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Pathology 3 > Final: ESO + ST > Flashcards

Final: ESO + ST Flashcards

1
Q

Esophageal webs

A
  • TWO LAYERS: submucosa and mucosa. NOT into muscular

- Congenital or acquired

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2
Q

Esophageal rings

A

THREE layers: submucosa, mucosa, muscularis

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3
Q

Achalasia

A
  • increased tone and pressure at LES
  • Barium: “bird’s beak”
  • path: lymphocytic infiltration of Auerbach’s plexus
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4
Q

Esophageal spasm

A
  • diffuse esophageal spasm (corkscrew)
  • uncoordinated contractions, esophagus contracts simultaneously
  • nutcracker esophagus
  • contractions proceed in a coordinated manner but AMPLITUDE excessive
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5
Q

Mallory-Weiss

A
  • bleeding at junction of stomach and esophagus

- MUCOSA and SUBMUCOSA but NOT muscularis

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6
Q

Boerhaave’s

A

full thickness tear

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7
Q

Esophagitis

A
  • most common cause: GERD

- infectious: candida, CMV, HSV (immunocompromised, HIV, DM)

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8
Q

GERD

A
  • mucosal damage to esophageal lining d/t stomach acid reaching esophagus
  • Causes: changes in barrier btw. ST and esophagus–LES relaxation, hiatal hernia
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9
Q

Hiatal hernia

A
  • sliding: GE junction moves ABOVE diaphragm w/ some of ST (most common)
  • Para-esophageal: ST herniated through diaphragm and lies beside the esophagus w/o movement of GE junction. WORSE
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10
Q

Shatzki ring

A

Also involves muscularis layer

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11
Q

Barrett’s esophagus

A
  • comonly associated w/ GERD. Pt at risk for adenocarcinoma
  • GOBLET cells.
  • Transfomration of squamous epithelium to columnar epithelium
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12
Q

Esophageal varices

A
  • Develops in patients w/ cirrhosis as a consequence of portal HTN
  • at risk for hemorrhage
  • esp assocaited w/ Hep C and ETOH abuse
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13
Q

Tumors of esophagus

A
  • benign: granular cell tumor, leiomyoma (most common), hemangioma
  • Benign tumors: usually smooth, non-ulcerated
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14
Q

Esophageal CA

A
  • two main forms: squamous cell carcinoma and adenocarcinoma
  • Squamous: UPPER part of esophagus; associated w/ TOBACCO and ETOH consumption
  • Adenocarcinoma: lower esophagus (squamo-columnar junction). Associated w/ GERD/Barrett’s
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15
Q

Congenital diaphragmatic hernia

A
  • usu on LEFT. ASX.
  • May compress lungs
  • Bochdalek hernia: left-sided (most common congenital hernia)
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16
Q

Congenital hypertrophic pyloric stenosis

A
  • hypertrophy of SM of pylorus.

- 2-3 weeks after birth, vomiting and regurgitation NON BILIOUS

17
Q

Gastric volvulus

A
  • SIGMOID colon.

- congenital or acquired

18
Q

Gastritis

A
  • Inflamed, hyperemic tissue. Blood btw. Tissue
  • Number one cause: H. Pylori. Number 2: NSAIDS
  • Duodenal: H. Pylori; Gastric: NSAIDS
19
Q

acute gastritis

A

Neutrophil infiltration

20
Q

H. Pylori

A
  • curved to spiral rod-shaped bacterium. Flagellated to burrow into stomach lining
  • Best test: SEROLOGY (however may be positive when infxn eradicated). Carbon breath test next best
21
Q

Peptic ulcer disease

A
  • benign: flat, smooth, regular edges
  • Malignant: angry, red, ulcerated
  • Not always accurate; either may present as both
22
Q

PUD complications

A
  • GI bleeding, perforation, gastric outlet obstruction, ulcer transformation into CA
  • pancreatitis or acute autodigestion of pancreas by pancreatic enzymes
23
Q

ZE syndrome

A
  • gastric acid hyper secretion d/t gastronome
  • Hundreds of ulcers; max dose PPIs have no effect
  • Tx: surgical resection of gastrinoma is curative
  • gastrinoma itself is found in PANREASE or DUODENUM. There are NO tumors in the ulcers themselves
24
Q

Menetriers disease

A
  • markedly enlarged gastric folds, increased amounts of mucus and DECREASED HCL
  • Two forms: adult–>over expression of TGF-alpha, Children–>post CMV for H. Pylori infection
25
Q

Atrophic Gastritis

A
  • loss of glandular cells (replaced by intestinal and fibrous tissues)
  • Two causes: persistent H. Pylori infection OR AI destruction of gastric lining
  • AI version predisposed to achlorhydria and gastric carcinoma (low acid is sig risk factor)
  • Also see B12 def/megaloblastic anemia
26
Q

Autoimmune Metaplastic Atrophic gastritis

A
  • AMAG–>immune response toward parietal cells and intrinsic factor (will find serum Ab to parietal cells and IF)
  • Associated w/ carcinoid tumors
27
Q

Carcinoid Tumors

A
  • range from benign, serotonin producing to highly malignant and undifferentiated
  • Excessive serotonin: loose stools.
  • histo: cells become abN large and nuclei stain deeper
28
Q

leiomyoma

A
  • benign SM tumor

- spindle shaped cells w/ dark staining nuclei

29
Q

gastric adenocarcinoma

A
  • like most cancers: increases mitosis, N:C ratio and hyperchromatism
  • signet ring cells: implies worse dx
30
Q

linitis plastica

A
  • Rare gastric CA; VERY poor prognosis

- ST transforms into leather-like scar tissue

Pathology 3 (10 decks)

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