoimmune enteropathy is inherited how

A

IPEX X-linked

81
Q

Explosive watery diarrhea, w/ frothy stools and abdominal distension -inherited how

A

Lactase def - AR

82
Q

Abdominal fullness, diarrhea, flatulence following dairy

A

Lactase def -acquired - downreglation of lactase gene

83
Q

Cholera -location -symptoms -complications

A

India, africa Severe watery diarrhea Dehydration, electrolyte inbalance

84
Q

Campylobacter spp -location -symptoms -complications

A

Developed countreies Watery or bloody diarrhea Arthritis Guillain-Barre syndrome

85
Q

Shigellosis -location -symptoms -complications

A

Worldwide Bloody diarrhea Reactive arthritis Urethritis, conjunctivitis Hemolytic uremic syndrome

86
Q

Salmonellosis -location -symptoms -complications

A

Worldwide Watery or bloody diarrhea Sepsis Abscess

87
Q

ENteric (typhoid fever) -location -symptoms -complications

A

India, mexico, philippines Bloody diarrhea Fever Chronic infection Carrier state Encephalopathy Myocarditis Intestinal perforation

88
Q

Yersinia spp -location -symptoms -complications

A

Nothern adn central europe Abdominal pain Fever Diarrhea Reactive arthritis Erythema nodosum

89
Q

Infectious enterocolitis assoc w/ Guillain Barre syndrome

A

Campylobacter spp

90
Q

ETEC -location -symptoms -complications

A

Developing countries Severe watery diarrhea Dehydrateion electrolyte imbalance

91
Q

EPEC -location -symptoms -complications

A

World wide Watery diarrhea dehydration Electrolyte inbalance

92
Q

EHEC -location -symptoms -complications

A

World wide Bloody diarrhea Hemolytic uremic syndrome

93
Q

EIEC -location -symptoms -complications

A

Developing countires Bloody diarrhea

94
Q

EAEC -location -symptoms -complications

A

World wide Nonbloody diarrhea afebrile Poorly defined

95
Q

Pseudomembranous colitis (C. diff) -location -symptoms -complications

A

Worldwide Watery diarrhea Fever Relapse, toxic megacolon

96
Q

Whipple disease -location -symptoms -complications

A

Rural Malabsorption Arthritis CNS disease

97
Q

Mycobacterial infection -location -symptoms -complications

A

World wide Malabsroption Pneumonia, infection at other sites

98
Q

Rice water stool -pathogenesis

A

Vibrio cholera - contaiminated drinking water

99
Q

Diarrhea w/ fishy order

A

Vibrio cholera

100
Q

Pathogenesis vibero cholera

A

Cholera toxin subunit A Unfolds –> cytosol –> refolds stimulates adenylate cyclase –> cAMP opens CFTR Release chloride into lumen

101
Q

HLA-B27

A

Reactive arthritis Campylobacter entercolitis Conjunctivitis, reactive arthritis, urethritis in shigella

102
Q

Erytehma nodosum bacteria

A

Campylobacter enterocolitis

103
Q

Hemolytic uremic syndrome

A

Shigella EHEC

104
Q

Anti-diarrheal medication are contrandicated in what

A

Shigella Delay clearance

105
Q

Plateau-like elevation of peyers patches in terminal ileum

A

Typhoid fever Salmonella

106
Q

Rose spots

A

Typhoid fever Salmonella

107
Q

Mimics appendicitis

A

Yersinia enterocolitica

108
Q

O157:H7

109
Q

Secretory, non-inflammatory diarrhea

110
Q

Heat labile toxin, heat stable toxin

111
Q

Detected with Tir

112
Q

Undercooked beef

113
Q

Antibiotics are contraindicated with what pathogen

A

EHEC Killing bacteria increases amount of toxin relased and enhances HUS SHiga like toxin

114
Q

Shiga like toxin

115
Q

Damaged crypts taht are distended by a mucopurulent exudate that form an eruption like a volcano taht leads to the formation of…

A

Pseudomembranous colitis PMC

116
Q

With what do you diagnose by toxin in stool

A

Pseudomembranous colitis (PMC)

117
Q

Whipples is due to

A

Actinomycete tropheryma whippelii

118
Q

Farmers Foamy macrophages Gram (+)

A

Whipple disease

119
Q

Diarrhea, weight loss, pain in joint (arthralgia)

