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Systems Pathology 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Stomach protrudes into the thorax

A

hiatal hernia

pg 59

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2
Q

Types of hiatal hernia

A

1) axial (sliding)
2) non-axial (rolling)
pg 59

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3
Q

Most common type of hiatal hernia

A

axial (sliding) 95%

pg 59

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4
Q

Type of hiatal hernia with a “bell-shaped” dilation

A

axial (sliding)

pg 59

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5
Q

Type of hiatal hernia where a separate portion of the stomach protrudes and is prone to strangulation or obstruction

A

non-axial (rolling)

pg 59

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6
Q

Population most affected by hiatal hernias

A

> 70 years

pg 61

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7
Q

Hiatal hernia are commonly asymptomatic, but when symptomatic they present like…

A

GERD-like esophagitis
possible perforation, hemorrhage
pg 61

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8
Q

Esophageal metaplasia

A

Barrett Esophagus

pg 63

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9
Q

In Barrett Esophagus stratified squamous transitions into what cell type?

A

columnar epithelia

pg 63

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10
Q

Risk factors for Barrett Esophagus

A

caucasians (30-100x), males (4x), obesity, family hx, 40-60 years
pg 63

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11
Q

What % of symptomatic GERD patients have Barrett Esophagus?

A

10%

pg 63

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12
Q

An endoscopic look at Barrett Esophagus would have what appearance?

A

red, velvety mucosa, bands (tongues), pre-cancerous lesions

pg 67

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13
Q

Complications of Barrett Esophagus

A

1) esophageal adenocarcinoma
2) ulceration and strictures
pg 68

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14
Q

Types esophageal tumors

A

1) leiomyoma
2) adenocarcinoma
3) squamous cell carcinoma
pg 69

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15
Q

Type of esophageal tumor: Benign, smooth muscle tumor

A

leiomyoma

pg 69

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16
Q

Type of esophageal tumor: 50% of esophageal cancers in the US

A

adenocarcinoma

pg 69

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17
Q

Risks for esophageal adenocarcinoma

A

US, GERD, Barrett esophagus, Caucasians, males (7x), obesity, irradiation, tobacco
pg 69

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18
Q

Type of esophageal tumor: most common worldwide

A

squamous cell carcinoma (90%)

pg 69

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19
Q

Late stage features of adenocarcinomas

A

obstruction, vomiting, cachexia, fatigue, weakness

pg 70

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20
Q

Prognosis of esophageal adenocarcinoma

A

poor <25% 5 year survival
(early lymphatic spread)
pg 70

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21
Q

Most common location of esophageal adenocarcinoma

A

distal 1/3 of the esophagus

pg 71

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22
Q

Risks for squamous cell carcinoma

A

> 45 years, males (4x), African American(6x), irritation, rural/underdeveloped, poverty, achalasia
pg 72

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23
Q

Features of squamous cell carcinoma

A

dysphagia, odynophagia, cachexia

pg 72

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24
Q

Prognosis of squamous cell carcinoma

A

very poor, <10% 5 year survival
(lymphatic mets)
pg 72

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25
Q

Most common location of squamous cell carcinoma

A

middle 1/3 of the esophagus

pg 73

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26
Q

Melena

A

black, “tarry” feces

pg 75

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27
Q

Types of gastric inflammatory diseases

A

1) acute gastritis
2) chronic gastritis
pg 78

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28
Q

Common risk factors for gastric inflammatory diseases

A

alcohol, NSAIDs, chemotherapy, irradiation, increased age

pg 78

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29
Q

Type of gastric inflammatory disease with a sudden onset that is often transient

A

acute gastritis

pg 79

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30
Q

Risk associated with acute gastritis with possible erosion/ulceration

A

hemorrhage
acute erosive hemorrhagic gastritis
pg 79

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31
Q

Risks for acute gastritis

A

NSAIDs, alcohol, smoking, physical trauma, irradiation, chemotherapy
pg 79

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32
Q

Symptoms of acute gastritis

A

epigastric pain, nausea, vomiting, anorexia, hematemesis, melena
pg 80

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33
Q

Small/shallow ulceration in the stomach/duodenum

A

acute peptic ulceration

pg 83

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34
Q

Causes of acute peptic ulceration

A

severe physiological stress, high doses of NSAIDs, intracranial disease
83

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35
Q

Type of gastric inflammatory disease that is less intense but more prolonged

A

chronic gastritis

pg 84

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36
Q

Symptoms of chronic gastritis

A

nausea & upper abdominal discomfort

pg 84

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37
Q

Possible causes of chronic gastritis

A

helicobacter pylori, increased age, other stressors

pg 84

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38
Q

Chronic gastritis may lead to…

A

peptic ulcer disease or gastric adenocarcinoma

pg 84

39
Q

What % of those with chronic gastritis have H. pylori infections?

A

70-90%

pg 86

40
Q

Chronic gastritis leading to gastric atrophy

A

autoimmune gastritis

pg 86

41
Q

Antibodies against parietal cells in autoimmune gastritis

A

pernicious anemia

pg 86

42
Q

Solitary “punched-out” lesion

A

peptic ulcer disease

pg 87

43
Q

Most common location of peptic ulcer disease

A 
proximal duodenum(4x)
pg 87
44
Q

Common locations of peptic ulcer disease

A 
proximal duodenum(4x)gastric antrum 
pg 87
45
Q

What % of those with peptic ulcer disease have an H. pylori infection?

