Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology III > GI 2 and liver, 4th quiz W2015 > Flashcards

GI 2 and liver, 4th quiz W2015 Flashcards

1
Q

Looking at all age groups, what is the most common cause of viral enteritis?

A

Norwalk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Among infants and young children, what is the most common cause of severe diarrhea?

A

Rotovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What micro-organism causes “picnic food poisoning”?

A

Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What microorganism that causes food poisoning is associated with Chinese food?

A

Bacillus cereus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What microorganism that causes food poisoning is associated with saltwater crabs and shrimp?

A

Vibrio (cholera and non-cholera)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What microorganism that causes food poisoning is associated with improperly prepared home canned fruits and vegetables?

A

Clostridium botulinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What microorganism is the number one cause of foodborne illness in the U.S.? Second?

A

1st: Norovirus
2nd: Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What microorganism causes bloody diarrhea?

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are toxins associated with gram-negative bacteria that are usually released after lysis of the bacteria?

A

Endotoxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are chromosomally encoded exotoxins that are produced and secreted by several bacterial organisms?

A

Enterotoxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Enterotoxins are often heat-stable and frequently cytotoxic, killings cells by doing what?

A

Altering the apical membrane permeability of the mucosal cells of the intestinal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What may be secreted or, similar to endotoxins, may be released during lysis of the cell?

A

Exotoxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What destroys most exotoxins?

A

Heating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are two common exotoxins?

A

Botulinum

Corynebacterium diphtheriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What condition is primarily seen in premature infants, where portions of the bowel undergo necrosis?

A

Necrotizing enterocolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What illness is characterized by offensive smelling diarrhea, fever, and abdominal pain?

A

Pseudomembranous enterocolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a cause of antibiotic-associated diarrhea that is often caused by clostridium difficile?

A

Pseudomembranous enterocolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In pseudomembranous enterocolitis, what is the pseudomembrane made of?

A

inflammatory cells, necrotic epithelium, and mucus in which the overgrowth of microorganisms takes place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Although colonoscopy and sigmoidoscopy are still employed, what is now the first-line diagnostic approach for pseudomembranous enterocolitis?

A

Stool testing for the presence of C. difficile toxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a condition in which inflammation and injury of the large intestine occur as a result of inadequate blood supply?

A

Ischemic colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What region of the intestine is rarely affected by ischemic colitis and why?

A

The recturm because it received blood from both the inferior mesenteric artery and the internal iliac arter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the most common types of benign small bowel tumors?

A 
Hyperplastic polyp
Adenomas
Stromal tumors - leiomyomas
Lipomas
Hamartomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the histological appearance of a leiomyoma.

A

Smooth muscle cells with elongated spindle cells containing cigar-shaped nuclei and no evidence of increased mitotic activity is seen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What condition is an autosomal dominant disorder characterized by mucocutaneous pigmentation and benign GI hamartomas.

A

Peutz-Jeghers syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where do you find the lesions of Peutz-Jeghers syndrome?

A

Mucocutaneous pigmentation on the face, lips and buccal mucosa.
Benign hamartomas - small bowel (90%), stomach and large bowel.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the histological appearance of a lesion of P-J syndrome?

A

Frond-like appearance with a stromal/smooth muscle core that is covered by acinar glands and normal mucosa. Nuclear atypia is absent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How common is primary cancer of the small intestine?

A

Relatively rare, accounting for only 2% of all GI cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common type of small bowel malignancy in the U.S.?

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the most common type of cancer found in the small bowel? From where?

A

Metastatic disease

Melanoma, and colon, breast, ovary, pancreas and stomach cancers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Carcinoid tumors arise from what? What do they usually secrete?

A

Neuroendocrine cells

Serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the histological appearance of a carcinoid tumor?

A

Typical endocrine appearance with collections of small round cells containing nuclei that are consistent in size and shape and surrounded by cytoplasm which stains pink to pale blue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a fleshy growth occurring on the lining of the colon or rectum? What is it a risk of developing into?

