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Path Midterm > Chapter 14 (2) > Flashcards

Chapter 14 (2) Flashcards

1
Q
  • In the stomach, generalized paths like benign gastritis may include epigastric pain, nausea, vomiting
  • ______ is the MC cause of infection
A

helicobacter pylori

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2
Q

With MUCOSAL ULCERATIONS that can lead to hemorhage in the stomach, a pt may have vomiting like “COFFEE GROUNDS” aka: _______, or ________ which are black tarry feces

A

hematemesis (vomitting of blood)

melena

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3
Q

Two MC risks of GASTRIC INFLAMMATORY DISEASES (acute & chronic)

A

alcohol

nsaids

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4
Q

_________ has an onset that follows TRANSIENT mucosal inflammation pattern, with multifactorial pathogenesis. The pH is close to _____

  • EPIGASTRIC PAIN, nausea, vomit, anorexia
  • Hematemesis associated with ALCOHOLICS
  • Dose-dep assoc w/ NSAIDs
A

acute gastritis

1 (strongly acidic)

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5
Q
  • Multiple small shallow ulcers in STOMACH & DUODENUM due to severe PHYSIOLOGICAL stress and NSAIDs
  • INTRACRANIAL DISEASE, aka _________, vomiting up of COFFEE GROUND HEMATEMESIS
A

acute peptic ulceration

Cushing ulcer

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6
Q
  • _______ gastritis is LESS SEVER but MORE PROLONGED and is associated w/ peptic ulcers, HELICOBACTER PYLORI (70-90%), and combines w/ other injuries
  • Increased acid prod
  • POOR CHILDHOOD SANITATION/HYGIENE
  • May complicate into gastric _______ bc its inflam (5x)
A

chronic

adenocarcinoma

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7
Q

Gastritis type MC in elderly females, DECREASED B12 ABSORPTION, can cause PERNICIOUS ANEMIA

(CHRONIC gastritis)

A 
autoimmune gastritis 
(CHRONIC gastritis)
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8
Q

_________ disease develops in highly acidic areas, in the PROXIMAL DUODENUM (4x) and cuases a solitary “PUNCHED OUT” lesion

  • Perforation/hemorrhage possible -> med emergency
  • 10% male 4% female lifetime risk
A

peptic ulcer

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9
Q

PEPTIC ULCER DISEASE is the result of chronic/recurrent gastritis and/or hyperacidity, and like gastritis, two risk factors are _________

A 
helicobacter pylori (MC, 70-90%)
nsaids
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10
Q

Peptic ulcer disease is MC at night 1-3 hrs ____ (after eating) and is relieved by ___ substances

A

postprandial

alkaline

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11
Q

_______ PEPTIC ULCER DISEASE have immediate postprandial RELEIF (dairy) while _______ ulcers are worse on EMPTY STOMACH or POSTPRANDIAL (after eating), and have less predictable features

  • Both are relief w/ alkaline, worse at night, inconsistent pain patterns
A

duodenal (dairy-duodenal)

gastric

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12
Q

Mass PROJECTING FROM MUCOSA into gastric lumen that is associated w/ chronic gastritis

A

gastric polyps

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13
Q
  • GASTRIC POLYPS are MC (75%) appears as ______ & ______ post biopsy, and is unlikely to transition into CA.
  • _______ are LEAST common but 30% transition into adenocarcinomas
  • Biopsy required to determine
A

inflammatory & hyperplastic
gastric adenomas

(GASTRIC POLPYS)

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14
Q
  • > 90%* of all gastric CA are GASTRIC ____, which are dx late and are already advanced, as symptoms develop late
  • RESEMBLES chronic gastritis
  • 5 yr survival:
A

adenocarcinomas

JAPAN

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15
Q

Used to take an esophageal biopsy of polyps

A

EGD (esophagogastroduodenoscopy)

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16
Q

MC occurring in the ______ intestine, INTESTINAL OBSTRUCTIONS present with pain, distention, constipation, and are 80% of all mechanical obstructions

A

small

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17
Q

CONGENITAL, BLIND ENDED OUTPOUCHING of the SI that occurs in 2% of all births (common), is 2x mc in males, and is MC asymptomatic (2% symptomatic)

A

meckel diverticulum
(small intestine)
(Rule of 2: 2% symptomatic, males 2Xs)

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18
Q

CONGENITAL GANGLIONIC MEGACOLON that occurs in the RECTUM or SIGMOID colon, LACKS neurologic ganglia in the DISTAL INTESTINES and obstructs the proximal bowl

A

hirschsprung disease

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19
Q

A ______ is an intestinal obstruct that is secondary to an abdominal wall defect while _______ start as inflammation –> fibrosis and cause adherent intestinal segments

A

herniation

adhesions

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20
Q

AKA: Ischemic bowel disease: that tend to have OCCLUDED arteries, ischemia from occlusion, and mucosal INFARCTION

A

ischemic colitis

IBD

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21
Q

______ is an intestinal obstruct with telescoping of the prox bowel into the distal segment while a _____ occurs with a twisting loop of bowel and poss infarction

A

intussusception

volvulus

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22
Q
  • Hirschsprung disease is dx by a FAILURE to _____

- MC in _______, more SEVERE in _______

A

pass meconium
males
females

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23
Q

Ischemic bowel disease that tend to have OCCLUDED arteries, ischemia from occlusion, and mucosal INFARCTION

A

ischemic colitis

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24
Q

_______ causes occlusion secondary to atherosclerosis, while _____ involves myocardial infarction, and ______ ischemia involves heart failure, hemorrhage, shock etc.

