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Pathology 3000 > Gastrointestinal Pathology > Flashcards

Gastrointestinal Pathology Flashcards

1
Q

Serosa

A

Outer layer of GI tract

Epithelium of peritoneum and connective tissue

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2
Q

Muscularis

A

Second to outermost layer of GI tract

Outer longitudinal layer, inner circular layer, myenteric plexus

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3
Q

Submucosa

A

Second from inner layer

Submucosal plexus, glands, blood vessels

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4
Q

Mucosa

A

Innermost layer

Smooth muscle, loose connective tissue, epithelium

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5
Q

Main functions of GI system

A

Ingestion, mastication, deglutition, digestion, absorption, excretion

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6
Q

Cleft lip

A

Congenital abnormality
Clefting of the lip, and sometimes palate
Due to failed fusion of nasal and maxillary processes in fetal development
Common to certain families
Repaired by modern orthodontic surgery

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7
Q

Dental caries

A

One of the msot common human diseases
Due to accumulation of bacterial plaques that erode through dentin and penetrate into the tooth
Prevented through water fluorination, brushing and dental hygiene

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8
Q

Stomatitis

A

Inflammation of the mouth

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9
Q

Causes of stomatitis (2)

A
  1. Herpes virus infection

2. Candida albicans infection (thrush)

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10
Q

Aphthous stomatitis

A

Canker sores

Painful, recurrent, spontaneous healing oral ulcers of unknown etiology

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11
Q

Oral cancers

A

Usually squamous cell carcinoma
Often related to alcohol and tobacco smoking
Some related to HPV

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12
Q

Morphology of oral cancer

A

Leukoplakia
Erythroplakia
Ulcer
Nodule

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13
Q

Leukoplakia

A

White plaque

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14
Q

Erythroplakia

A

Red plaque

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15
Q

Esophageal clinical presentations (5)

A
  1. Dysphagia
  2. Odynophagia
  3. Retrosternal burning
  4. Aspiration
  5. Regurgitation
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16
Q

Dysphagia

A

Difficulty swallowing

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17
Q

Odynophagia

A

Retrosternal chest pain during swallowing

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18
Q

Hiatal hernia

A

Sliding or paraesophageal
Proximal part of stomach herniates into thoracic cavity
Acquired condition

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19
Q

Paraesophageal hiatal hernia

A

Uncommon
Can be life threatening
Can become ischemic, and if it becomes necrotic a sugery is needed

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20
Q

Sliding hiatal hernia

A

Very common not usually clinically significant

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21
Q

Esophageal varices

A

Dilated veins in the distal esophagus
Usually due to portal hypertension in patients with cirrhosis of the liver
Rupture can result in catastrophic upper GI bleeding

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22
Q

Esophagitis

A

Inflammation of the esophagus, common causing heartburn

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23
Q

Causes of esophagitis (3)

A
  1. Reflux esophagitis
  2. Infectious esophagitis
  3. Chemical irritants
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24
Q

Reflux esophagitis

A

GERD

Due to reflux juices into esophagus

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25
Q

Infectious esophagitis

A

Viruses (HSV), fungi (Candida)

typically in immunosuppressed persons

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26
Q

Chemical irritants

A 
Exogenous chemicals (lye)
Pill (medications, getting stuck)
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27
Q

Carcinoma of the esophagus

A 
4% of cancers
Higher incidence in Asia and Africa
Poor prognosis
Squamous cell carcinoma (upper or lower)
Adenocarcinoma in lower develops in Barrett's esophagus (intestinal metaplasia)
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28
Q

Barrett’s esophagus

A

Biggest risk factor for cancer
Due to reflux
Adenocarcinoma, can metastasize throughout intestines

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29
Q

Stomach clinical presentations (5)

A
  1. Pain
  2. Vomiting
  3. Bleeding
  4. Dyspepsia
  5. Systemic consequences (B12 deficiency, anemia)
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30
Q

Hematemesis

A

Vomiting blood

31
Q

Melena

A

Black tarry stool

32
Q

Dyspepsia

A

Abdominal discomfort

33
Q

Gastritis

A

Acute or chronic

34
Q

Acute gastritis

A

Erosive
Stress, shock, food, exogenous chemicals, drugs
Ulcerations

35
Q

Chronic gastritis

A

Helicobacter pylori related

Autoimmune (with pernicious anemia)

36
Q

Peptic ulcers

A

Can bleed
Multifactorial
Mucosa is broken and replaced by granulation tissue
Can erode into an artery and cause significant hemorrhage

37
Q

Peptic ulcers contributing factors (3)

A
  1. Gastric acid
  2. Mucosal barrier defects (stress, shock, NSAIDs, smoking)
  3. Helicobactor pylori infection
38
Q

Peptic ulcer complications (4)

A
  1. Hemorrhage
  2. Penetration into the pancreas
  3. Perforation (peritonitis)
  4. Cicatrization
39
Q

