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Pathology > GI > Flashcards

GI Flashcards

1
Q

in a hiatal hernia, the ____ is pulled into the thorax

A

gastroesophageal junction

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2
Q

Gastric metaplasia of lower esophageal mucosa- columnar epithelium replaces stratified squamous epithelium:

A

Barrett’s Esophagus

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3
Q

what are the symptoms associated with Barrett’s esophagus:

A
  1. odynophagia
  2. ulceration
  3. hemorrhage
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4
Q

Individuals with Barrett esophagus are at an increased risk of:

A

adenomcarinoma

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5
Q

In barrets esophagus, _____ replaces ______

A

columnar epithelium; stratified squamous epithelium

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6
Q

What are two types of esophageal cancer?

A
  1. squamous cell carcinoma
  2. adenocarcinoma
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7
Q

In cases of ________ individuals experience dysphagia due to narrowing of lumen or interference with peristalsis

A

esophageal cancer

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8
Q

Esophageal squamous cell carcinoma, occurs more often in _____, has _____ variation, and a _____ prognosis

A

older adults; geographical; poor

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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

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10
Q

Esophageal squamous cell carcinoma is most common in the _____ of the esophagus

A

middle 1/3

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11
Q

What are some risk factors associated with esophageal squamous cell carcinoma?

A
  1. alcohol & tobacco
  2. plummer-vison (patterson-kelly)
  3. diet
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12
Q

Esophageal adenocarcinoma typically isolated in the:

A

lower segment of esophagus

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13
Q

What is a risk factor for esophageal adenonocarcinoma:

A

barrett esophagus

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14
Q

What esophageal cancer is the most common in the U.S.

A

Esophageal adenocarcinoma

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15
Q

What are the steps of an esophagus developing esophageal adenocarcinoma?

A
  1. squamous epithelium
  2. esophagitis
  3. barrett esophagus (columnar epithelium)
  4. dysplasia
  5. carcinoma
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16
Q

List the epithelial cells of the stomach:

A
  1. mucous cells
  2. parietal cells
  3. chief cells
  4. endocrine cells
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17
Q

The parietal cells of the stomach are responsible for secreting:

A

HCL & intrinsic factor

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18
Q

The chief cells of the stomach are responsible for secreting:

A

pepsin

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19
Q

The endocrine cells of the stomach (also called _____) are responsible for secreting:

A

G-cells; gastrin

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20
Q

Inflammation of the gastric mucosa:

A

gastritis

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21
Q

Gastritis that is purely erosive in nature, due to irritants and NSAIDS:

A

Acute gastritis

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22
Q

Gastritis that is either erosive or non-erosive in nature, due to infection or autoimmune process

A

Chronic gastritis

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23
Q

What are the symptoms of acute erosive gastritis?

A
  1. epigastric burning
  2. pain
  3. nausea
  4. vomiting
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24
Q

Describe the erosions seen in acute erosive gastritis:

A

shallow

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25
Q

What may be the cause of acute erosive gastritis?

A
  1. aspirin
  2. NSAIDS
  3. Alcohol
  4. stress
  5. shock
  6. sepsis
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26
Q

One of the major causes of hematemesis in alcoholics:

A

acute erosive gastritis

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27
Q

Chronic gastritis is referred to as ____ or ____ gastritis

A

infectious or autoimmune

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28
Q

The most common form of chronic gastritis is due to:

A

infection by helicobacter pylori

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29
Q

Why autoimmune chronic gastritis occur?

A

autoantibodies to parietal cells

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30
Q

Helicobacter pylori gastritis may lead to: (3)

A
  1. peptic ulcer diseases
  2. adenocarcinoma
  3. MALT lymphoma
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31
Q

H. Pylori is considered a potential:

A

Human carcinogen

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32
Q

How do we test for H. Pylori?

