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GI 2 Midterm > Chapter 17 Slide Set 2 > Flashcards

Chapter 17 Slide Set 2 Flashcards

1
Q

What causes chronic gastritis?

A

H. Pylori (90%)

Autoimmune gastritis (10%)

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2
Q

What causes hirschprung disease at the cellular level?

A

Migration of neural crest cells arrested prematurely

Ganglion cells undergo premature death

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3
Q

Where is H. Pylori most often found?

What stain to visualize?

What cells are prominent?

A

Antrum of stomach

Warthin-Starry

Intraepithelial and LP neutrophils

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4
Q

Barrett’s esophagus develops most commonly in whom?

Symptoms?

What association with 10-20% of pts?

A

White males 40-60

Heartburn, regurg, dysphagia

Chronic GERD

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5
Q

Perforated ulcer pain refers where?

A

Back, LUQ or chest

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6
Q

What is Hamman’s sign?

Associated with what?

A

Crunching sound upon auscultation of the heart due to pnemomediastinum

Boerhaave’s syndrome

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7
Q

What is the most common site of acquired diverticula?

A

Sigmoid colon

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8
Q

What % of people with esophageal varices die initially?

% recur w/in a year?

% develop bleeding?

A

30

50

25-40

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9
Q

What is the result of a superficial mucosal tear, associated with alcohol?

A

Mallory-Weiss syndrome

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10
Q

Gene mutation associated with Hirschsprung’s?

A

RET

Dr. hirschsprung got dat RETro ass

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11
Q

Blood supply to the upper third of esophagus?

A

Inferior thyroid a

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12
Q

What lab value for MCV is microcytic?

Macrocytic?

A

< 70

> 110

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13
Q

Autoimmune gastritis occurs where?

Inflammatory infiltrate?

Acid production?

Gastrin production?

Other lesion?

A

Body of stomach

Lymphocytes and macrophages

Decreased

Increased

Neuroendocrine hyperplasia

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14
Q

Diffuse gastric cancer has what LOF gene?

Encodes for what?

What chromosome?

A

CDH1

E-cadherin

16

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15
Q

Tylosis (hyperkeratosis of palms and soles of feet) is a RF for what?

What gene mutation

Aka what syndrome?

A

Esophageal SCC

RHBDF2

Howel-Evans

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16
Q

What is associated with a transmural tear of the esophagus?

A

Boerhaave’s syndrome

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17
Q

What stomach disease gets better after eating?

A

PUD

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18
Q

Blood supply to the lower third of esophagus?

A

Left gastric a

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19
Q

Adenocarcinoma of the esophagus are most often preceded by what?

A

Barrett’s

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20
Q

What cancer incidence is 20x higher in Japan, Chile, Costa Rica, and Eastern Europe?

A

Gastric adenocarcinoma

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21
Q

What is the most common mesenchymal tumor of the abdomen?

Arise from where?

Peak age?

A

GIST

Interstitial cells of Cajal

60

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22
Q

What cancer evokes a desmoplastic reaction that stiffens the gastric wall?

A

Intestinal type gastric adenocarcinoma

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23
Q

GIST tumors have GOF mutations?

A

KIT

PDGFRA

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24
Q

Main characteristics of pyloric stenosis?

A

3-5x more common in males
Monozygotic twins have high rate of concordance
Assoc. with turner syndrome and trisomy 18
Presents in 3-6wks post birth with nonbilious vomiting

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25
Q

What causes PUD?

A

H. Pylori
cigarettes
NSAID

26
Q

What has a better prognosis: small bowel GIST or gastric GIST?

A

Gastric

27
Q

Intestinal type gastric cancers are associated with what mutations?

A

Increased Wnt signaling due to loss of APC and GOF in B-catenin

Sporadic

28
Q

How to treat variceal hemorrhage?

A

Splanchnic vasoconstrictor
Balloon tamponade
Variceal ligation

29
Q

Triad for achalasia?

A

Incomplete LES relaxation
Increased LES tone
Loss of peristalsis (vagus or nuclear ganglion issue)

30
Q

What disease has histologically hyperplasia of foveolar mucous cells with elongated glands in a corkscrew-like appearance, and hypertrophy of rural folds?

A

Ménétrier disease

31
Q

What type of cancer causes linitis plastica and has signet-ring cells with discohesive cells?