  • Misc causes of ischemic bowel disease involve scarring/stricture
A

thrombosis
arterial embolism
non-occlusive

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25
Q

______ ischemic bowel disease has episodic bloody diarrhea and mimics ibd while _______ has sudden/severe abdom pain, nausea, frank blood in stool

  • Elderly at risk for both, CVD
A

chronic

acute

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26
Q

_____ features include weight loass, cachexia, abdom distention, etc and consequences including vitamin deficiencies, anemia, peripheral neuropathies
- Can transition to ________

A

malabsorption

cystic fibrosis

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27
Q

TORTUOUS VESSELS, MALFORMED DILATIONS MC in CECUM or ASCENDING colon with idiopathic cause (poss mech stress)

A

angiodysplasia

28
Q
  • _______ are thin walled VARICES MC vasc d/o of GI TRACT
  • > 50 increased risk, increased intraabdominal pressure (VALSALVA’S)
  • Can develop in advanced _______ causing portal HTN
A

hemorrhoids

liver cirrhosis

29
Q

Hemorrhoids can range from asympt to v painful, as it irritates surrounding tissues, causes perianal _____ and frank blood in stool. Patients may be EMBARRASSED

Internal hemorrhoids: _______ anorectal line
External hemorrhoids: _______ anorectal line

A

pruritis
above
below

30
Q

Top THREE malabsorption diarrheal diseases in the US, caused by intestinal inflammation (in ORDER)

A

pancreatic insufficiency
celiac disease
chrohn disease

31
Q

Malabsorption manifests as CHRONIC DIARRHEA from DEFECTIVE ABSORPTION, and can be _____ (chronic), with excessive fat in feces or ______, bloody diarhhea

A

steatorrhea

dysentery

32
Q

_____ features include weight loass, cachexia, abdom distention, etc and consequences including vitamin deficiencies, anemia, peripheral neuropathies

A

malabsorption

33
Q

NON-INFECTIOUS MALABSORPTION reaction to GLIADIN in grains such as wheat barley and rye, that causes VILLOUS ATROPHY

A

celiac disease

34
Q
  • 1% of US & Europe population has celiac disease, and the MC patients are ______ (race and age)
  • Symptoms range STEATORRHEA, BLOATING, ABDOMINAL DISTENTION
A

caucasians 30-60 yo

35
Q

Pruritic blisters on limbs, buttocks, found in 10% of CELIAC DISEASE patients

  • Similar appearance to HERPES VESICLES
A

dermatitis herpetiformis

36
Q
  • AKA tropical sprue, inflam cycle beginning with DIARRHEA, steatorrhea, weight loss then MALAISE and NUTRITIONAL DEFICIENCIES that will cause stunted growth
  • MC in CHILDREN 2-3 yrs old
A

environmental enteropathy

37
Q

Environmental enteropathy can either be _________ which RESPONDS TO ANTIBIOTICS or ________ which causes VILLUS FLATTENING

A

infectious

autoimmune

38
Q

Lactase deficiency can either be _______ MC in young adulthood or ________

  • Dx via breath hydrogen test, unremarkable biopsy
A

acquired

congenital

39
Q
  • Major GLOBAL health problem where MICROBIAL INFECTIONS cause inflam and diarrhea
  • 12k children die each day
A

infectious enterocolitis

40
Q

Cholera is caused by _______ which releases a CHOLERA TOXIN that causes massive CHLORIDE ION secretion into the GI tract which causes abrupt vomiting & RICE WATER STOOL, HYPOTENSION, SHOCK

A

vibrio cholerae

41
Q
  • MC bacterial enteric path in US, caused by contaminated chicken and is MC non invasive but enterotoxins can invade
  • Can be ACUTE SELF-LIMITED and last less than a month
A

campylobacter enterocolitis

42
Q

In acute self limited colitis, campylobacter jejuni presents with an accum of neutrophils & _______, while e. coli has neutrophils and _________

A

crypt abscess

normal crypt architecture

43
Q

AKA ANTIBIOTIC ASSOCIATED COLITIS, as antibiotics disrupt microbiota and causes a CLOSTRIDIUM DIFFICILE overgrowth, build up of neutrophils
- HOSPITALIZATION increases risk, leukocytosis occurs

