Gen Path Exam 3 - GI Pathology Flashcards
What type of disease?
Gastroesophageal reflux disease (GERD)
Injury
What type of disease?
Barret esophagus
Injury
What type of disease?
Peptic ulcer disease
Injury
What type of disease?
H pylori gastritis
Infection
What type of disease?
Familial adenomatous polyposis
Developmental
What type of disease?
Peutz-Jeghers syndrome
Developmental
What type of disease?
Celiac disease
Immune-mediated
What type of disease?
IBD - ulcerative colitis & Crohn’s
Immune-mediated
What type of disease?
Esophageal adenocarcinoma
Neoplasia
What type of disease?
Esophageal squamous cell carcinoma
Neoplasia
What type of disease?
Gastric adenocarcinoma
Neoplasia
What type of disease?
Adenomatous polyp
Neoplasia
What type of disease?
Colorectal adenocarcinoma
Neoplasia
What type of disease?
Mallory-Weiss tears
Injury
What are the causes of Mallory-Weiss syndrome?
Esophageal lacerations
Induced by severe vomiting
Patients with which diseases are affected by Mallory-Weiss syndrome?
Bulimia
Alcoholism
What is the clinical presentation of Mallory-Weiss syndrome?
Painful hematemesis (vomiting blood)
Vomiting blood
Hematemesis
How is Mallory-Weiss syndrome treated?
Tx underlying cause
Surgical intervention/cautery
How is Gastroesophageal reflux disease (GERD) caused?
Backflow of gastric contents
What is the esophageal epithelium sensitive to?
Acid
What are the 5 risk factors of Gastroesophageal reflux disease (GERD)?
Alcohol
Tobacco
Obesity
CNS depressants
Pregnancy
What is the most common cause of esophagitis?
Gastroesophageal reflux disease (GERD)
What is the most common GI ailment in the US?
Gastroesophageal reflux disease (GERD)
Gastroesophageal reflux disease (GERD) is most commonly seen in which people?
Infants
Adults over 40
What disease?
Heartburn
Dysphagia
Regurgitation of sour-tasting gastric contents
Lingual erosion of teeth
Gastroesophageal reflux disease (GERD)
What disease?
Tx is medication (antacids, proton pump inhibitors) and reduce risk factors
Gastroesophageal reflux disease (GERD)
What are the causes of barrett esophagus?
Intestinal metaplasia in esophagus mucosa
Complication of chronic GERD
Who is affected by barrett esophagus?
Middle aged men
Describe the intestinal metaplasia within esophagus mucosa seen in barrett esophagus
Squamous -> non-ciliated columnar
What disease?
Red, velvety mucosa above gastroesophageal junction
Symptoms of GERD or asymptomatic
Barrett esophagus
What disease?
Tx includes endoscopy with biopsy and intervention if dysplasia is seen
Barrett esophagus
What do patients with barrett esophagus have an increased risk for developing?
Esophageal adenocarcinoma
What are the causes of esophageal adenocarcinoma?
Malignancy from esophageal glands
What disease most commonly arises from barrett esophagus?
Esophageal adenocarcinoma
What are the 5 risk factors of esophageal adenocarcinoma?
Barrett esophagus
Long standing GERD
Obesity
Tobacco
Previous radiation tx
What disease?
Dysphagia
Odynophagia (pain on swallowing)
Progressive weight loss
Chest pain
Vomiting
Esophageal adenocarcinoma
What diseases?
Tx is combo of surgery, chemo, and radiation depending on stage
Esophageal adenocarcinoma
Esophageal squamous cell carcinoma
Gastric adenocarcinoma
Colorectal adenocarcinoma
What disease?
Overall 5 year survival < 25%; usually at advanced stage at time of diagnosis
Esophageal adenocarcinoma
What are the causes of esophageal squamous cell carcinoma?
Malignancy from esophageal epithelium
Smoking/drinking
Who is affected by esophageal squamous cell carcinoma?
Males > 45
African Americans
What disease?
Dysphagia
Odynophagia (pain on swallowing)
Weight loss
Esophageal squamous cell carcinoma
What disease?
Overall 5 year survival is 9%; usually advanced stage at time of diagnosis
Esophageal squamous cell carcinoma
What is the most common cause of barret esophagus?
GERD
Peptic ulcer disease is from an imbalance between mucosal defenses and damaging effects of ____________ and ___________
gastric acid; pepsin
What are the 2 most common causes of peptic ulcer diseases?
Chronic NSAID use
H pylori
What disease?
Epigastric pain 1-3 hrs after meals
Nausea, vomiting, bloating
Can become chronic and recurring
Peptic ulcer disease
What disease?
Diagnosed by endoscopy
Treated by tx underlying cause
Peptic ulcer disease
What is the cause of H pylori gastritis?
H pylori colonizes gastric mucosa
Where is there an increased incidence of H pylori gastritis?
Areas with poverty and household crowding
What disease?
Can lead to chronic gastritis, peptic ulcers, and increased risk for gastric cancer
H pylori gastritis
What disease?
Diagnosed by urea breath test, stool test, endoscopic biopsy
H pylori gastritis
What disease?
Tx by antibiotics or proton pump inhibitors
H pylori gastritis
What is the cause of gastric adenocarcinoma?
Malignancy from gastric glands
What are the 3 risk factors of gastric adenocarcinoma?
H pylori infection
Chronic gastritis
Smoked foods
What disease?
