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LCK STEP > CHAPTER: GI Path > Flashcards

CHAPTER: GI Path Flashcards

1
Q

3 different types of salivary gland tumors

A

Warthin = B, germinal centers (kind of makes sense b/c parotid sep from lymph tissue late in development)
Pleomorphic adenoma = B, recurs, stroma + epi
Muco-epi-dermoid carcinoma = M, mucinous + squamous
Malignancy esp if CN 7 palsy

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2
Q

Achalasia vs peptic stricture

A

Both tight LES
Peptic - scarring, normal peristalsis above
Achalasia - lose myenteric (movement, musc prop), uncoord or no peristalsis above

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3
Q

HSV 1 esophagitis

A

Punched out ulcers

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4
Q

Sclerodermal esophageal dysmotility - cause

A

Atrophy SM -> ↓LES -> acid reflux

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5
Q

Esophageal varices are dilation of what vien

A

L gastric

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6
Q

4 parts mumps

A

↑amylase due to 1 + 2

  1. Bilat parotid swelling
  2. Pancreatitis
  3. Ochitis
  4. ASEPTIC MENINGITIS
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7
Q

Alcohol ↑risk of what type eso cancer

A

SQQ only (upper 2/3)

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8
Q

What oral cavity ulcer is painful, resolves on own and is red with a gray base? 2 disease you’d see in

A

Apthous ulcer

  1. Behcet - recurrent apthous, genital ulcers, ureitis
  2. HSV 1
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9
Q

Most common location for cancer in the oral cavity? Is hairy leukoplakia precancerous?

A

Floor mouth

Hairy = EBV @ lateral tongue, hyperplasia so NOT precursor

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10
Q

H.Pylori ↑risk what 2 types cancer

A

Stomach adenocarcinoma

MALToma - makes sense since this is an infection

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11
Q

What is Menetrier disease

A

Hyperplasia gastric mucosa
Looks like brain gyri on scans
Parietal cell atrophy = ↓acid
Pre-cancerous

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12
Q

What is going on if a pt has gastric tissue around belly button and in supraclavicular LN

A

Gastric cancer mets
Virchow = L supraclav LN - everything below belly button drains via thoracic duct to L
Sister Mary Josephy nod w/ intestinal type stomach cancer

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13
Q

Which ulcers hemm vs perf

A 
Hemm 
1. Gastric - L gastric art (less curve) 
2. POST duo - gastroduodenal art 
Perf = ANT duo 
Shoulder pain b/c free air in ab aggravates diaphragm (phrenic nerve)
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14
Q

What GI disease can cause a T cell lymphoma

A

Celiac
Ab - antigen complex (AI) -> APC present on MHC 2
Th mediated cell damage

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15
Q

How does stool pH change with lactose intol? Why?

A

More acidic

Bacteria ferment lactose not being absorbed -> short FAs

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16
Q

Cause of lactase def

A

Absent gene = inherited

Change to gene expression with age - make less of it

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17
Q

Histo + symptoms of Whipple disease

A 
Intracell GP bact - not gonna show on stains
PAS + foamy macrophages (looks like fat)
@ LP of GI + mesenteric LNs
\+ cardiac 
\+ staetorrhea 
\+ arthralgia
\+ neuro 
"Foamy whipped cream in CANS"
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18
Q

What layers of tissue are affected by UC

A

Mucosa + submucosa

Lose haustra -> lead pipe

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19
Q

Crohn’s vs UC
Where’s the pain
Which can have perianal disease
Associated diseases

A 
Crohn's= RLQ, perianal disease (fistulas b/c transmural inflam), Ca ox stones
UC = LLQ pain, crypt abscess, p-ANCA 1ary sclerosing cholangitis
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20
Q

Extra-GI manifestations of Crohn’s and UC

A

Rash
Eye inflam
Oral ulcers
Arthritis - peripheral or spondylitis

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21
Q

If you see red cells w/ stippling nuclei after appendectomy, what was it?

A

Carcinoid tumor in appendix

Either caused appendicitis if at base occluding or incidental if at tip

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22
Q

GI infection can cause what complications in kids after resolution (lymphoid hyperplasia causes)

A

Appendicitis

Leading edge for intussception often @ ileocecal jxn -> blood stools

23
Q

Stress on the R colon vs L

A

L: diverticulum @ sigmoid colon (no muscularis externa b/c go through @ vasa recta)
R: angiodysplasia = dilation of vessels causes blood poop

24
Q

If a pt is presenting with poop in their urine and LLQ pain, what are you thinking?

