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GI Flashcards

1
Q

3 Salivary gland tumors

A
  1. Pleomorphic adenoma
  2. Mucoepidermoid carcinoma
  3. Warthin tumor
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2
Q

most common malignant tumor of salivary gland

A

Mucoepidermoid carcinoma

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3
Q

Salivary gland’s benign cystic tumor with germinal centers.

A

Warthin tumor

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4
Q

Most common salivary gland tumor

A

Pleomorphic adenoma

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5
Q

Cancer (obstruction) cause dysphagia to solids or liq?

A

Solids –>liq (Achalasia cause liq–>solids)

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6
Q

Achalasia increase risk of which cancer?

A

Squamous cell carcinoma of esophagus

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7
Q

Endoscopy of Eosinophilic esophagitis shows?

A

Esophageal rings and linear furrows

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8
Q

Eosinophilic esophagitis main symptom?

A

Dysphagia

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9
Q

Varices located in what part of esophagus?

A

lower 1 ⁄3 of esophagus

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10
Q

HSV-1 appearance in esophagitis infection?

A

punched-out ulcers

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11
Q

CMV appearance in esophagitis infection?

A

linear ulcers

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12
Q

Esophagitis caused by?

A
  1. reflux
  2. infection in immunocompromised
  3. caustic ingestion
  4. meds
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13
Q

Candida infection of esophagus (esophagitis) appearance?

A

white pseudomembrane

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14
Q

GERD associated with?

A

Associated with asthma

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15
Q

Plummer-Vinson syndrome triad?

A

Triad of Dysphagia, Iron deficiency anemia, and Esophageal webs.
(“Plumbers” DIE).

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16
Q

Plummer-Vinson syndrome increase risk of which esophageal cancer?

A

Increased risk of esophageal squamous cell carcinoma “Plumbers” DIE

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17
Q

Sclerodermal esophageal dysmotility

A

Smooth muscle atrophy & decreased LES pressure–>dysmotility/reflux/dysphagia

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18
Q

Acute gastritis 3 causes?

A
  1. NSAIDs
  2. Burns (Curling ulcer)
  3. Brain injury (Cushing ulcer)
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19
Q

Chronic gastritis 2 causes?

A
  1. H Pylori

2. AI-Pernicious anemia

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20
Q

Ménétrier disease MOA

A

Gastric hyperplasia of mucosa, parietal cell atrophy–can’t make acid

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21
Q

Acid is made by which cells in stomach?

A

Parietal

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22
Q

Parietal cells provide what 2 things in stomach?

A
  1. IF

2. Acid

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23
Q

Gastric cancer types

A
  1. gastric adenocarcinoma
  2. lymphoma
  3. GI stromal tumor
  4. carcinoid
  5. Intestinal
  6. Diffuse
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24
Q

Leser-Trélat sign is?

A

Sudden multiple seborrheic keratoses caused by stomach CA

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25
Q

Most commonly gastric CA?

A

adenocarcinoma

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26
Q

Rarest stomach CA?

A

carcinoid

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27
Q

Stomach CA associated with H. Plyori?

A

Intestinal

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28
Q

signet ring cells & linitis plastica associated with which kind of stomach CA?

A

Diffuse

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29
Q

Signet ring cells

A

mucin-filled cells with peripheral nuclei

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30
Q

Linitis plastica

A

stomach wall grossly thickened and leathery

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31
Q

involvement of left supraclavicular node by metastasis from stomach.

A

Virchow node

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32
Q

Bilateral metastases to ovaries. Abundant mucin-secreting, signet ring cells.

A

Krukenberg tumor

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33
Q

Subcutaneous periumbilical mets from stomach?

A

Sister Mary Joseph nodule

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34
Q

Most common cause of both stomach and duodenal ulcers?

A

H Pylori infection

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35
Q

In addition to H Pylori, stomach ulcers also caused by?