A
  1. visualize gram negative s-shaped rods
  2. biopsy & silver stain
  3. urea breath test
  4. antibody test for H. pylori
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33
Q

Autoimmune gastritis may also be called:

A

atrophic gastritis

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34
Q

Autoantibodies against gastric parietal cells causing gastric mucosal atrophy:

A

Autoimmune (atrophic) gastritis

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35
Q

What are some risk factors for autoimmune (atrophic) gastritis:

A
  1. no intrinsic factor
  2. low serum vitamin B12
  3. pernicious anemia
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36
Q

Deeper than erosions and may extend to muscularis:

A

Gastric stress ulcers

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37
Q

Risk factors for gastric stress ulcers include:

A

ICU patients (shock, trauma, burn, sepsis

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38
Q

Most peptic ulcers are generally:

A

solitary lesions

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39
Q

Most peptic ulcers occur in the _____

A

duodenum

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40
Q

98% of peptic ulcers are laced in the:

A

duodenum & stomach

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41
Q

Sharpley-demarcated ulcer with a clean, smooth base:

A

peptic ulcer

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42
Q

Chronic peptic ulcer lesions may exhibit:

A

puckering due to fibrosis

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43
Q

Describe the clinical symptoms/coures of peptic ulcer disease:

A
  1. acute/chronic blood loss
  2. nausea, vomting, hematemesis, melana
  3. perforation (major cause of death in PUD)
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44
Q

what is the major cause of death in PUD?

A

perforation

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45
Q

In peptic ulcer disease:

immediate pain=

delayed pain=

A

gastic ulcer

duodenal ulcer

46
Q

Peptic ulcer disease can be described as a ____ disease with decreased ____

A

multifactorial; decreased mucosal resistance

47
Q

A common infectious cause of peptic ulcers is:

A

infection with H. Pylori

48
Q

What drugs may cause peptic ulcers?

A

aspirin & NSAIDs

49
Q

Hormonal hypersecretion syndromes leading to peptic ulcers can be described as:

A

neuroendocrine

50
Q

What are two neuroendocrine syndromes associated with peptic ulcers?

A
  1. Cushing syndrome (corticosteroids)
  2. Zollinger-Ellison syndrome (gastrin)

Hypersecretion of these hormones

51
Q

What are five complications of peptic ulcer disease?

A
  1. minor hemorrhage
  2. major hemorrhage
  3. perforation
  4. stenosis & obstruction
  5. penetration into pancrease
52
Q

Condition characterized by gastrin-secreting timor in pancreas or duodenum (“gastrinoma”)

A

Zollinger-Ellison Syndrome

53
Q

Gastrinoma:

A

Zollinger-Ellison Syndrome

54
Q

In Zollinger-Ellison syndrome hypergastrinemia causes:

A

hypersecretion of gastric acid

55
Q

Can be described as severe peptic ulcer disease with multiple ulcers in unusual locations:

A

Zollinger-Ellison syndrome

56
Q

Gastric adenocarcinoma is seen more often in _____ individuals and has a _____ prognosis

A

older; poor

57
Q

Risk factors for gastric adenocarcinoma include:

A
  1. smoked fish (due to nitrosamines)
  2. H. Pylori infection
  3. Chronic atrophic gastritis
  4. gastric adenomatous polyps
58
Q

Gastric adenocarcinoma most often occurs in the:

A

lesser curve of antro-pyloric region

59
Q

Describe the intestinal type of adenocarcinoma:

A

Bulky tumors composed of glandular structures

60
Q

Describe the diffuse type of gastric adenocarcinoma:

A

Infiltrative growth of poorly-differentiated cells (linitis plastica)

61
Q

Metastatic adenocarcinoma to the ovaries:

A

Krukenburg tumor

62
Q

B/L ovarian metastases is commonly seen in:

A

Krukenburg tumors

63
Q

Krukenburg tumors are frequently of _____ origin, caused by ______ cells

A

gastric origin; mucous-producing

64
Q

Gastrointestinal tract lymphomas include:

A
  1. non-hodgkin lymphoma
  2. primary lymphomas
  3. secondary lymphomas
65
Q

Is hodgkin lymphoma or non-hodgkin lymphoma associated with the gastrointestinal tract?

A

Non-Hodgkin

66
Q

Primary lymphomas of the gastrointestinal tract include:

A

MALT-omas and other NHLs

67
Q

Secondary lymphomas of the gastrointestinal tract involve:

A

Extranodal spread

68
Q

gastric MALT lymphoma:

What is the most common site for extranodal lymphomas?

A

Stomach

69
Q

B-cell lymphomas of mucosa-associated lymphoid tissue:

A

MALT lymphomas

70
Q

Gastric MALT lymphomas are associated with:

A

H. pylori infection

71
Q

What can be found in the innermost layer of the small intestine?

