Chapter 17 - GI Tract Flashcards

1
Q

Rule of 2’s for Meckels

A
Occurs in 2% of pop
Present within 2 ft of ileocecal valve
Approx. 2 inches long
2x more common in males
Most often symptomatic by age 2
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2
Q

Condition characterized by new onset regurgitation and projectile nonbilious vomiting after feeding in assocation with palpable, firm 1-2 cm ovoid abdominal mass

A

Pyloric stenosis

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3
Q

Disease more common in pts with Down syndrome in which there is failure to pass meconium in immediate postnatal period and subsequent abdominal distention

A

Hirschprung

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4
Q

Pathogenesis of hirschprung

A

NCC fail to migrate from cecum to rectum or ganglion cells undergo premature death

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5
Q

Dx and associated genetics with Hirschprung

A

Dx by rectal suction biopsy

Associated with heterozygous LOF in RTK gene RET

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6
Q

Secondary achalasia may occur with infection by what organism?

A

Trypanosoma cruzi —> Chagas disease

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7
Q

What conditions might accompany esophageal mucosal webs in the upper esophagus?

A

Iron-deficiency anemia
Glossitis
Cheilosis (cracking at corners of mouth)

May be part of Paterson-Brown-Kelly or Plummer-Vinson syndrome

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8
Q

CREST syndrome associated with systemic sclerosis

A
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
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9
Q

Symptoms of achalasia

A

Dysphagia for solids and liquids, difficulty belching, chest pain

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10
Q

Mucormycosis of GI tract is most commonly seen in pts with what condition?

A

Diabetes

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11
Q

Most common cause of reflux esophagitis and associated morphology

A

GERD

Simple hyperemia may be only alteration, may also see basal zone hyperplasia and elongation of LP papillae

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12
Q

Plummer Vinson syndrome

A

Upper esophageal mucosal webs
Iron deficiency anemia
Glossitis
Cheilosis

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13
Q

MCC of esophageal varices is portal HTN. What is the second most common cause worldwide?

A

Hepatic schistosomiasis

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14
Q

Describe metaplasia associated with Barrett esophagus

A

Columnar metaplasia of the esophageal squamous mucosa

[goes from nonkeratinized stratified squamous to nonciliated columnar epithelium with goblet cells]

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15
Q

Risk factors for esophageal SCC

A
Adults > 45
Males 4x more likely
African Americans 8x more likely
Alcohol use
Tobacco use
Poverty
Caustic esophageal injury
Achalasia
Tylosis
Plummer-vinson syndrome
Fruit-deficient diet
Hot beverages
Mediastinal radiation
Ingestion of mursik (Kenya)
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16
Q

Molecular pathogenesis of esophageal SCC

A

Amplification of SOX2

LOF mutations in tumor suppressors, TP53, E-cadherin, and NOTCH1

17
Q

Most common cause of chronic gastritis

A

H.pylori

18
Q

Most common cause of diffuse atrophic gastritis

A

Autoimmune gastritis

19
Q

Toxin associated with H.pylori

A

Cytotoxin-associated gene A (CagA) - associated with increased risk of gastric cancer

20
Q

Stain used to detect H.pylori

A

Warthrin-Starry silver stain

21
Q

Most common type of gastric polyps

A

Hyperplastic (inflammatory) polyps

22
Q

Most common malignancy of the stomach

A

Gastric adenocarcinoma

23
Q

Geographic distribution of gastric adenocarcinoma

A

Variable, but high in Japan, China, Costa Rica, and Eastern Europe

24
Q

H.pylori eradication often results in remission of what type of gastric cancer?

A

MALToma

25
Q

Most common mesenchymal tumor of abdomen

A

Gastrointestinal stromal tumor (GIST)

26
Q

Mutation of ____ or ______ is usually an early event in sporadic GIST

A

KIT; PDGFRA

27
Q

Diagnostic marker of GIST

A

KIT in interstitial cells of Cajal

28
Q

Most common acquired GI emergency of neonates

A

Necrotizing enterocolitis; presents when oral feeding is initiated

29
Q

Hallmark of malabsorption

A

Steatorrhea

30
Q

What would biopsy of duodenum or proximal jejunum need to show to be diagnostic of celiac disease

A

Increased numbers of CTLs, crypt hyperplasia, and villous atrophy

31
Q

Characteristic finding in 10% of celiac patients caused by anti-gluten Abs cross-reacting with basement membrane proteins in the skin

A

Dermatitis herpetiformis - presents as itchy blistering skin lesion