GI

Question 1

supplies the stomach, gallbladder, proximal small bowel

Answer 1

celiac trunk

Question 2

supplies the lower duodenum to 2/3 transverse colon

Answer 2

superior mesenteric artery

Question 3

supplies the distal 1/3 of transverse colon to rectum

Answer 3

inferior mesenteric artery

Question 4

regions between 2 major arteries that supply the colon

Answer 4

watershed zones

Question 5

watershed zone between the SMA and IMA

Answer 5

splenic flexure

Question 6

watershed zone between the IMA and superior rectal artery

Answer 6

rectosigmoid junction

Question 7

tubular structure with adventitia, no serosa

Answer 7

esophagus

Question 8

squamocolumnar junction of the esophagus is also referred to as the

Answer 8

z-line

Question 9

this type of esophagitis has punched out appearing lesions

Answer 9

herpes esophagitis

Question 10

this esophagus pathology has a velvety salmon colored mucosa

Answer 10

barrett’s esophagus

Question 11

malignancy usually at or just above the squamocolumnar junction

Answer 11

esophageal adenocarcinoma

Question 12

malignancy that can occur anywhere along the esphagus, typically an ulcerative/fungating lesion

Answer 12

squamous cell carcinoma

Question 13

you should ink the __________ when grossing the esophagus

Answer 13

adventitia

Question 14

cancers involving the EGJ that have their epicenter within the proximal __ cm of the cardia are staged as esophageal cancers

Answer 14

2

Question 15

key staging for esophagus

Answer 15

depth of invasion

Question 16

most common malignant tumor of the stomach

Answer 16

carcinoma

Question 17

major factor in pathogenesis of peptic ulcers

Answer 17

H. pylori

Question 18

usually solitary and less than 4 cm often in in the antrum or EGJ, along lesser curvature

Answer 18

peptic ulcer disease

Question 19

signet-ring cell carcinoma of stomach that has a leather bottle appearance due to diffuse thickening of the wall

Answer 19

linitus plastica

Question 20

gastric malignancy that appears centrally depressed and peripherally heaped up

Answer 20

high grade adenocarcinoma

Question 21

gastric malignancy that has focal prominent swollen/giant fold of mucosa/rugae

Answer 21

MALT lymphoma

Question 22

mesenchymal tumor in the muscularis of stomach with overlying mucosa in tact; usually a wellcircumscribed homogenous tan brown tumor

Answer 22

GIST

Question 23

key staging for stomach carcinoma grossing

Answer 23

depth of invasion

Question 24

key staging for stomach GIST

Answer 24

containment within stomach

Question 25

a stomach MALT is staged based on this protocol

Answer 25

NHL (hematologic) protocol

Question 26

stomach subtotal/total resection other than for tumor

Answer 26

88307

Question 27

stomach subtotal/total resection for tumor

Answer 27

88309

Question 28

4 things that can cause an obstruction of the small and large bowel

Answer 28

-herniation -adhesions -intussception -volvulus

Question 29

blind pouch on the antimesenteric side

Answer 29

Meckel's diverticulum

Question 30

40% of cases involve the small bowel

Answer 30

Crohns disease

Question 31

vascular compromise that can be mucosal, mural, or transmural

Answer 31

ischemic bowel

Question 32

these are common in the duodenum

Answer 32

peptic ulcers

Question 33

~50% of these have ectopic gastric mucosa or pancreatic parenchyma on cut section

Answer 33

Meckel diverticulum

Question 34

most common cause of ischemic bowel

Answer 34

arterial thrombus/embolus

Question 35

most common location for ischemia

Answer 35

splenic flexure watershed zone

Question 36

most common site for carcinoid tumor

Answer 36

appendix

Question 37

key concept for staging small bowel

Answer 37

depth of invasion

Question 38

at least __ lymph nodes must be located/examined for small/large bowel staging

Answer 38

12

Question 39

majority of adenocarcinomas of the small bowel occur in the

Answer 39

duodenum

Question 40

part or all of the ascending colon and cecum are removed and the colon is reconnected to the small intestine

