Gastropatho Flashcards
(129 cards)
1
Q
where are bile salts reabsorbed
A
terminal ileum
2
Q
Heterotrophic salivary gland trapped in lymph node is
A
Warthin tumor
3
Q
What is the mneumonic for warthin tumor
A
Warriors in germany love smoking
4
Q
what is the most common salvary gland tumor
A
pleomorphic adenoma
5
Q
2 main problems in achalasia
A
1) disordered esophageal motility
2) inability to relax LES ( loss of post ganglionic inhibitory neurons that contain NO and VIP)
6
Q
what do we see on endoscopy in eosinophilic esophagitis
A
esophageal rings and linear furrows.
7
Q
boerhave which part of the esophagus
A
distal esophageal rupture
8
Q
difference between hematamesis of esophageal varices and mallory weis
A
wehde painful wehde painless
9
Q
sclerodermal esopheag motillity due to what
A
smooth muscle atrophy –> dec LES pressure and dysmotility
10
Q
what are drugs that cause pill esophagitis
A
bisphosphonates - tetracyclines - potassium chloride - NSAIDS and iron
11
Q
plummer vinson has increased risk of
A
esopheal squamous cell carcinoma
12
Q
Obesity can lead to ? cancer ? why?
A
adneocarcinoma due to increase in abdominal pressure that can lead to hiatel hernia –> gerd –> cancer ( adenocarcinoma )
13
Q
achalasia can lead to what cancer
smoking to what
A
both can lead to squamous and adeno
14
Q
squamous epithelium? adde mnl esophageous
A
upper 2/3 from esophageous
15
Q
most common cause of squamous cell carcinoma is
A
alcohol
16
Q
adult onset GERD . keep in mind
A
asthma
17
Q
DM and GERD how does it present
A
ma bekun 3ndon heartburn w hal osas krml asln ma be7eso . bas they present as nocturnl cough and hoarsness
18
Q
GERD histology
A
basal zone hyperplasia
elongation of lamina propria with scattered eosinphils and neutrophils
19
Q
corpus of stomach is the
A
body
20
Q
parietal cells location
A
body and fundus
21
Q
Vit B12 def in a setting of autoimmune disease suggests
A
pernicous anemia
22
Q
difference between ulcer and erosion
A
erosion : loss of epithelial layer ( can extend to muscularis mucusa y3ni b3dna bil mucusa )
ulcer : extends kela loss of mucusal layer - submucusa
23
Q
chronic gastritis leads ato atrophy of parietal cells and ?
A
intestinal G cells metaplasia ( increase risk of gastric cancers ) and maltoma
24
Q
H pylori affect what part of stomach
Autoimmune affect what part
A
H pylori: antrum and duedeum
Autoimmune : fundus / body
25
hypersensitivity of autoimmune gastritis
type 4 hypersensitivity ( CD4 +)
26
menetrier disease cause - can lead to - histology
hypoalbuminenia
gastric adenocarcinoma
hyperplasia not inflammation
27
type A blood increase risk of what cancer
Gastric intestinal
28
intestinal gastric cancer is more common where in stomach
lesser curvature
29
chronic gastritis increase risk of what >
intestinal gastric cancer
30
Gross image of gastric cancer diffuse
stomach wall grossly thickened ( llinitis plastica)
31
duedenal ulcer hypertrophy of what glands
brunner ( found in duedenum
32
Keef el H pylori bt2ze?
