GI Flashcards
1
Q
in a hiatal hernia, the ____ is pulled into the thorax
A
gastroesophageal junction
2
Q
Gastric metaplasia of lower esophageal mucosa- columnar epithelium replaces stratified squamous epithelium:
A
Barrett’s Esophagus
3
Q
what are the symptoms associated with Barrett’s esophagus:
A
- odynophagia
- ulceration
- hemorrhage
4
Q
Individuals with Barrett esophagus are at an increased risk of:
A
adenomcarinoma
5
Q
In barrets esophagus, _____ replaces ______
A
columnar epithelium; stratified squamous epithelium
6
Q
What are two types of esophageal cancer?
A
- squamous cell carcinoma
- adenocarcinoma
7
Q
In cases of ________ individuals experience dysphagia due to narrowing of lumen or interference with peristalsis
A
esophageal cancer
8
Q
Esophageal squamous cell carcinoma, occurs more often in _____, has _____ variation, and a _____ prognosis
A
older adults; geographical; poor
9
Q
What is the most common type of esophageal cancer world-wide?
What is the most common type of esophageal cancer in the United States?
A
squamous cell carcinoma; adenocarcinoma of the esophagus
10
Q
Esophageal squamous cell carcinoma is most common in the _____ of the esophagus
A
middle 1/3
11
Q
What are some risk factors associated with esophageal squamous cell carcinoma?
A
- alcohol & tobacco
- plummer-vison (patterson-kelly)
- diet
12
Q
Esophageal adenocarcinoma typically isolated in the:
A
lower segment of esophagus
13
Q
What is a risk factor for esophageal adenonocarcinoma:
A
barrett esophagus
14
Q
What esophageal cancer is the most common in the U.S.
A
Esophageal adenocarcinoma
15
Q
What are the steps of an esophagus developing esophageal adenocarcinoma?
A
- squamous epithelium
- esophagitis
- barrett esophagus (columnar epithelium)
- dysplasia
- carcinoma
16
Q
List the epithelial cells of the stomach:
A
- mucous cells
- parietal cells
- chief cells
- endocrine cells
17
Q
The parietal cells of the stomach are responsible for secreting:
A
HCL & intrinsic factor
18
Q
The chief cells of the stomach are responsible for secreting:
A
pepsin
19
Q
The endocrine cells of the stomach (also called _____) are responsible for secreting:
A
G-cells; gastrin
20
Q
Inflammation of the gastric mucosa:
A
gastritis
21
Q
Gastritis that is purely erosive in nature, due to irritants and NSAIDS:
A
Acute gastritis
22
Q
Gastritis that is either erosive or non-erosive in nature, due to infection or autoimmune process
A
Chronic gastritis
23
Q
What are the symptoms of acute erosive gastritis?
A
- epigastric burning
- pain
- nausea
- vomiting
24
Q
Describe the erosions seen in acute erosive gastritis:
A
shallow
25
What may be the cause of acute erosive gastritis?
1. aspirin
2. NSAIDS
3. Alcohol
4. stress
5. shock
6. sepsis
26
One of the major causes of hematemesis in alcoholics:
acute erosive gastritis
27
Chronic gastritis is referred to as ____ or ____ gastritis
infectious or autoimmune
28
The most common form of chronic gastritis is due to:
infection by helicobacter pylori
29
Why autoimmune chronic gastritis occur?
autoantibodies to parietal cells
30
Helicobacter pylori gastritis may lead to: (3)
1. peptic ulcer diseases
2. adenocarcinoma
3. MALT lymphoma
31
H. Pylori is considered a potential:
Human carcinogen
32
How do we test for H. Pylori?