A

Colorectal polyp

Colorectal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the most common type of polyp found in the colon?

A

Hyperplastic polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What can be described as rice grains on the colonic mucosa, with minimal epithelial atypia, where the cells display normal differentiation and maturation?

A

Hyperplastic polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does a adenomatous polyp look like and what is it also known as?

A

Small, smooth, rounded.

AKA tubular adenoma because of the rounded nature of the neoplastic glands that form it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the gross appearance of a villous adenoma?

A

Sessile, larger than a tubular adenoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

The majority of the polyps found in this condition are non-neoplastic, hamartomatous, self-limiting and benign, but there is an increased risk of developing adenocarcinoma.

A

Juvenile polyposis syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Histologically, a slide shows edematous stroma, eroded surface and cystic epithelial elements. What is the condition?

A

Juvenile polyposis syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What condition is inherited and consists of hundreds to thousands of polyps formed mainly in the epithelium of the large intestine? What happens if it goes untreated?

A

Familial adenomatous polyposis

The polyps start out benign, but untreated there is malignant transformation into colon cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the combination of polyposis, osteomas, fibromas, and sebaceous cysts?

A

Gardner’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What condition has a gross appearance of the mucosal surface of the colon being a carpet of small adenomatous polyps?

A

Familial adenomatous polyposis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What does adenocarcinoma look like microscopically?

A

Still glandular configuration, but the glands are irregular and are very crowded. Many of them have lumens containing bluish mucin. Hyperchromatism and pleomorphism are seen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How is LeiomyoSARCOMA different from LeiomyoMA?

A

Both have increased cellularity, but leiomyosarcoma greater cell density and cells have more mitotically active nuclei.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What do non-Hodgkin’s lymphoma cells look like?

A

They have prominent clumped chromatin and nucleoli with occasional mitotic figures. They can be seen infiltrating through the mucosa.

45
Q

While moderate hepatocyte swelling is reversible, more severe damage has irregularly clumped cytoplasmic organelles and large clear spaces. These may not be reversible. What is this process known as?

A

Ballooning degeneration

46
Q

A dying (apoptotic) hepatocyte may shrink down to form what? What condition(s) is it associated with?

A

An eosinophilic councilman body

Viral hepatitis, yellow fever, other viral syndromes

47
Q

What is iron overload in hepatocytes?

A

Hemochromatosis

48
Q

What is copper overload in hepatocytes?

A

Wilson’s disease

49
Q

What is triglyceride fat droplet accumulation in hepatocytes?

A

Steatosis

50
Q

What is the most common cause of fatty change in developed nations?

A

Alcoholism

51
Q

What category of liver disease involves quiescent lymphocytes collecting in the portal tracts which may migrate into specific areas of the periportal parenchyma as activated lymphocytes?

A

Viral hepatitis

52
Q

What is a sign of very recent hepatocyte destruction?

A

Apoptotic hepatocytes

53
Q

Apoptotic hepatocytes usually don’t incite a diffuse inflammatory reaction. However, scavenger macrophages (also known as what?) engulf the apoptotic cell fragments within a few hours, generating localized clumps of inflammatory cells which does what?

A

Kupffer cells and circulating monocytes

Activates a cascade of multiple cytokines

54
Q

Unlike other responses which are reversible, what points toward a state of generally irreversible hepatic damage?

A

Fibrosis

55
Q

Ongoing liver damage with liver cell necrosis followed by fibrosis and hepatocyte regeneration results in what?

A

Cirrhosis (nodular)

56
Q

With cirrhosis, what do you see microscopically?

A

The regenerative nodules of hepatocytes are surrounded by fibrous connective tissue that bridges between portal tracts.

57
Q

What type of disorders is by far the most frequent concerning the liver?

A

Inflammatory

58
Q

Other than hepatitis A, B, C, D, and E, what viruses effect the liver?

A

Epstein-Barr
Cytomegalovirus
Yellow fever virus

59
Q

How serious is HAV?