A

Villi

72
Q

Developmental defect of the ileum- a blind pouch containing all layers:

A

Meckel Diverticulum

73
Q

Meckel Diverticulum may be referred to as:

A

left-sided appendix

74
Q

What condition may produce symptoms similar to appendicitis?

A

Meckel Diverticulum

75
Q

Causes of bowel obstruction:

A
  1. herniation
  2. adhesions
  3. intussusception
  4. volvulus
76
Q

Herniation is caused by:

A

Weakness in peritoneum

77
Q

Locations of hernias include:

A
  1. inguinal
  2. femoral
  3. umbilicus
  4. incisional
78
Q

Fibrotic bridges of peritoneum:

A

Adhesions

79
Q

Intestinal adhesions may:

A

trap & kink bowel segments

80
Q

Adhesions are usually a sequelae of:

A

Prior surgery or infection

81
Q

When the small intestine invaginates into itself & becomes necrotic unless everted:

A

Intussusception

82
Q

When the small intestine invaginates into itself, it will become _____ unless ____

A

necrotic; everted

83
Q

Rotation of a loop of intestine about its own mesenteric root:

A

Volvulus

84
Q

Where do volvulus most commonly occur?

A

Small intestine & sigmoid colon

85
Q

Volvulus leads to:

A

necrosis

86
Q

Adenocarcinoma of the small intestine is:

A

rare

87
Q

A low-grade malignancy of neuroendocrine cells, appearing as mucosal nodules:

A

Carcinoid tumor

88
Q

A carinoid tumor is a low-grade malignancy of ____ cells appearing as ____

A

neuroendocrine cells; mucosal nodules

89
Q

A carcinoid tumor may occur throughout the gastrointestinal tract but are most common in the:

A

appendix

90
Q

A carcinoid tumor may produce hormones such as:

A

serotonin

91
Q

Caused by a serotonin-producing carcinoid tumor that is asymptomatic until metastasis to the liver:

A

Carcinoid syndrome

92
Q

Carcinoid syndrome is caused by a ____ producing carcinoid tumor that is:

A

Serotonin; asymptomatic until metastasis to the liver

93
Q

In carcinoid syndrome, what happens to the serotonin that is no longer metabolized by the liver?

A

Causes cramping, diarrhea, flushing & bronchospasm

94
Q

Name the characteristic feature of the large intestine:

A

Crypts

95
Q

Name the characteristic feature of the small intestine:

A

Villi

96
Q

The large intestine may be referred to as the:

A

Colon

97
Q

What plexi are in the enteric nervous system?

A

Myenteric (Auerbach) & submucosal (Meissner)

98
Q

The colon is colonized by:

A

Non-pathogenic strains of bacteria

99
Q

Hirschsprung disease may also be referred to as:

A

Congenital megacolon

100
Q

Developmental defect of enteric nervous system- agangliosis of terminal colon (myenteric plexus):

A

Hirschprung disease- congenital megacolon

101
Q

Consists of out-pouchings of mucosa & submucosa through muscular layer of colon:

A

Diverticulosis

102
Q

Diverticulosis is associated with:

A

A low bulk diet & straining during defication

103
Q

If diverticulosis becomes inflamed it transitions to:

A

Diverticulitis

104
Q

neoplastic polys of the intestine may also be called:

A

Adenomatous polyps; adenomas

105
Q

What are two categories of adenomas?

A
  1. neoplastic
  2. non-neoplastic
106
Q

What are the two types of neoplastic polyps in the intestine?

A
  1. tubular adenoma
  2. villous adenoma
107
Q

What are two types of non-neoplastic polyps in the intestine?

A
  1. Hyperplastic polyp (most common)
  2. Hamartomatous polyp (Peutz-Jeghers syndrome)
108
Q

Non-neoplastic hyperplasia of the epithelium; most common:

A

Hyperplastic polyp

109
Q

A hyperplastic polyp is considered:

A

NOT pre-malignant

110
Q

-Large, pedunculate polyp, consisting of all layers of the mucosa

-may be associated with Peutz-Jeghers syndrome

-risk for intussusception

-no malignant change

A

Hamartomatous polyp

111
Q

-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)

A

Peutz-Jegher syndrome

112
Q
A

Pathology (28 decks)

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