A

LLQ = diverticulitis

That cause coloverical fistula

25
Q

Where do Zenker diverticulums form

A

Bet thryro-pharyngeal and crico-pharyngeal parts of inf pharyngeal constrictor
Behind thyroid cartilage
Elderly men false eso diverticulum

26
Q

What is the damaged tissue in Hischsprung

A

Both plexi - can’t relax - contracted tissue is bad

27
Q

Describe presentation of malrotation

A

Bad MIDGUT rotation during development
Fibrous bands can cause duo obstruction
“From cecum + R colon to retro”

28
Q

Site of volvulus in kids vs adults

A 
Kids = midgut around SMA
Adults = sigmoid around IMA
29
Q

Which art do emboli usually occlue causing acute mesenteric ischemia

A

SMA - pain out of proportion

30
Q

What is an ileus

A

Hypomotility w/o obstruction = constipation w/o gs

Associated with hypoL

31
Q

Where hyperplastic polyps

A

Recto-sigmoid

Not cancer

32
Q

2 types adenomatous polyps - mutation

A

Villous worse than tubular

APC/KRAS (FAP)

33
Q

HNPCC
Mutation
Type polyp
Area of colon

A 
AD 
X DNA mismatch repair (BRAF)
MIS
Prox colon always
Serrated polyps = saw tooth crypts
Arises de novo - not from polyp
↑risk GYN + CRC cancer
34
Q

Mut + area of colon involved with FAP

A

Chr 5q APC mutated tumor suppressor gene, AD
Always rectum
Adenomatous polyps

35
Q

Cancer risk for Peutz Jeghers vs juvenille polyposis syndrome

A

Both AD
PJ = hamartomatous polyps + hyperpig mucosal freckles, ↑breast + GI cancer
JPS = hamartomatous polyps, ↑CRC

36
Q

Cytokine that cause fibrosis in cirrhosis

A

TGF beta

37
Q

What does gamma glutamyl transferase tell you

A

Liver or biliary disease causing ↑ALP

38
Q

Histo Reye syndrome

A

ASA X mito enzymes (↓B ox)

Mitochondrial abnormalities + fatty liver change

39
Q

What is in a Mallory body

A

Alcoholic hepatitis - eos intra-cytoplasmic inclusions

Damaged keratin

40
Q

Treat hepatic encephalopathy

A

Lactulose

Rifaximin or neomycin - ↓bacteria making NH4 in the gut

41
Q

Mechanism by which Aspergillus causes HCC

A

p53 mut

42
Q

Cell marker for HCC

A

↑AFP

43
Q

2 chemicals that ↑risk angiosarcoma

A

Arsenic

Vinyl chloride

44
Q 
Gilbert synd
Crigler Najjar
Dubin Johnson
Rotor
Physiologic jaundice of newborn
A 
UDP glucuronosyltransferase makes CBR
G: ↓UDP, benign
CN: XUDP = jaundice, kernicterus, death
DJ: defective liver excretion = black liver (incidental)
Rotor: milder DJ, no black liver 
PJN: ↓UDP to start
45
Q

Acute vs chronic hepatitis histo

A

Acute: inflam lobules + portal tract, hepatocyte apoptosis

Chronic = > 6mo, portal tract inflam

46
Q

Mut + trt Wilson disease

A

Ch 13 AR mut liver Cu transporting ATPase

Penicillamine, trientine, oral Zn

47
Q

Mut + presentation + trt hemochromatosis

A

Ch 6 AR, bad sensing, liver thinks you’re deplete, ↑intestinal absorption
Cirrhosis + diabetes + skin pig (bronze diabetes)
Ca pyrophos @ jts
Phlebotomy
Chelate: deferasirox, deferoxamine, oral deferiprone

48
Q

Cause of 1ary biliary cirrhosis

A

AI - granulomas of intralob bile ducts

+ Anti mitoAb

49
Q

Pt w/ pruritus + ↑ALP thinking

A

Biliary tract disease

50
Q

Which GB stones can you seen on imaging - causes for both

A

Cholesterol - E therapy, statins, cholestyramine, rapid weight loss
Pigment = BR = see on imaging
Infections - ascaris lumbricoides, clonorchis
TPN
Chronic hemolysis
Alcoholic cirrhosis : ↓bile salt prod
Crohns: ↓bile salt reabsorb

51
Q

Causes of acute pancreatitis

A 
Ones you know +
AI
Scorpion string
↑TGs
ERCP
52
Q

What lines pancreatic pseudocysts

A

Granulation tissue (NOT epi)

53
Q

What cells does pancreatic adenocarcinoma arise from

A

Ducts -> histo therefore glandular
Migratory thrombophelbitis - redness + tenderness on palpation of extremities
+ palpable non-tender GB

LCK STEP (27 decks)

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