A

Benign, self-limited

60
Q

Which hepatitis virus can involve (1) acute hepatitis with resolution (2) chronic hepatitis > mb cirrhosis (3) fulminant hepatitis w/massive liver necrosis and (4) the backdrop for HDV?

A

Hepatitis B

61
Q

Which hepatitis virus is most widespread, globally?

A

Hepatitis B

62
Q

What makes HBV so hardy?

A
  • Prolonged incubation period
  • Remains in the blood up to and during active episodes of acute and chronic hepatitis
  • Present in all physiologic and pathologic body fluids except stool
  • Withstands extremes of temp and humidity
63
Q

What is the most common chronic blood-borne infection in the U.S. and accounts for almost half of all patients in the U.S. with chronic liver disease?

A

Hepatitis C

64
Q

How is HBV transmitted?

A

Inoculations(IV drug use 60%) and blood transfusions. Risk of sexual transmission is low.

65
Q

Which hepatitis virus is the highest risk perinatally?

A

HBV

66
Q

What is generally the course of HCV?

A

Often undetected clinically. Once symptomatic it is indistinguishable from HAV/HBV, although it is often milder.

67
Q

What is a characteristic clinical feature of chronic HCV infection?

A

Episodic elevations in serum aminotransferases.

68
Q

What is the only way to prevent HDV and why?

A

Prevent HBV because the D virus is “replication defective” and requires genetic information from the B virus to replicate.

69
Q

Where is HDV common?

A

Mediterranean, Middle East, Northern Africa. It is uncommon in the U.S.

70
Q

Hepatitis E symptoms resolve over the course of 6 weeks. However, who should be worried about HEV?

A

Pregnant women; it can lead to fulminant hepatic necrosis and death (15-25%)

71
Q

Which hepatitis virus is termed an “innocent bystander” virus?

A

Hepatitis G; no known pathogenic activity.

72
Q

What is a liver parenchymal cell with a characteristic hazy staining appearance to the cytoplasm on light microscopy?

A

Ground glass hepatocyte

73
Q

The classic ground glass appearance is associated with what condition and occurs as a result of what abundant substance?

A

Chronic hepatitis B; hepatitis B antigen in the endoplasmic reticulum.

74
Q

What is the term used when hepatic insufficiency progresses from onset of symptoms to hepatic encephalopathy within 2 to 3 weeks?

A

Fulminant hepatitis

75
Q

What may reactivate a latent HBV infection with fulminant hepatitis as a possible outcome?

A

HAV or non-heptotropic virus, drugs (acetominophen) or chemical toxicity.

76
Q

Transection of a fulminant liver will reveal what?

A

Necrotic areas with a muddy, red appearance with blotchy bile staining.

77
Q

What does Fulminant hepatitis look like microscopically?

A

Complete destruction of hepatocytes in contiguous lobules leaving only a collapsed reticulum framework and preserved portal tracts.

78
Q

If a patient survives more than a week with a fulminant hepatitis, the liver can recover, potentially completely. Under what circumstances is the parenchymal framework preserved and what is this compared to?

A

With centrilobular zonal necrosis caused by direct hepatotoxins or by ischemia. With more massive destruction of confluent lobules, regeneration is disorderly.

79
Q

What does alcohol impaired hepatic metabolism of methionine lead to?

A

Decreased intrahepatic glutathione (GSH) levels thus sensitizing the liver to oxidative injury.

80
Q

Induction of what increases break down of alcohol in the endoplasmic reticulum and increases the conversion of acetaminophen to toxic metabolites (especially what)

A

Cytochrome P-450

NAPQI - N-acetyl-p-benzoquinone-imine

81
Q

What is the antidote for acetaminophen poisoning?

A

N-acetyl-cysteine (NAC)

82
Q

What is the leading cause of liver disease in most Western countries?

A

Excessive alcohol consumption

83
Q

What three conditions are collectively referred to as alcoholic liver disease?

A

Hepatic steatosis
Alcoholic hepatitis
Cirrhosis

84
Q

Describe the process of hepatic steatosis (fatty liver)?

