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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
Where do Zenker diverticulums form
Bet thryro-pharyngeal and crico-pharyngeal parts of inf pharyngeal constrictor Behind thyroid cartilage Elderly men false eso diverticulum
26
What is the damaged tissue in Hischsprung
Both plexi - can't relax - contracted tissue is bad
27
Describe presentation of malrotation
Bad MIDGUT rotation during development Fibrous bands can cause duo obstruction "From cecum + R colon to retro"
28
Site of volvulus in kids vs adults
``` Kids = midgut around SMA Adults = sigmoid around IMA ```
29
Which art do emboli usually occlue causing acute mesenteric ischemia
SMA - pain out of proportion
30
What is an ileus
Hypomotility w/o obstruction = constipation w/o gs | Associated with hypoL
31
Where hyperplastic polyps
Recto-sigmoid | Not cancer
32
2 types adenomatous polyps - mutation
Villous worse than tubular | APC/KRAS (FAP)
33
HNPCC Mutation Type polyp Area of colon
``` 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
Mut + area of colon involved with FAP
Chr 5q APC mutated tumor suppressor gene, AD Always rectum Adenomatous polyps
35
Cancer risk for Peutz Jeghers vs juvenille polyposis syndrome
Both AD PJ = hamartomatous polyps + hyperpig mucosal freckles, ↑breast + GI cancer JPS = hamartomatous polyps, ↑CRC
36
Cytokine that cause fibrosis in cirrhosis
TGF beta
37
What does gamma glutamyl transferase tell you
Liver or biliary disease causing ↑ALP
38
Histo Reye syndrome
ASA X mito enzymes (↓B ox) | Mitochondrial abnormalities + fatty liver change
39
What is in a Mallory body
Alcoholic hepatitis - eos intra-cytoplasmic inclusions | Damaged keratin
40
Treat hepatic encephalopathy
Lactulose | Rifaximin or neomycin - ↓bacteria making NH4 in the gut
41
Mechanism by which Aspergillus causes HCC
p53 mut
42
Cell marker for HCC
↑AFP
43
2 chemicals that ↑risk angiosarcoma
Arsenic | Vinyl chloride
44
``` Gilbert synd Crigler Najjar Dubin Johnson Rotor Physiologic jaundice of newborn ```
``` 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
Acute vs chronic hepatitis histo
Acute: inflam lobules + portal tract, hepatocyte apoptosis | Chronic = > 6mo, portal tract inflam
46
Mut + trt Wilson disease
Ch 13 AR mut liver Cu transporting ATPase | Penicillamine, trientine, oral Zn
47
Mut + presentation + trt hemochromatosis
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
Cause of 1ary biliary cirrhosis
AI - granulomas of intralob bile ducts | + Anti mitoAb
49
Pt w/ pruritus + ↑ALP thinking
Biliary tract disease
50
Which GB stones can you seen on imaging - causes for both
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
Causes of acute pancreatitis
``` Ones you know + AI Scorpion string ↑TGs ERCP ```
52
What lines pancreatic pseudocysts
Granulation tissue (NOT epi)
53
What cells does pancreatic adenocarcinoma arise from
Ducts -> histo therefore glandular Migratory thrombophelbitis - redness + tenderness on palpation of extremities + palpable non-tender GB

LCK STEP (27 decks)

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