Gastrointestinal tract Pathology Flashcards
most common form of congenital intestinal atresia
imperforate anus
most common type of TEF
type C
h’
[diagnosis: diaphragmatic hernia]
posterolateral defect, usually on the left; more common
bochdalek
[diagnosis: diaphragmatic hernia]
anteromedial defect
morgagni
[diagnosis]
herniation of abdominal viscera through an enlarged umbilical ring; (+) amnion sac
omphalocele
[diagnosis]
herniation of abdominal viscera directly into the amniotic cavity; usually on the right of the umbilicus
gastroschisis
[diagnosis]
failed involution of vitelline/omphalomesenteruc duct
meckel diverticulum
rule of 2 of meckel diverticulum
2% of the population 2 feet of the ileocecal valve 2 inches long 2x more common in males 2 years old when most often symptomatic 2 types of common ectopic tissue (gastric and pancreatic)
[diagnosis]
associated with turners syndrome, trisomy 18, erythromycin/azithromycin exposure during 1st 2 weeks of life
pyloric stenosis
[diagnosis]
new-onset regurgitation, feeding abnormalities, 1-2cm abdominal mass
pyloric stenosis
[diagnosis]
failure to pass meconium, explosive passage of flatus and feces; megacolon
hirschsprung disease
in hirschsprung disease, the aganglionic segment is ___ (dilated/constricted)
constricted
[type of esophageal obstruction]
dysphagia to both solids and liquids; static dysphagia
functional obstruction
[type of esophageal obstruction]
dysphagia first to solids then liquids; progressive dysphagia
mechanical obstruction
[functional esophageal obstruction]
high amplitude contractions of the distal esophagus
nutcracker esophagus
[functional esophageal obstruction]
repetitive simultaneous contractions of the distal esophageal smooth muscle
diffuse esophageal spasm
[diverticula]
increased wall stress above LES
epiphrenic diverticula
[diverticula]
increased wall stress above the UES
pharyngoesophageal (zenker) diverticula
___ muscle is associated with the pharyngoesophageal diverticula
cricopharyngeus muscle
[diagnosis]
incomplete LES relaxation, increase LES tone, esophageal aperistalsis
achalasia
postocaval anastomosis associated with esophageal varices
esophageal branch of left gastric vein and azygous vein
[diagnosis]
red velvety mucosa, presence of goblet cell, intestinal metaplasia
barrett esophagus
[diagnosis: esophageal CA]
associated with hot drink ingestion, HPV, caustic esophageal injury, commonly seen at the middle third of esophagus
squamous cell CA
[diagnosis: esophageal CA]
associated with chronic GERD, H. pylori; commonly seen at the distal third of esophagus
adenoCA
[diagnosis: esophageal CA]
precursor lesion: barrett esophagus
adenoCA
[diagnosis]
dysphagia, odynophagia, hematemesis, obstrcution, symptoms of GERD, weifht loss
esophageal CA
[diagnosis: gastritis]
dominant infiltrate in acute gastritis
neutrophils
[diagnosis: gastritis]
dominant infiltrate in chronic gastritis
mononuclear infiltrate
[diagnosis]
imbalance between mucosal protective mechanism and injurious stimuli in stomach
gastritis
[diagnosis]
intact surface epithelium with foveolar cell hyperplasia; superficial mucosal defect due to epithelial loss
acute gastritis
[ulcers]
proximal duodenal ulcers associated with severe burns and trauma
curling ulcers
[ulcers]
ulcers associated with increased ICP
cushing ulcers
gram negative, microaerophilic, urease-positive, helical bacterium, motile, lophotrichous flagella
H. pylori
[gastritis]
seen in antrum, subepithelial plasma cells, hyperplastic/inflamatory, loss of chief cell, presence of neutrophils, intestinal metaplasia,
H. pylori associated
[gastritis]
seen in the body, lymphocytes, macrophages, neuroendocrine hyperplasia, antibodies to parietal cells, gastric glands present, endocrine cell hyperplasia,
autoimmune gastritis
[diagnosis: ulcer]
mucosal atrophy, decreased gastric acid secretion, epigastric pain with meals or shortly after meals, no nocturnal awakening, associated with adenoCA