A

Whipple disease

120
Q

Osmotic diarrhea assoc w/ viral

121
Q

NPS4

122
Q

DS-RNA virus

123
Q

Autoinfection

A

Strongyloides Larvae stage is outside host

124
Q

Iron deficiency anemia assoc worm

A

Necator duodenale Ancylostoma duodenale Hook worm

125
Q

Worms travel to anus at night Scotch tape test

A

Enterobius vermicularis Pin worms

126
Q

worm- bloody diarrhea adn rectal prolapse

A

Trichuris trichiura Whipworm

127
Q

Adult worms residing within mesenteric veins

A

Schistosomiasis

128
Q

Single worm very large

A

Intestinal cestodes Tape worm

129
Q

Worm causes B12 defieicny and megaloblastic anemia

A

Diphyllobothrium latum Fish tape wrom

130
Q

worm causes liver abscess adn dysentery

A

Entamoeba histolytica

131
Q

Flask shaped ulcer

A

Entamoeba histolytica

132
Q

Resistant to chlorine Public swimming pools Rural streams campers

A

Giardia lamblia

133
Q

Trophozoties, pear shaped with two equal size nuclei

A

Giardia lamblia

134
Q

Chronic diarrhea in AIDS patietns

A

Cryptosporidium

135
Q

Ab against flaggellin

136
Q

GI disease in teens to 20s

A

Inflammatory bowel disease

137
Q

Noncaseating granulomas

138
Q

Skip lesions

139
Q

Disease associated iwth onset of smoking

140
Q

Disease associated with stopping smoking

A

Ulcerative colitis

141
Q

What is common w/ crohns disease

A

perianal disease

142
Q

Ulcerative colitis vs Crohns in location and depth

A

Crohns - regional - transmural UC - colon and rectum -mucosa and submucosa

143
Q

Broad based ulcers with pseudopolyp

A

Ulcerative colitis

144
Q

Polyp in left colon smooth, nodular protrusion on crests of mucosal folds Piling of goblet cells

A

Hyperplastic polyps benign

145
Q

Rectal bleeding, mucus discharge, inflammatory lesion on anterior rectal wall

A

Inflammatory polyp (juvenile, peutz-hjegher, Hamartomatous)

146
Q

SMAD4 polyp

A

Juvenile polyp

147
Q

TGF-beta signaling pathways polyp

A

Juvenile polyp

148
Q

Congenital malformations and clubbing

A

Juvenile polyposis

149
Q

STK11 mutation

A

Peutz-Jeghers syndrome

150
Q

AMP kinase mutation polyp

A

Peutz-Jeghers syndrome

151
Q

Pigmented macules

A

Peutz-jeghers syndrome

152
Q

APC mutation polyp

153
Q

Focal hamartomatous malformation of small intestine and colon

A

Juvenile polyps

154
Q

Juvenile polyp inheritence

155
Q

What is initiating event for juvenile polyps

A

Mucosal hyperplasia

156
Q

Juvenile polyps are filled with

A

Mucin and inflammatory debris

157
Q

Juvenile polyps age

158
Q

Peutz-Jeghers inheritance

159
Q

Multiple GI polyps and mucocutanous hyperpigmentation

A

Peutz-Jeghers syndrome

160
Q

Dark blue-brown macules on lips nostrils, buccal mucosa

A

Peutz-Jeghers syndromes

161
Q

Epithelial dysplasia in colon

A

Colorectal adenomas

162
Q

Adenomas most important characteristic correlating risk of malignancy

163
Q

Full gland length exhibits serrated architecture No dysplastic changes Right colon

A

Sessile serrated adenoma

164
Q

Carpets of polyps -condition -inheritence -age -mutation

A

Familial adenomatous polyposis (FAP) AD Teenage APC mutation

165
Q

Hypertrophy of retinal pigment epithelium

A

Familial adenomatous polyposis (FAP)

166
Q

MSH2 or MLH1 -condition -inheritance -age -location

A

Hereditary nonpolyposis colorectal cancer aka Lynch syndrome -AD -under age 50 -Right colon

167
Q

Sporadic colon tumors mutation

A

APC/ Beta-catenin pathways WNT signaling

168
Q

Signet ring cells

A

Loss of E cadherin Colonic adenocarcinoma

169
Q

Right vs left colonic adenocarcinoma

A

Right - fatigue, weakness due to iron def anemia Left - occult bleeding, changes in bowel habits or cramping and LLQ discomfort

170
Q

Colonoic adenocarcinoma prognostic factor

A

Depth of invasion and presence of metastases

171
Q

Pencil thin poops

A

colonic adenocarcinoma

172
Q

Anal canal upper 1/3

A

Columnar rectal epithelium Glandular carcinoma Adenocarcinoma

173
Q

Anal canal middle 1/3

A

Transitional epithelium Cloacogenic carcinoma: basaloid tumors

174
Q

Anal canal lower 1/3

A

Stratified squamous epithelium Squamous carcinoma HPV infection

175
Q

External hemorrhoids

A

Below anorectal line painful Indicative of hepatic pathology

176
Q

Internal hemorrhoids

A

Above anorectal line Painless Straining

177
Q

Tumor of appendix

A

Carcinoid tumor

178
Q

Well differentiated neuroendocrine tumor

A

Carcinoid tumor

179
Q

Yellow swelling at tip of appendix

A

Carcinoid tumor

180
Q

Sclerosing Retroperitionitis etiology

A

idiopathic

181
Q

Dense fibrosis teh may extend to involve mesentery Compresses teh ureters

A

Sclerosing retroperitonitis

182
Q

Peritoneal tumors

A

Rare Mesothelioma: asbestos exposure

183
Q

t(11;22)(p13;q12)

A

EWS-WT1 fusion gene Aggressive tumor Desmosplastic small round cell tumor Children young adults Peritoneal tumors

184
Q

Loss of ganglion cells

Abnormalities in RET

A

Hirschsprung disase

GI2- AM (11 decks)

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