1. visualize gram negative s-shaped rods
2. biopsy & silver stain
3. urea breath test
4. antibody test for H. pylori
33
Autoimmune gastritis may also be called:
atrophic gastritis
34
Autoantibodies against gastric parietal cells causing gastric mucosal atrophy:
Autoimmune (atrophic) gastritis
35
What are some risk factors for autoimmune (atrophic) gastritis:
1. no intrinsic factor
2. low serum vitamin B12
3. pernicious anemia
36
Deeper than erosions and may extend to muscularis:
Gastric stress ulcers
37
Risk factors for gastric stress ulcers include:
ICU patients (shock, trauma, burn, sepsis
38
Most peptic ulcers are generally:
solitary lesions
39
Most peptic ulcers occur in the _____
duodenum
40
98% of peptic ulcers are laced in the:
duodenum & stomach
41
Sharpley-demarcated ulcer with a clean, smooth base:
peptic ulcer
42
Chronic peptic ulcer lesions may exhibit:
puckering due to fibrosis
43
Describe the clinical symptoms/coures of peptic ulcer disease:
1. acute/chronic blood loss
2. nausea, vomting, hematemesis, melana
3. perforation (major cause of death in PUD)
44
what is the major cause of death in PUD?
perforation
45
In peptic ulcer disease:
immediate pain=
delayed pain=
gastic ulcer
duodenal ulcer
46
Peptic ulcer disease can be described as a ____ disease with decreased ____
multifactorial; decreased mucosal resistance
47
A common infectious cause of peptic ulcers is:
infection with H. Pylori
48
What drugs may cause peptic ulcers?
aspirin & NSAIDs
49
Hormonal hypersecretion syndromes leading to peptic ulcers can be described as:
neuroendocrine
50
What are two neuroendocrine syndromes associated with peptic ulcers?
1. Cushing syndrome (corticosteroids)
2. Zollinger-Ellison syndrome (gastrin)
Hypersecretion of these hormones
51
What are five complications of peptic ulcer disease?
1. minor hemorrhage
2. major hemorrhage
3. perforation
4. stenosis & obstruction
5. penetration into pancrease
52
Condition characterized by gastrin-secreting timor in pancreas or duodenum ("gastrinoma")
Zollinger-Ellison Syndrome
53
Gastrinoma:
Zollinger-Ellison Syndrome
54
In Zollinger-Ellison syndrome hypergastrinemia causes:
hypersecretion of gastric acid
55
Can be described as severe peptic ulcer disease with multiple ulcers in unusual locations:
Zollinger-Ellison syndrome
56
Gastric adenocarcinoma is seen more often in _____ individuals and has a _____ prognosis
older; poor
57
Risk factors for gastric adenocarcinoma include:
1. smoked fish (due to nitrosamines)
2. H. Pylori infection
3. Chronic atrophic gastritis
4. gastric adenomatous polyps
58
Gastric adenocarcinoma most often occurs in the:
lesser curve of antro-pyloric region
59
Describe the intestinal type of adenocarcinoma:
Bulky tumors composed of glandular structures
60
Describe the diffuse type of gastric adenocarcinoma:
Infiltrative growth of poorly-differentiated cells (linitis plastica)
61
Metastatic adenocarcinoma to the ovaries:
Krukenburg tumor
62
B/L ovarian metastases is commonly seen in:
Krukenburg tumors
63
Krukenburg tumors are frequently of _____ origin, caused by ______ cells
gastric origin; mucous-producing
64
Gastrointestinal tract lymphomas include:
1. non-hodgkin lymphoma
2. primary lymphomas
3. secondary lymphomas
65
Is hodgkin lymphoma or non-hodgkin lymphoma associated with the gastrointestinal tract?
Non-Hodgkin
66
Primary lymphomas of the gastrointestinal tract include:
MALT-omas and other NHLs
67
Secondary lymphomas of the gastrointestinal tract involve:
Extranodal spread
68
gastric MALT lymphoma:
What is the most common site for extranodal lymphomas?
Stomach
69
B-cell lymphomas of mucosa-associated lymphoid tissue:
MALT lymphomas
70
Gastric MALT lymphomas are associated with:
H. pylori infection
71
What can be found in the innermost layer of the small intestine?