1) depletion of somatostain producing cells
| release cytotoxins that inhibit proudction of bicarb --> ulcer
33
celiac disease what hypersenistivity?
type 4
34
dermatitis herpitififomis what layer
dermis papilla
35
celiac what layer
lamina propria
36
celiac increase risk of what cancer . if we control celiac, doe sthe risk decrease?
t cell lymphoma - no
37
Celiac disease HLA
HLAQ2 HLAQ8
38
lactose intolerance : stool ph keef ? why ?
decreased due to the colonic bacteria fermenting lactorse and changing it to short fatty acid like acetate w hek --> decrease pH of stool
39
pancreatic insuffieciency fat voluble be2el and what vit
VIT b12 ( unknown mechanism leh)
40
pancreatic insuffiecncy fe
dec in duedenal pH and fecal elastase
41
fecal elastase is a
noninvasive stool marker of pancreatic exocrine function
42
tropical sprue versus celiac sprue location
both deu je bas tropical kamem ileum
43
tropical sprue assocuated with what anemia
megaloblastic anemia ( folate andV12)
44
treatment of whipple
ceftriaxone
45
perianal disease asssociated with
crohn ( sah spares rectum bas ma khas el anus)
46
bile acid absorbed in
terminal ileum
47
TG absorbed in
jejunem
48
PAS
Carb in tissue
49
theory of tropical sprue
infection --> inflammation --> bacterial overgrowth
50
diverticulum lacks what layer
Muscularis layer
51
mnuemonic for zenker
Elderly MIKE
52
zenker cause
cricopharngeal problem inn motility --> increase pressure --> pouch muscle weaknes in psterior hypopharynx
53
omphalomesentric cyst
cystic dilation of vitelline duct
54
most common congenital anomaly of GI tract is
Meckel
55
hirshprung cause
FAILURE of neural crest cell migration that occurs very early and happens caudally
56
cause of intessuption in adults
tumor
57
cause of intessuption in chidlren
rota virus
| adenovirus --> peyer patches hypertrophy --> lead point( lymphooid hyperplasia_
58
thumbprint sign due to mucusal edema seen in
colonic ischemia
59
premature formula + postal vein gas
necrotizing enterocolitis
60
well demarcated necrotic zones seen in
adhesion
61
hirshprung associated with mutation in what?
RET
62
which cancer more aggresisve the colitis associated or sporadic
colitis because mutifocal and flat earl p53 and late APC . 3ks lsporadic ( early APC and later p53)
63
overexpression of COX 2 has been linked to ?
colorectal cancer .
64
example of a mismatch repair gene
MLH1
65
histology of cirrhosis
diffuse bridging fibrosis ( via stellate cells) and regenerative nodules
66
cirrhosis lead to an increase in estrogen that leads to?
1) gynecomastia
2) spider angiomata
3) palmar erythema
67
bil cirrhosis, sho by3mlo el stellate cells
they transform into myofibroblasts secrete TGF beta --> deposit type I collagen ( lie beneath the endothelial cells)
68
what are the functional liver markers
albuminin- bilirubin - PT - platlets
69
for Spontaneous bacterial peritonitis give C
cefotaxime
70
AST is located where in the cell? and this explain why it is more affected by what pathology?
AST think inside so mitochondria and since alcohol is a mitochondrial liver toxin then it will be affected in alcoholic liver disease
71
AST> ALT in NASH suggests
progression to fibrosis
72
where do we see malory bodies
alcoholic hepatitis
73
what are mallory bodies?
intracytoplasmic eosinophilic inclusions of damaged keratin filaments
74
fibrosis and regenerative nmodule sthink
Alcoholic cirrhosis
75
NASH long term can lead to
cirhosis and HCC
76
swollen and necrotic hpatocytes with neurtophilic infiltration
alcoholic hepatitis
77
which tumor secreats EPO
kidney - liver
78
increase AFP
liver cancer, liver diseases
79
aflatoxin from aspergillus induce what mutation
p53
80
angiosarcoma
malignant associated with arsenic- vinyl chloride
81
UCB or CB water soluble and can be filtered by kdiney out
CB loosly bound to albumin
82
dubin johnson due to defect in what
MRP2 ( defective canalicular secretion)
83
granulomatous destruction of bile ducts seen in
PBC
84
what ethinicty is relayed to gall stone disease
Native american
85
brown pigment stones are related to
infections ( mnruh 3nd mr.brown besir 3na infection)
86
TPN and alcoholic cirrhois sassociated with what type of stones
pigment stones
87
causes of acalculous cholecystitis :
gallbladder stasis- hypoperfusion(ischemia) - infection(CMV)
88
failure to visualize gallbladder on HIDA suggest
obstruction
89
calcified gallbladder is
porcelain
90
ascending cholangitis
| raynolds?