A

NSAIDs

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36
Q

In addition to H Pylori, duodenal ulcers also caused by?

A

ZES

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37
Q

Symptoms in perforation of stomach or duodenal ulcer?

A
  • Free air under diaphragm

- Referred pain to shoulder (via phrenic n)

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38
Q

3 Ulcer complications

A
  1. Hemorrhage
  2. Obstruction
  3. Perforation
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39
Q

Pancreatic insufficiency causes malabsorption of?

A
  1. fat
  2. fat-soluble vitamins (A, D, E, K)
  3. B12.
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40
Q

Difference between Tropical Sprue & Celiac ?

A

Responds to Abx.

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41
Q

Tropical sprue assoc. w/ what anemia type?

A

megaloblastic anemia due to folate deficiency and, later, B12 deficiency

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42
Q

PAS ⊕

A

Whipple disease

43
Q

Foamy macrophages in intestinal lamina propria

A

Whipple disease

44
Q

Whipple disease 3 sxs.? (Mnemonic)

A
  1. Cardiac
  2. Arthralgias, and
  3. Neurologic

“Foamy Whipped cream in a CAN”

45
Q

Whipple disease MOA

A

Infection with Tropheryma whipplei (intracellular gram ⊕)

46
Q

Rectum v Anus?

A

Rectum –>Anus (outside)

47
Q

IBS: Recurrent abdominal pain associated with ≥ 2 of the following:

A
  1. Pain improves with defecation
  2. Change in stool frequency
  3. Change in appearance of stool
48
Q

Cause of appendicitis in kids?

A

lymphoid hyperplasia

49
Q

Initial pain location in appendicitis?

A

Initial diffuse periumbilical pain migrates to McBurney point (1 ⁄3 the distance from right anterior superior iliac spine to umbilicus).

50
Q

McBurney point

A

1 ⁄3 the distance from right anterior superior iliac spine to umbilicus

51
Q

Sxs. Appendicitis?

A
  1. Pain,
  2. Nausea,
  3. fever
52
Q

Physical signs with appendicitis?

A
  1. psoas,
  2. obturator, and
  3. Rovsing signs
53
Q

Rovsing’s sign=

A

Pain in right lower abdomen w/ palpation left abdomen.

54
Q

Appendicitis Ddx.

A

Differential: diverticulitis (elderly), ectopic pregnancy (use β-hCG to rule out).

55
Q

“True” diverticulum definition?

A

all 3 gut wall layers outpouch

56
Q

Meckel is true or fake diverticulum?

57
Q

“False” diverticulum or pseudodiverticulum—

A

only mucosa and submucosa outpouch. Occur especially where vasa recta perforate muscularis externa.

58
Q

MC location of diverticulum?

A

Most often in sigmoid colon.

59
Q

Sxs. of diverticulosis?

A
  1. Often asymptomatic or
  2. vague discomfort
  3. bleeding (painless hematochezia),
  4. diverticulitis.
60
Q

Melena is?

A

black, tarry stools.

61
Q

Hematochezia is?

A

brb fresh blood per anus, usually in or with stools.

62
Q

Complications of diverticulitis?

A
  1. Abscess
  2. Fistula (colovesical fistula=pneumaturia)
  3. Obstruction (inflammatory stenosis)
  4. Perforation –>peritonitis
63
Q

Zenker is true or pseudo diverticulum?

64
Q

Zenker diverticulum location?

A

Pharyngoesophageal

65
Q

Zenker diverticulum sxs? (mnemonic)

A

“Elder MIKE has bad breath”
Elderly

Males
Inferior pharyngeal constrictor
Killian triangle
Esophageal dysmotility

Halitosis

66
Q

Vitelline duct?

A

a long narrow tube that joins the yolk sac to the midgut lumen of the developing fetus.

67
Q

Location of Meckel’s diverticulum?

A

distal ileum, usually within 60–100 cm (2 feet) of the ileocecal valve

68
Q

Meckel’s Mnemonic?