Villi
72
Developmental defect of the ileum- a blind pouch containing all layers:
Meckel Diverticulum
73
Meckel Diverticulum may be referred to as:
left-sided appendix
74
What condition may produce symptoms similar to appendicitis?
Meckel Diverticulum
75
Causes of bowel obstruction:
1. herniation
2. adhesions
3. intussusception
4. volvulus
76
Herniation is caused by:
Weakness in peritoneum
77
Locations of hernias include:
1. inguinal
2. femoral
3. umbilicus
4. incisional
78
Fibrotic bridges of peritoneum:
Adhesions
79
Intestinal adhesions may:
trap & kink bowel segments
80
Adhesions are usually a sequelae of:
Prior surgery or infection
81
When the small intestine invaginates into itself & becomes necrotic unless everted:
Intussusception
82
When the small intestine invaginates into itself, it will become _____ unless ____
necrotic; everted
83
Rotation of a loop of intestine about its own mesenteric root:
Volvulus
84
Where do volvulus most commonly occur?
Small intestine & sigmoid colon
85
Volvulus leads to:
necrosis
86
Adenocarcinoma of the small intestine is:
rare
87
A low-grade malignancy of neuroendocrine cells, appearing as mucosal nodules:
Carcinoid tumor
88
A carinoid tumor is a low-grade malignancy of ____ cells appearing as ____
neuroendocrine cells; mucosal nodules
89
A carcinoid tumor may occur throughout the gastrointestinal tract but are most common in the:
appendix
90
A carcinoid tumor may produce hormones such as:
serotonin
91
Caused by a serotonin-producing carcinoid tumor that is asymptomatic until metastasis to the liver:
Carcinoid syndrome
92
Carcinoid syndrome is caused by a ____ producing carcinoid tumor that is:
Serotonin; asymptomatic until metastasis to the liver
93
In carcinoid syndrome, what happens to the serotonin that is no longer metabolized by the liver?
Causes cramping, diarrhea, flushing & bronchospasm
94
Name the characteristic feature of the large intestine:
Crypts
95
Name the characteristic feature of the small intestine:
Villi
96
The large intestine may be referred to as the:
Colon
97
What plexi are in the enteric nervous system?
Myenteric (Auerbach) & submucosal (Meissner)
98
The colon is colonized by:
Non-pathogenic strains of bacteria
99
Hirschsprung disease may also be referred to as:
Congenital megacolon
100
Developmental defect of enteric nervous system- agangliosis of terminal colon (myenteric plexus):
Hirschprung disease- congenital megacolon
101
Consists of out-pouchings of mucosa & submucosa through muscular layer of colon:
Diverticulosis
102
Diverticulosis is associated with:
A low bulk diet & straining during defication
103
If diverticulosis becomes inflamed it transitions to:
Diverticulitis
104
neoplastic polys of the intestine may also be called:
Adenomatous polyps; adenomas
105
What are two categories of adenomas?
1. neoplastic
2. non-neoplastic
106
What are the two types of neoplastic polyps in the intestine?
1. tubular adenoma
2. villous adenoma
107
What are two types of non-neoplastic polyps in the intestine?
1. Hyperplastic polyp (most common)
2. Hamartomatous polyp (Peutz-Jeghers syndrome)
108
Non-neoplastic hyperplasia of the epithelium; most common:
Hyperplastic polyp
109
A hyperplastic polyp is considered:
NOT pre-malignant
110
-Large, pedunculate polyp, consisting of all layers of the mucosa
-may be associated with Peutz-Jeghers syndrome
-risk for intussusception
-no malignant change
Hamartomatous polyp
111
-Autosomal dominant condition
-characterized by pigmented macules of oral mucosal & perioral skin
-hamartamatous polyps of bowel
-increased risk for adenocarcinoma outside GI tract (pancreas, breast, lung, ovary, uterus)
Peutz-Jegher syndrome
112