```
jaundice
fever
RUQ
reynolds:
altered mental status
shock
```
91
why does TPN lead to gallstones
because no nutrients reach the gut so no secretin-CCK - bile secretion--> cholesterol builds up
92
what stones does crohn lead to ?
chol: no absoption of bile acids in terminal ileum .
| andpigment since no absoption of Vit B12 --> hemolysis --> pigment stones
93
leh akcoholic cirhosis lead to gallstones
liver cannotmake bile acid anymore
94
where do we see suprammamary / impacted teeth
gardner syndorme
95
what charactraistic of poly most relate with risk of malignanyc
size
96
Villous adenoma release
mucus . so secreatry diarrhea
97
which part of the colon is always involved in lynch
proximal colon
98
right side tumors more associated with what mutations
| left side tumors?
right side = microsatellite instability
| left side = APC ( which is chromosomal instability pathway )
99
what do we see on barium enema in colon cancer
apple core lesions
100
loss of APC bil sura el kalemet ele tahet
decrease in intercellular adheson
| increase in proliferation
101
CRC with microsatellite instabikity pathway betun what poly
serrated
102
APC on what chromosome
5
103
in wilson , the mutation is in which gene
ATP7B
104
wilson can present with what renal disease
Fancomi
105
el deposits in wilson disease besiro bi aya membrane of eye
descemet
106
wilson which chromosome/
chromosome 13
107
ATP7B gene in wilsone responsible for
1) excreates Cu in bile
| 2) inserts cuppor in ceruloplasmin and release it to blood
108
hallmark of Wilson
decrease cerulosplasmin in serum .
109
what exam do we use to detect wilson kleyser fisher
slit lamp exam
110
treatment of wilson
penicillamase
trientine
oral zinc
111
hemochromastosis on ch . associated with which HLA , C282Y > H63D
6
| HLA A3
112
wilson increase risk of
hcc
113
HISTOLOGY OF hemochromatosis is
micro nodular cirrhoisis
114
hemochromatosis can lead to shi khaso bil gonads and shi joints
```
hypogonadosim
arthropathy ( callcium pyrophosphate deposition)
```
115
labs in hemochromo . iron - ferritin - TIBC - saturation
high high low high .
116
transfeerin saturation is
iron / TIBC
117
treatment if hemochromo
chelation with deferasirox , rebeated phlebotomy , deferoxamine , defirprone
118
with primary sclerosing cholangitis , fe increased risk of of 2 cancers
cholangiocarcinoma and gallbladder cancer
119
granuloma in bile ducts
primary biliary cholangitis
120
2 things increase risk of cholangiocarcinoma
```
primary sclerosing cholangitis
clonorchis sinesis( chinese liver fluke)
```
121
primary biliary cholangitis looks on pathology like
graft versus host disease
122
what drugs can increase risk of pancreattis
```
sulfa drugs
NRTI
protease inhibitors
GLP1
6 MERCAPTO
```
123
mneumonic of pancreatitis
I GET SMASHED
124
3 complications of chronic pancreatitis
pancreatic insuff manifesting as steatorhea , fat soluble vit def , and diabetes - pseudocyst - splenic vein thrombosis
125
gastric veins in fundus think
splenic vein thrombosis
126
pancreatitis and child think
| first cause pancreatitis and adults think
CF
| Alcohol
127
pancreatitic adenocarcvinoma when it presents, it presents as
abdominal pain radiating to the back
128
courvoiser sign
obstructive jaundice with palpable non tender gallbladdder
129
amylase and lipase in chronic pancreatitis can be
normal le2ano asln batal fe enzymes