A

pseudomembranous colitis

44
Q
  • 1/2* of all gastroenteritis is _______, presents with nausea, vomiting, abdom pain, diarrhea
  • Children: ________
  • Adults: ________
A

viral
rotavirus
norovirus

45
Q
  • Regional &TRANSMURAL inflammation that causes fissues, skip lesions, granulomas, strictures and is 1:500
  • Risk for GI adenocarcinoma 8-10 yr post dx
A

crohn disease

IBD

46
Q
  • MC parasitic infection that RESISTS COLD AND CHLORINE, stems from fecal, water contam and alters SI enzymes
  • AKA: giardiasis, BEVER FEVER
A

giardia lamblia

47
Q

SUPERFICIAL MUCOSAL ULCERATIONS that begins in RECTUM, moves proximal, presents as PSEUDOPOLYPS, is 1:5000 in patients 20-25 yrs
- _________ is INHIBITORY

A 
ulcerative colitis (IBD)
smoking
48
Q

Sigmoid ________ is active and inflamed, while colonic ________ indicates a simple presence, non inflammatory

A

diverticulitis

diverticulosis

49
Q

________ are defects in the colon wall (95% sigmoid), can lead to INFECTION, possible PERFORATION and HEMORRHAGE
- Increased risk with AGE, constipation, decreased fiber

A

acquired diverticulum

50
Q

50% people ______ get SIGMOID DIVERTICULITIS, 20% are SYMPTOMATIC, which includes TENESMUS
- Tx: INCREASE FIBER

A

> 60 yrs old

51
Q

ALTERED BOWEL HABITS, DIARRHEA, CONSTIPATION, chronic & relapsing ABDOMINAL PAIN MC between 20-40 yrs females with NO CELLULAR INFLAMMATION abnormalities

A

irritable bowel SYNDROME

52
Q

Abnormal local immune response that is idiopathic

  • Crohn: MC in _______, TRANSMURAL
  • Ulcerative colitis: RECTUM –> DISTAL COLON, ________
A

inflammatory bowel DISEASE
ileum
mucosa/submucosa

53
Q
  • Regional & TRANSMURAL inflammation that causes fissues, skip lesions, granulomas, strictures and is 1:500
  • Risk for GI adenocarcinoma 8-10 yr post dx
A

crohn disease

54
Q

MC location for chron disease symptoms (3)

A

terminal ileum
ileocecal valve
cecum

55
Q

SUPERFICIAL MUCOSAL ULCERATIONS that begins in RECTUM, moves proximal, presents as PSEUDOPOLYPS, is 1:5000 in patients 20-25 yrs
- _________ is INHIBITORY

A

ulcerative colitis

smoking

56
Q
  • Ulcerative colitis as an _______ onset of TENESMUS, FEVER, ABDOMINAL PAIN and presents with GROSSLY BLOODY and MUCOID STOOL
  • Increased adenocarcinoma risk with dysplasia
A

insidious

57
Q

POLYP is a mass that protrudes into lumen of colon, can be inflam (min risk), hamartomas (min risk), or ________, which is piled up epithelia resembling benign dyslplasia

A

hyperplastic

58
Q

________ polyp is a neoplastic mass that is DYSPLASTIC, PREMALIGNANT, and can become adenocarcinoma

A

adenomatous

59
Q

50% of ALL US ADULTS > 50 yrs, onset >40 yrs have _________, benign tumors but with dysplasia pose risk of aggressive adenocarcinomas

  • MALIGNANT UNTIL PROVEN BENIGN
  • Larger = greater CA risk
A

adenomas

60
Q

____________ is a rare autosomal dominant mutation that has a 100% chance of CA, MC by 30 yo
- Detected by fecal occult blood, tx by PROPHYLACTIC COLECTOMY

A

familial adenomatous polyposis

61
Q

Tumors of the colon are the MC carcinoma: _______% of US pop develops colorectal CA, _____% LETHAL, and ______% of CA-RELATED DEATH

A

5
40
15

62
Q

55k deaths from ________, the MC MALIGNANCY of GI tract, MC dx from age 50-70, w/ a HIGHLY PROCESSED DIET of low fiber and high carbs (USA has highest rate obvs)
- _____ % of ALL CA-related mortality

A

colorectal adenocarcinoma

15%

63
Q

Early on, colorectal adenocarcinoma is __________ but progresses insidiously to alter BM, fatigue, weakness, and can mets via regional lymph & hematopoietic, MC to ________

A

asymptomatic

liver

64
Q
  • Neoplasms of the SI are rare, only 1% of GI MALIGNANCIES, and are MC in the ____
  • 50% ADENOCARCINOMAS, 50% CARCINOID TUMORS
  • Dx when advanced (asymp early), shows ABDOMINAL PAIN/CRAMPING
A

duodenum

65
Q

MC ACUTE ABDOMINAL CONDITION that presents with RLQ TENDERNESS, deep/constant pain, ANOREXIA, NAUSEA, VOMITING

A

acute appendicitis

66
Q

________ MC cause of APPENDICITIS (50-80%), ischemia –> inflammation
- High morbidity & mortality when PERFORATED due to peritonitis, sepsis potential

A

obstruction

67
Q

MC tumor of the appendix is _______, possible adenocarcinoma but it is rare

A

carcinoid

Path Midterm (4 decks)

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