Gastrointestinal Flashcards
Cleft lip and palate embryologic defect
Failure of the facial prominences to fuse
Bechet syndrome triad
REcurrent oral aphous ulcers
Genital Ulcers
Uveitis
Aphthous ulcer is composed of
granulation tissue
HSV1 remains dormant in which structure
Trigeminal ganglia
2 precursor lesions of sq cell carcinoma of mouth
Leukoplakia
Erythroplakia
How to differentiate Leukoplakia, thrush and hairy leukoplakia
Leukoplakia cannot be scraped away (thrush can)
Hairy leukoplakia is on LATERAL tongue and is hairy looking
4 organs affected by mumps
Bilateral parotids
Orchitis
Pancreatitis
Meningitis
Siladenitis presentation
unilateral parotid swelling
Siladenitis cause
Parotid stone –> S. aureus infection
Pleomorphic adenoma components
Stroma and epithelial tissue –> BIPHASIC
How to distinguish beign/malignant parotid gland tumors
Malignant tumors affect facial nerve
weakness, decreased lacrimation, salivation and taste
Pleomorphic adenoma recurrence rate
High b/c it has irregular borders –> incomplete resections
Cystic tumor with lymphoid tissue and germinal centers in the parotid
Warthin tumor
TE fistula presentation (4)
Vomiting and coughing with FIRST FEEDING
Abdominal distension
Polyhydramnios
Esophageal web is a protrusion of which layer
Esophageal mucosa only
Esophageal web presentation
dysphagia for solids
Zenker diverticulum layers
Mucosa only (false diverticlum)
Zenker location
b/w upper esophageal sphicnter and pharynx
Zenker presentation
Halitosis
“feels like lump in throat”
Dysphagia
Painful hematemesis in bullemic or alcoholic
Mallory Weiss
Mallory weiss defect
longitudinal of mucosa at Gastroesophageal junction
Subcutaneous emphysema w/ shoulder pain
Borhaave syndrome –> ruputred GE junction
Painless and Massive hemetemesis of bright blood
Ruptured esophageal varicies
Esophageal varicies veins
L gastric vein + azygos vein/esophageal vein
Dysphagia for solids + liquids with halitosis
Achalasia
Achalasia underlying defect
No ganglion cells in myenteric plexus = no VIP = no relaxation
Imaging findings in Achalasia
Dilated esophagus
Increased LES pressure
infectious cause of achalasia
Trypanasoma cruzi
HIatal hernia
Cardia of stomach herniates into esophagus–> GERD
Paraesophageal hernia
Cardia herniates lateral to esophagus, above diaphragm
“bowel sounds in the lung fields” is characteristic of
Paraesophageal hernia
Classic GERD presentation
Heartburn
Persistent cough
late complication of GERD
Ulceration w/ stricture
what causes strictures in GERD
loss of mucosa = loss of stem cells = fibrosis
specific cell changes that occur in Barrets Esophagus
Non Keratinized Stratified Squamous epithelium –> Non ciliated columnar epithelium w/ goblet cells
Adenocarcinoma of esophagus location
lower 1/3
3 major risk factors for adenocarcinoma
GERD
Hiatial Hernia
Barret Esophagus
Sq Cell carcinoma of esophagus location
Upper 2/3
3 classic presentations of esophageal cancer
Dysphagia for solids that progresses to liquieds
Hematemesis
Weight loss
Sq cell carcinoma has which unique symptom
Hoarseness and cough
cancer in upper 1/3 mets to which nodes
cervical nodes
cancer in lower 1/3 mets to
celiac / gastric nodes
Middle 1/3 mets to
mediastinal / tracheobronchial nodes
failure of the lateral folds of the ventral wall causes
Gastroschisis (not covered by peritoneum)
Omphalocele
Omphalocele is a failure of
Bowel to return to abdominal cavity from umbilical cord
non billous vomiting several weeks after birth + abdominal mass
Pyloric stenosis
Sever hypovelmia causing an ulcer is called
Curling ulcer
2 mechanisms by which NSAIDs cause gastritis
Decreased PGE2 = More acid, less mucus
Increased intracranial pressure causing ulcers is called
Cushing ulcer –> increased vagal stimulation = increased acid
erosion vs ulceration
erosion - epithelium only
ulceration = entire mucosa and beyond
autoimmune gastritis is which type of hypersensitivity
TYpe IV
where are parietal cells located
boidy and fundus
4 features of pernicious anemia
Mucosal atrophy
Achlorhydria
Megaloblastic anemia
Intestinal type gastric cancer
H pylori affects which area
pylorus, antrum
2 cancers H pylori increases risk for
Intestinal type adenocarcinoma MALT lymphoma(marginal zone)
2 tests to determine presence of H.pylori
+ urea breath test
Ag present in stool
Histology of H pylori
The align the mucosal cells but do not invade
Type of ulcers caused by h pylori
duodenal
How to differentiate b/w gastric and duodenal ulcer in HPI
duodenal = improved pain with meals (bicarb secreted)
Gastric = worse with meals (acid secreted)
2 complications of posterior duodenal ulcer rupture
gastroduodenal artery rupture
Pancreatitis
2 complication of gastric ulcer rupture
Left gastric artery rupture (on lesser curvature)
Intestinal type adenocarcinoma
3 risk factors for intestinal type gastric cancer
Chronic gastritis from any cause
Bllod group A (type A for cA)
Nitrosamines in bbq food
2 features of diffuse type gastric cancer
Signet ring cells
Desmoplasia –> linitis plastica
Patient develops tons of seborrhic keratoses within a week and acanthosis nigracans…suggestive of?
Gastric cancer
Left supraclavicular node enlargement is suggestive of
GI cancer…particularly Gastric
lymph node affected by intestinal type
periumbilical node
intestines are near the umbilicus
Bilateral ovary metastisis is common in which type of gastric cancer
diffuse
will see signet ring cells in ovary
billous vomit with duodenal distension
duodenal atresia
2 conditions associated with down syndrome
Duodenal Atresia
hirsprungs
meckel diverticulum layers
TRUE diverticulum. all layers are involved
2 embryonic correlations to meckel diverticulum
Persistent omphalomesenteric duct
Persistent viteline duct
most common cause of painless hematochezia in kids? adults?
Kids- meckel
Adults- diverticulosis
General rule for infarction/bloody diarrhea
Infarction = Bloody diarrhea!
2 MCC sites of volvulus
sigmoid in adults
cecum in kids