Gastrointestinal

Question 1

Achalasia

Answer 1

“failure to relax”/functional obstruction

absence of esophageal peristalsis and impaired relaxation of lower esophageal sphincter

Question 2

achalasia clinical manifestation

Answer 2

dysphagia, odynophagia, pyrosis aspiration of food and liquid, inflammation of esophageal myenteric plexus, dilation above and below obstruction

Question 3

Esophageal varices

Answer 3

venous blood from the gastrointestinal tract is delivered to the liver via the portal vein before reaching the inferior vena cava

Question 4

hiatal hernia

Answer 4

protrusion of the stomach above the diaphragm through a widened diaphragmatic hiatus

Question 5

sliding hernia

Answer 5

the gastroesophageal junction is pulled into the thorax and is found above the diaphragm

Question 6

paraesophageal hernia

Answer 6

gastroesophageal junction is in the normal location BUT a portion of the stomach rolls up beside it into the thorax. (may be strangulated by the diaphragm)

Question 7

Gastroesophageal reflux disease

Answer 7

gastric acid makes its way into the lower part of the esophagus

Question 8

GERD morphology

Answer 8

eosinophils are recruited into the squamous mucosa followed by neutrophils which usually are associated with more severe injury + basal zone hyperplasia +elongation of lamina propria papillae

Question 9

Barrett Esophagus

Answer 9

replacement of distal esophageal normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells

Question 10

barrett esophagus morphology

Answer 10

patches of red, velvety mucosa extending upward from the gastroesophageal junction

Question 11

diagnosis of barrett esophagus

Answer 11

endoscopic evidence of ABNORMAL MUCOSA above the gastroesophageal junction + histologically documented gastric or intestinal METAPLASIA

Question 12

Esophageal adenocarcinoma

Answer 12

tumors produce mucin and form glands

Question 13

esophageal squamous cell carcinoma

Answer 13

begins as an in situ lesion in the form of squamous dysplasia (gray-white plaque like thickening)

Question 14

cushing ulcers

Answer 14

arising in the stomach, duodenum, or esophagus of persons with brain injury, have a high incidence of perforation

Question 15

curling ulcers

Answer 15

occurring in the proximal duodenum and associated with severe burns or trauma (reduced fluid or blood > ischemic death + sloughing off)

Question 16

stress ulcers

Answer 16

occurs in critically ill patients with shock, sepsis, or severe trauma

Question 17

Helicobacter pylori gastritis

Answer 17

high acid production in the antral end of the stomach - creates an imbalance between gastroduodenal mucosal defenses and damaging forces through its flagellum, urease, adhesins, and toxins

Question 18

helicobacter pylori gastritis morphology

Answer 18

neutrophils, lymphoid aggregates, intestinal metaplasia

Question 19

autoimmune gastritis

Answer 19

antibodies to parietal cells and intrinsic factor

Question 20

Peptic Ulcer Disease

Answer 20

a

Question 21

Hirschsprung disease

Answer 21

congenital megacolon