Answer 40

right hemicolectomy

Question 41

part of all of the descending colon is removed and the transverse colon is reconnected to the rectum

Answer 41

left hemicolectomy

Question 42

part of all of the sigmoid colon is removed and the descending colon is reconnected to the rectum

Answer 42

sigmoid colectomy

Question 43

sigmoid colon and a portion of the rectum are removed and the descending colon is reconnected to the remaining rectum

Answer 43

low anterior resection

Question 44

2 measurements of the colon

Answer 44

-length -diameter or circumference

Question 45

circumference is measured when the bowel is

Answer 45

open

Question 46

absence of ganglion cells and ganglia in muscle wall and submucosa

Answer 46

Hirschsprung disease

Question 47

there will be progressive dilation/hypertrophy in the proximal part of the aganglionic segment in this disease

Answer 47

Hirschsprung disease

Question 48

infection causing pseudomembranous colitis

Answer 48

C. difficile

Question 49

one of most common congenital anomalies of colorectal function

Answer 49

Hirschsprung disease

Question 50

stain for hirschsprung biopsies

Answer 50

acetylcholinesterase stain

Question 51

three types of specimens that may be received from patients with suspected Hirschsprung disease

Answer 51

-rectal mucosal-submucosal biopsies -seromuscular biopsies -pull-through resection specimens

Question 52

this HD biopsy is an intraoperative frozen section diagnosis

Answer 52

seromuscular biopsies

Question 53

usually received when a patient has had a previous rectal submucosal biopsy in which no ganglion cells were observed

Answer 53

seromuscular biopsy

Question 54

specimens received as a part of the corrective surgery for proven cases of HD

Answer 54

pull through resection specimens

Question 55

a severe episode of colitis with segmental or total dilation of the colon

Answer 55

toxic megacolon

Question 56

toxic megacolon can occur due to (3)

Answer 56

-UC -Crohns -antibiotic associated pseudomembranous colitis

Question 57

complication of toxic megacolon

Answer 57

perforation

Question 58

the lumen in toxic megacolon is typically filled with

Answer 58

air

Question 59

passage of fresh blood through the anus

Answer 59

hematochezia

Question 60

dark stool with partially digested blood

Answer 60

melena

Question 61

often related to straining, weakening, muscles, nerve damage or trauma to anal area

Answer 61

rectal prolapse

Question 62

perforated diverticulas can form an abscess typically in the

Answer 62

pericolic adipose tissue

Question 63

representative sections for Crohns and UC are taken every __ cm

Answer 63

10

Question 64

to diagnose familial polyposis, how many polyps need to be counted

Answer 64

100 or more

Question 65

if there are clearly more than 100 polyps, you can say

Answer 65

innumerable

Question 66

these tumors appear as grayish-white nodules (deep mucosal, submucosal) in the colon

Answer 66

neuroendocrine

Question 67

this marking maybe present in a colon specimen

Answer 67

endoscopic tattoo

Question 68

mesorectal margin

Answer 68

circumferential radial margin

Question 69

this must be included on all rectal tumor cases

Answer 69

evaluation of the mesorectal excision

Question 70

this is the single most important predictor of clinical behavior of colorectal cancer

Answer 70

pathological stage

Question 71

most widely used system for staging colorectal cancer in NA

Answer 71

TNM staging system

Question 72

colorectal tumors are classified based on

Answer 72

depth of invasion

Question 73

key staging for anus tumor

Answer 73

size

Question 74

diverticulum in the esophagus/small intestine CPT code

Answer 74

88304

Question 75

esophagus/stomach/small bowel/colon/rectal/anal biopsy

Answer 75

88305

Question 76

colon/smallbowel resection other than for tumor

Answer 76

88307

Question 77

colon/small bowel resection for tumor

Answer 77

88309