Dyspepsia (indigestion)
Dysphagia
Nausea
Weight loss
Gastric adenocarcinoma
What disease?
Overall 5 year survival < 30%; usually at advanced stage at time of diagnosis
Gastric adenocarcinoma
What is the cause of celiac disease?
Autoimmune rxn to gluten
What does the intestinal lining show in pts with celiac disease?
Villous atrophy (becomes flat)
What disease?
Abdominal pain
Nausea
Vomiting
Bloating
Diarrhea
Constipation
Fatigue
Dermatitis herpetiformis (itchy, blistering skin lesion)
Celiac disease
What disease is diagnosed by the following?
Positive serological test (ID of autoantibodies)
Intestinal biopsy
Celiac disease
What disease?
Tx is a strict gluten free diet
Celiac disease
What disease has an increased risk of malignancy?
Celiac disease
What is the cause of IBD?
Chronic inflammatory conditions of GI tract (ex: Crohn’s, ulcerative colitis)
What is the oral manifestation of IBD?
Pyostomatitis vegetans
Yellow-ish, slightly elevated, pustules on red
oral mucosa
Pyostomatitis vegetans
Most common on buccal and labial mucosa,
soft palate, and ventral tongue
Pyostomatitis vegetans
“Snail track” lesions; variably painful
Pyostomatitis vegetans
What part of the GI is affected by ulcerative colitis?
Colon
Rectum
What disease?
Relapsing disorder
Bloody diarrhea
Lower abdominal pain and cramps
Symptoms may persist for days/weeks/months
Ulcerative colitis
What disease?
Tx is colectomy in severe cases (curative)
Ulcerative colitis
Which IBD can occur in any area of the GI tract?
Crohn’s disease
What disease?
Intermittent attacks
Diarrhea (with or without blood)
Fever
Abdominal pain
Oral manifestations – may be first sign
Crohn’s disease
What are the oral manifestations of Crohn’s disease?
Aphthous ulcers
Cobblestone lesions
Linear ulcers/fissures in vestibule
What diseases have the following tx options?
Anti-inflammatory drugs
Corticosteroids
Biologics
Immunomodulators
Crohn’s disease
Ulcerative colitis
What disease?
Tx is surgery for severe cases (not curative)
Crohn’s disease
Are adenomatous polyps benign or malignant?
Benign
What do adenomatous polyps give rise to?
Majority of colorectal adenocarcinomas
What disease?
Usually asymptomatic
May cause bleeding or obstruction
Adenomatous polyp
What disease?
Diagnosed by colonoscopy + biopsy
Screening colonoscopy recommended at age 50
Adenomatous polyp
What disease is treated by the following?
Excision
Surveillance due to risk of recurrence/progression to colorectal adenocarcinoma
Adenomatous polyp
What is the cause of colorectal adenocarcinoma?
Malignancy from colorectal glands
What do most cases of colorectal adenocarcinoma arise from?
Adenomatous polyps
What dietary factors can contribute to colorectal adenocarcinoma?
Low fiber
High refined carbs + fat
What is the most common malignancy of the GI tract?
Colorectal adenocarcinoma
What disease?
May be asymptomatic
Fatigue and weakness (secondary to anemia)
Changes in bowel habits
Abdominal cramping
Colorectal adenocarcinoma
What disease?
Diagnosed by colonoscopy and biopsy
Colorectal adenocarcinoma
What disease?
Early detection through routine colonoscopy screening improves prognosis
Colorectal adenocarcinoma
What disease?
Contributes to 15% of cancer-related deaths (second to lung cancer)
Colorectal adenocarcinoma
Which lab test would most likely confirm the
diagnosis of celiac disease?
Serology for ID of autoantibodies
Describe the genetic inheritance of familial adenomatous polyposis
Autosomal dominant
What is the cause of familial adenomatous polyposis?
Mutations in adenomatous polyposis coli gene (APC)
What disease?
Onset in childhood/teen years
Familial adenomatous polyposis
What disease?
Colorectal carcinoma develops in 100% of pts
Familial adenomatous polyposis
What disease?
Hundreds to thousands of adenomatous polyps
Familial adenomatous polyposis
What disease?
Diagnosed by family hx, colonoscopy, biopsy, and genetic testing for APC mutation
Familial adenomatous polyposis
What disease?
Tx is prophylactic colectomy to prevent progression to cancer
Familial adenomatous polyposis
What is Gardner syndrome a subset of?
Familial adenomatous polyposis
What disease?
Prominent extra-intestinal manifestations
Gardner syndrome
What disease?
Multiple osteomas (benign tumors of bone)
Gardner syndrome
What disease?
Multiple unerupted and supernumerary teeth
Gardner syndrome
Describe the genetic inheritance of Peutz-Jeghers syndrome
Autosomal dominant
What disease?
Oral and perioral freckles on lips and cheeks that first present during childhood and adolescence
Peutz-Jeghers syndrome
What disease?
Skin and mucosal freckles
Multiple gastrointestinal hamartomatous polyps
Peutz-Jeghers syndrome
What disease?
Do not have carry same level risk of colorectal cancer as adenomatous polyps
Increased risk of malignancy
Peutz-Jeghers syndrome
What disease?
Diagnosed by family hx and genetic testing
Peutz-Jeghers syndrome
What disease?
Oral and perioral pigmentation persists throughout life and does NOT require treatment
Peutz-Jeghers syndrome
What disease?
Tx is lifelong monitoring for development of neoplasia
Peutz-Jeghers syndrome