Cicatrization

A

Scarring, stenosis

40
Q

Gastric tumors

A

Benign or malignant

41
Q

Benign gastric tumors

A

Polyps

42
Q

Malignant gastric tumors

A

Adenocarcinoma, lymphoma

43
Q

Carcinomas of the stomach

A

Adenocarcinoma
More common in Japan and Chile
Etiology is not clear - nitrosamines in food, H pylori
Superficial, polypoid, ulcerated, diffuse infiltrating

44
Q

Linitis plastica

A

Carcinoma of the stomach
Diffuse infiltrating
Stomach becomes very hard, like leather

45
Q

Intestines clinical presentations (5)

A
  1. Diarrhea
  2. Blood in stool
  3. Abdominal pain
  4. Obstruction
  5. Weight loss
46
Q

Gastrointestinal infections

A

Often cause acute, self-limited diarrheal illness (excluding Giardia)

47
Q

Causes of infectious diarrhea (4)

A
  1. Viral infections
  2. Bacterial infections
  3. Bacterial toxins
  4. Parasites
48
Q

Viral infections causing diarrhea

A

Rotavirus, Norwalk virus

49
Q

Bacterial infections causing diarrhea

A

E coli, Campylobacter jujuni, Clastridium difficile

Travels diarrhea

50
Q

Bacterial toxins causing diarrhea

A

Shigella toxin
Food poisoning
Usually the same day

51
Q

Parasites causing diarrhea

A

Giardia lamblia

52
Q

Malabsorptive syndromes

A

Inability of intestine to absorb nutrients from food

Most common in Canada is Celiac sprue

53
Q

Celiac sprue

A

Hypersensitivity to gliaden (break down of gluten)
Injury to duodenal villi causes them to be flattened
Weight loss, diarrhea, nutritional deficiencies

54
Q

Inflammatory bowel disease

A

Chronic inflammation disease of the intestines
Causes chronic abdominal pain and diarrhea (blood, mucus)
Crohns and Ulcerative Colitis
Might be familial

55
Q

Crohns Disease

A

Segmental distribution, including small intestine
Thickening of wall with stricture of the intestine
Deep, transmural ulcers, inflammation
Granuloma, fistula, cancer
Cobblestone inflammation

56
Q

Ulcerative Colitis

A

Continuous involvement of the colon
Limited to mucosa, but can have superficial ulcers and inflammatory pseudopolyps
Never involves ileum, small intestine and is never patchy

57
Q

Causes of intestinal obstruction (2)

A
  1. Paralytic ileus

2. Mechanical (obstructive) ileus

58
Q

Mechanical ileus (7)

A
  1. Atresia or stenosis
  2. Stricture
  3. Intussusception
  4. Volvulus
  5. Hernia
  6. Adhesions
  7. Neoplasms
59
Q

Intussusception

A

Invagination of one segment of the intestine into the following segment

60
Q

Volvulus

A

Twisting of the intestine around its mesenteric root, which cuts off blood supply

61
Q

Hernia

A

Protrusion of the abdominal contents into the abdominal wall
Usually due to weakness or defect in abdominal wall
Bowel can close off and become necrotic
Asymptomatic except bulge

62
Q

Diverticulosis of the colon

A

Outpouchings of the colon
Congenital or acquired due to increased intraluminal pressure in sigmoid
Very common in Canada

63
Q

Complications of diverticulosis of the colon

A

Inflammation, strictures, fistulas, rupture causing peritonitis

64
Q

Hemorrhoids

A

Dilated submucosal veins in anal canal

Bleeding, pain

65
Q

Angiodysplasia

A

Abnormal submucosal vessels that can bleed in the colon

66
Q

Ischemic bowel disease (3)

A
  1. Acute thrombosis of mesenteric arteries, veins (mesenteric thrombosis)
  2. Vasculitis
  3. Mechanical obstruction of vessels
67
Q

Mesenteric thrombosis

A

Ischemic bowel disease
Can be due to atherosclerosis
Infarction of intestines, can be fatal

68
Q

Intestinal neoplasms

A

Colon mostly
Epithelial tumors (adenomas/carcinomas) are 90%
More common than lymphomas or mesenchymal tumors

69
Q

Classification of intestinal tumors (3)

A
  1. Non-neoplastic polyps
  2. Benign neoplasms
  3. Malignant neoplasms
70
Q

Non-neoplastic polyps of the intestine

A

Hyperplastic polyp, inflammatory polyp, juvenile polyp, Peutz-Jeghers polyp

71
Q

Benign neoplasms of the intestine

A

Tubular ademona, villous adenoma, tubulovillous adenoma, benign stromal tumors

72
Q

Malignant neoplasms of the intestine

A

Adenocarcinoma, carcinoid, lymphona, sarcoma

73
Q

Carcinoma of the large intestine

A

Third most common cancer of the interal organs

74
Q

Genetic factors - Colon Cancer (2)

A
  1. Familial adenomatous polyposis

2. Hereditary non-polyposis colorectal cancer (Lynch syndrome)

Pathology 3000 (14 decks)

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