A

70-90%

pg 90

46
Q

What % of those with an H. pylori infection have peptic ulcer disease?

A

5-10%

pg 90

47
Q

Symptoms of peptic ulcer disease

A

nausea/vomiting, bloating cachexia, fatigue, epigastric pain

pg 92

48
Q

What time(s) are the symptoms for peptic ulcer disease most common?

A

night and 1-3 hrs postprandial

pg 92

49
Q

Which type of peptic ulcer disease is typically relived by eating?

A

duodenal

pg 93

50
Q

Which type of peptic ulcer disease is typically worsened by eating?

A

gastric

pg 93

51
Q

Most common type of gastric polyp

A

inflammatory and hyperplastic polyps (75%)

pg 96

52
Q

Second most common type of gastric polyp

A

Fundic gland polyp (15%)

pg 96

53
Q

Least common gastric polyp

A 
gastric adenomas (10%)
pg 96
54
Q

What % of gastric adenomas become adenocarcinomas?

A

30%

pg 96

55
Q

90% of all stomach cancers

A

gastric adenocarcinomas

pg 100

56
Q

Hpertrophy/narrowing of the pyloric sphincter

A

pyloric stenosis

pg 102

57
Q

How common is pyloric stenosis?

A

1:~400

pg 102

58
Q

Classic symptom of pyloric stenosis

A

projectile vomiting

pg 102

59
Q

Risks for pyloric stenosis

A

family hx, Caucasians, males(4x), Turner syndrome

60
Q

Most common location of intestinal obstructions

A

small intestine

pg 106

61
Q

What % of intestinal obstructions are mechanical?

A

80%

pg 106

62
Q

Examples of mechanical obstructions

A

hernia, adhesions, intussusception, volvulus

pg 106

63
Q

Abdominal wall defect, allows a segment of intestine to protrude

A

hernia

pg 106

64
Q

Inflammation leading to fibrosis

A

adhesions

pg 106

65
Q

A proximal segment telescopes into a distal segment

A

intussusception

pg 106

66
Q

Twisting a loop of bowel

A

volvulus

pg 106

67
Q

Congenital out pouching of the small intestine

A

Meckel Diverticulum

pg 112

68
Q

What % of Merkel Diverticulum are symptomatic?

A

2%

pg 112

69
Q

Lack of neurologic ganglia in rectum

A

Hirschsprung disease

pg 114

70
Q

How is Hirschsprung disease usually dx’ed?

A

failure to pass meconium
severe dilation of proximal bowels
pg 114

71
Q

Hirschsprung disease is more common in ____(males or females)

A

males

pg 114

72
Q

Lessened blood flow to the large intestine

A

ischemic bowel disease

pg 117

73
Q

Arteries involved in ischemic bowel disease

A

superior mesenteric, inferior mesenteric, celiac

pg 117

74
Q

Causes of ischemic bowl disease

A

thrombosis, arterial, embolism, non-occlusive ischemia(heart failure, hemorrhage, shock), volvulus, dissecting aneurysm, scarring/stricture
pg 118

75
Q

Types of ischemic bowel disease

A

1) chronic
2) acute
pg 119

76
Q

Which type of ischemic bowel disease is the most dangerous?

A

acute
risk for septic or hypovolemic shock, 50% mortality
pg 119

77
Q

Risks for ischemic bowel disease

A

elderly, cardiovascular disease

pg 119

78
Q

Vascular lesion, submucosal & mucosal vessels are tortuous/dilated

A

angiodyplasia

pg 121

79
Q

Most common location for angiodyplasia

A

cecum

pg 121

80
Q

Angiodyplasia is the cause of what % of lower intestinal bleeds

A

20%

pg 121

81
Q

Dilated hemorrhoidal venous plexus

A

hemorrhoids

pg 122

82
Q

Most common GI vascular disorder

A

hemorrhoids (5% of adults)

pg 122

83
Q

Risks for hemorrhoids

A

> 50 years, increased intraabdominal pressure, liver cirrhosis
pg 122

84
Q

Types of hemorrhoids

A

1) internal
2) external
pg 123

85
Q

How do you distinguish a internal from external hemorrhoid?

A

Internal hemorrhoids are about the anorectal line, external are below
pg 123

86
Q

Common causes of malabsorption in the US

A

1) celiac disease
2) crohn disease
3) pancreatic insufficiency
pg 124

87
Q

Excessive fat in feces

A

steatorrhea

pg 125

88
Q

Characteristics of steatorrhea

A

bulky, frothy, greasy, yellow/gray diarrhea

pg 125

89
Q

Bloody diarrhea

A

dysentery

pg 125

90
Q

Features of malabsorption

A

weight loss, muscle wasting, abdominal distension, borborygmus, flatulence, anorexia
pg 126

91
Q

Consequences of malabsorption

A

vitamin deficiencies, iron-deficiency anemia, osteopenia, tetany, amenorrhea, impotence, infertility, hyperkeratosis, edema, peripheral neuropathies
pg 126

92
Q

Immune-mediated reaction to gliadin

A

celiac disease

pg 127

93
Q

Gluten breaks into what two components?

A

gliadin and glutenin

pg 127

94
Q

Common population with celiac disease

A

Caucasians, 30-60 years

pg 128

Systems Pathology 2 (8 decks)

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