gastric ulcer
[diagnosis: ulcer]
antral gastritis, increased Gi secretion, epigastric pain several hours after meals, nocturnal awakening present, not associated with gastric adenoCA
duodenal ulcer
[diagnosis]
cerebriform enlargement of rugal folds due to epithelial hyperplasia without inflammation
hypertrophic gastropathies
[diagnosis]
hypoproteinemia due to protein-losing enteropathy
menetrier disease
[diagnosis]
- gastrinoma/ pancreatic islet tumor
- gastric hypersecretion
- peptic ulcer disease
zollinger-ellison syndrome
most common GI malignancy
adenoCA
most common site of extranodal lymphomas
stomach
most common mesenchymal tumor of abdomen
GIST
[diagnosis]
dense, lymphocytic infiltrate in lamina propria; low grade GI tumor that can transform to DLBCL
coarsely nodular mucosa
CD19, CD20 (+)
CD5, CD10 (-)
CD43 (+)
gastric lymphoma/MALT lymphoma
most important prognostic factor in GI carcinoids
location
____ (location) carcinoids are often multiple and agressive
midgut
[diagnosis]
tumor originating from the Interstitial cells of Cajal
KIT(+)
GIST
prognostic factors that determine the clinical behavior of GISTs
grade, tumor size, location
most common cause of intestinal obstruction
hernias
most common cause of intestinal obstruction in children
intussusception
most common site of ischemic bowel disease
colon, splenic flexure
watershed areas of the bowel
sigmoid colon and rectum
hallmark of malabsorption syndrome
steatorrhea
[diagnosis]
antibodies agains transglutaminase, CD8 T-lymphocytes within villus, triggered by exposure to gliadins
celiac disease
[diagnosis: IBD]
transmural wall involvement, , any part of GIT; noncaseating granuloma; fat malabsorption
Crohns Disease
[diagnosis]
mural wall involvement, colon and rectum; toxic megacolon, no recurrence after surgery, marked pseudopolyp
Ulcerative colitis
[diagnosis]
paneth cell metaplasia (left colon)
CD
[diagnosis]
skip lesions, ileum and colon involvement, thick wall, deep knife-like ulcers
CD
[diagnosis]
diffuse lesions, colon only, strictures are rare, thin, superficial, broad based ulcers
UC
most common site of diverticular disease
sigmoid colon
cut-off for polyp to be considered to have high malignacy risk
> 4cm
[diagnosis: polyp]
elephant-feet glands, seen in the right colon, high malignant potential, absent dysplasia
sessile serrated
[diagnosis: polyp]
multiple GI hamartomatous polyp and mucocutatenous hyperpigmentation, autosomal dominant
peutz-jegher polyp
[diagnosis: familial tumor syndrome]
APC gene mutation in Ch 5
FAP
[diagnosis: familial tumor syndrome]
MSH2, MLH1 gene mutation
HNPCC
Cite the Amsterdam criteria for lynch syndrome
3 family members (first degree, FAP ruled out)
2 generations
1 diagnosed under age 50
most common site of metastasis of colon CA
liver
[diagnosis: colon CA]
bulky, exophytic, tumor bleed, IDA, weakness, fatigue
Proximal colon (right sided) colon CA
[diagnosis: colon CA]
napkin-ring, annular configuration, marked change in bowel habits, bowel obstruction
distal colon (left sided)
[diagnosis: hemorrhoids]
intestinal-type lining, absent pain except when thrombosed, superior hemorrhoidal plexus involved
internal hemorrhoids
[diagnosis: hemorrhoids]
stratified squamous, non-keratinizing lining, pain is present, involved inferior hemorrhoidal plexus
external hemorrhoids
most common cause of acute appendicitis in children
lymphoid hyperplasia
most common cause of appendicitis in adults
fecalith
most common well-differentiated neuroendocrine tumor, that is almost always benign
appendicial tumor
cite examples of enteric bacteria that can cause peritonitis
- Staphylococcus
- Streptococcus
- C. perfringes
most common primary soft tissue tumor of the peritoneum
desmoplastic small round cell tumor
Most frequently detected mutation in pancreatic CA
KRAS
Migrating thrombophlebitis of the superficial vein. Paraneoplastic. Pancreatic CA
Trosseau Sign