A 
"The six 2’s":
2 times as likely in males.
2 inches long.
2 feet from the ileocecal valve.
2% of population.
first 2 years of life. 
2 types of epithelia (gastric/
pancreatic).
69
Q

Risk for Hirschsprung is increased with what condition?

A

Down’s Syndrome

70
Q

Hirschsprung disease associated with mutations in what gene?

71
Q

characterized by lack

of ganglion cells/enteric nervous plexuses (Auerbach and Meissner plexuses) in distal segment of colon.

A

Hirschsprung

72
Q

Hirschsprung MOA

A

Due to failure of neural crest cell migration.

73
Q

Normal portion of the colon proximal to the aganglionic segment is dilated, resulting in a “transition zone.”

A

Hirschsprung

74
Q

Failure to pass meconium within 48 hours

A

Hirschsprung

75
Q

Hirschsprung 3 sxs.

A
  1. bilious emesis,
  2. abdominal distention
  3. failure to pass meconium in 48 hrs.
76
Q

Anomaly of midgut rotation during fetal development

A

Malrotation

77
Q

Ladd bands?

A

fibrous bands in Malrotation

78
Q

Malrotation can lead to what 2 conditions?

A

volvulus, duodenal obstruction.

79
Q

Twisting of portion of bowel around its mesentery;

lead to obstruction and infarction

80
Q

Volvulus type more common in elderly?

A

Sigmoid volvulus (v. midgut in infants/kids)

81
Q

Intussusception MOA?

A

Telescoping A of proximal bowel segment into distal segment

82
Q

Intussusception location?

A

commonly at ileocecal junction

83
Q

Most common pathologic lead point to form Intussusception?

A

Meckel diverticulum

84
Q

Bull’s-eye appearance on ultrasound.

A

Intussusception

85
Q

Intussusception in adults due to?

A

associated with intraluminal mass or tumor that acts as lead point that
is pulled into the lumen

86
Q

Intussusception seen after what illness MC?

A

adenovirus

87
Q

“Currant jelly” stools in what 2 conditions?

A
  1. Intussusception

2. Acute mesenteric ischemia

88
Q

POOP

A

Acute mesenteric ischemia

89
Q

Acute mesenteric ischemia due to occlusion of what BV?

A

Superior mesenteric artery (SMA)

90
Q

Chronic mesenteric ischemia sxs.?

A

postprandial Crampy epigastric pain followed by hematochezia.
“Intestinal angina”

91
Q

Chronic mesenteric ischemia MOA

A

atherosclerosis of celiac artery, SMA, or IMA

92
Q

Commonly occurs at watershed areas (splenic flexure, distal colon)

A

Colonic ischemia

93
Q

Tortuous dilation of vessels causing hematochezia

A

Angiodysplasia

94
Q

Angiodysplasia MC where?

A

Most often found in cecum, terminal ileum, ascending colon

95
Q

Angiodysplasia Dg.?

A

angiography

96
Q

Most common cause of small bowel obstruction

97
Q

Intestinal hypomotility without obstruction

98
Q

Ileus sxs.

A

constipation and decrflatus; distended/tympanic abdomen with decrbowel sounds

99
Q

Ileus causes

A

abdominal surgeries, opiates, hypokalemia, sepsis

100
Q

Ileus tx.?

A

Treatment: bowel rest, electrolyte correction, cholinergic drugs (stimulate intestinal motility).

101
Q

Meconium ileus occurs in?

102
Q

Seen in premature, formula-fed infants with immature immune system.

A

Necrotizing enterocolitis

103
Q

meconium plug obstructs intestine, preventing stool passage at birth.

A

Meconium ileus

104
Q

Necrosis of intestinal mucosa (primarily colonic) with possible perforation, which can lead to pneumatosis intestinalis

A

Necrotizing enterocolitis

Facts (16 decks)

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