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