A

Diffuse type gastric adenocarcinoma

32
Q

Signet ring cell with mucin is what kind of cancer?

Located where most commonly?

A

Adenocarcinoma

Distal third of esophagus

33
Q

What do benign esophageal tumors cause?

Arise where?

What kind of tumors are they?

A

Obstruction

Wall of esophagus (submucosal)

Mesenchymal in smooth muscles

34
Q

Geographic distribution of SCC?

Age? M v F?

Highest risk group?

Occurs where?

A

Iran, china, hong kong

> 45, Males 4:1

AA 8x more common

50% middle third of esophagus

35
Q

ZE syndrome mean age?

Location?

Predom cell type?

Gene mutation?

A

50

Fundus

Parietal

MEN1

36
Q

Blood loss and severe burn or trauma causes what?

A

Curling ulcer

37
Q

Autoimmune gastritis serology?

Sequelae?

Associations?

A

Ab to parietal cells

Atrophy, pernicious anemia (B12 def), adenocarcinoma, carcinoid

Thyroiditis (Hashimoto’s), DM, Graves

38
Q

Symptoms of food impaction, dysphagia or feeding intolerance along with an atopic dermatitis indicates what?

A

Eosinophilic esophagitis

39
Q

Gastric bleed caused by a submucosal a. That does not branch properly within the wall of the stomach is what?

Found where?

A

Dieulafoy lesion

Lesser curvature of stomach

40
Q

What describes esophageal webs with iron deficiecny anemia, cheilosis, glossitis, and kolionychia?

A

Paterson-Brown Kelly

Or Plummer-Vinson syndrome

41
Q

Blood loss and intracranial disease with stomach ulcer?

High incidence of what?

A

Cushing ulcer

Perforation

42
Q

Metastases to LN in left supraclavicular fossa is what?

Indicates what?

A

Virchow node

Metastatic gastric cancer

43
Q

What B cell markers does MALToma express?

A

CD19, CD20, CD43 (25%)

44
Q

Neoplastic lymphocytes infiltrate gastric glands focally to create diagnostic lymphoepithelial lesions in what and has a desne lymphocytic infiltrate in what?

A

MALToma

45
Q

Gastric bleeding recognized by longitudinal stripes of edematous eryhtematous mucosa in the antral mucosa is what?

Aka what?

A

GAVE

Watermelon stomach

46
Q

Irish node is metastasis where?

Sister Mary Joseph?

A

Left axillary LN

Periumbilical LNs

47
Q

Menertrier Disease mean age of pt?

Location?

Predominant cell type?

gene factor?

A

30-60

Body and fundus

Mucous

TGF-a

48
Q

What does an ulcer do to the epithelium?

Erosion?

A

Knocks out the mucosal layer

Loss of superficial epithelium

49
Q

Where does peptic ulcer disease most commonly affect?

A

Duodenum or gastric antrum

50
Q

What causes MALToma?

What translocation is most common?

What gene mutation?

A

H. Pylori

T(11;18) on ch. 21

API2-MLT

51
Q

Describe the metaplasia associated with Barrett’s esophagus

A

Metaplasia of the lower esophageal mucosa from stratified squamous epithelium to nonciliated columnar epithelium with goblet cells

52
Q

Carney triad in young females which includes GIST, paraganglioma, and pulmonary chondroma has what mutation?

A

NF1

53
Q

What is the most common place for carcinoid tumors?

Prognosis there?

A

Jejunum and ileum

Poor (very aggressive)

54
Q

Primary cause of achalasia?

Secondary (top 4)?

A

Ganglion cell degeneration or unknown

T. Cruzi, diabetes, malignancy, down syndrome

55
Q

What is associated with a bird beak sign on radiograph?

A

Achalasia

56
Q

What cancer usually has a precursor lesion of gastric dysplasia/adenoma?

A

Gastric adenocarcinoma

57
Q

What kind of peptic ulcer is solitary, sharply punched out which may perforate making it an emergency?

A

Duodenal ulcer

58
Q

Krukenberg tumor is what?

A

Gastric cancer metastasis to the ovary

59
Q

Malignant transformation of ulcers is what?

A

Rare

60
Q

Pouch of douglas metastasis is what?

A

Boumer shelf

61
Q

Blood supply to the middle third of esophagus?

A

Branches of thoracic aorta

GI 2 Midterm (5 decks)

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