A

The intake of alcohol causes microvesicular droplets of lipids to accumulate in hepatocytes. Chronic intake causes these globules to compress and displace the nucleus to the periphery.

85
Q

What is the major intermediate metabolite of alcohol en route to acetate production that induces lipid peroxidation and subsequent oxidative damage?

A

Acetaldehyde

86
Q

Hepatocytes may accumulate keratin and other proteins, which become visible as eosinophilic cytoplasmic inclusions. What is this called? What are they characteristic of?

A

Mallory bodies

Alcoholic liver disease

87
Q

What is almost always accompanied by prominent activation of fibroblasts which give rise to fibrosis? What generally signals an irreversible stage of the disease process?

A

Chronic alcoholic hepatitis

The appearance of fibrotic bands

88
Q

How many grams of daily ethanol intake is associate with significant risk? Severe injury?

A

80 gm

160 gm for 10 to 20 years

89
Q

How does alcoholic hepatitis contrast to steatosis?

A

Acutely, usually following a bout of heavy drinking

90
Q

What is a syndrome characterized by central nervous system dysfunction in association with liver failure including portal-systemic shunts?

A

Hepatic encephalopathy

91
Q

What is one of the most common findings with portal hypertension? (what other organ is affected?)

A

Splenomegaly

92
Q

What liver condition is strongly associated with obesity, dyslipidemia, hyperinsulinemia, insulin resistance and type 2 diabetes?

A

Nonalcoholic fatty liver disease (NAFLD)

93
Q

What is presumed to be the most likely explanation for the elevated serum aminotransferases and/or GGT values documented in 24% of the the general U.S. adult population?

A

Nonalcoholic fatty liver disease (NAFLD)

94
Q 
What condition reveals the following on biopsy?: 
steatosis
multifocal parenchymal inflam.
Mallory hyaline bodies
hepatocyte death
sinusoidal fibrosis
A

Nonalcoholic steatohepatitis NASH

95
Q

What are the usual primary and secondary causes of hemochromatosis?

A

Primary - genetic defect causing excessive iron absorption

Secondary - excessive administration of iron

96
Q

What condition is an autosomal recessive disorder marked by the accumulation of toxic levels of copper in many tissues and organs, principally the liver, brain, and eyes?

A

Wilson’s disease

97
Q

What sign in the eye is pathognomonic for Wilson’s disease?

A

Kayser-Fleischer’s ring

98
Q

What is an autosomal recessive disorder marked by abnormally low serum levels of this protein that inhibits proteases which are normally released from neutrophils at sites of inflammation?

A

Alpha 1-antitrypsin deficiency

99
Q

A1AT deficiency is more likely to cause disease where in the body in children vs. adults?

A

Liver in children

Lung in adults

100
Q

Microscopically, periportal red hyaline globules with periodic acid-schiff (PAS) stain are characteristic of what condition?

A

A1AT deficiency

101
Q

What condition is an autoimmune disease in which there are T cell mediated destruction of the bile ducts of the liver?

A

Primary biliary cirrhosis

102
Q

What is the primary histologic feature of primary biliary cirrhosis?

A

Granulomatous destruction of medium sized intrahepatic bile ducts

103
Q

What condition has hepatomegaly, xanthomas and xanthelasmas with later development of jaundice and severe pruritus?

A

Primary biliary cirrhosis

104
Q

What is an important identifying lab for PBC? (95% sensitivity)

A

Positive anti-mitochondrial antibody test

105
Q

What condition is associated with the bile ducts initially becoming inflamed, with segmental stricture and dilatation?

A

Primary sclerosing cholangitis

106
Q

What do you expect to see with a barium swallow in a patient with primary sclerosing cholangitis?

A

Beaded appearance of intra-hepatic ducts

107
Q

What condition do patients with primary sclerosing cholangitis also have 70% of the time?

A

Ulcerative colitis

108
Q

What do the bile ducts look like histologically on biopsy for a patient with primary sclerosing cholangitis?

A

Onion skin pattern

109
Q

What cancer is a primary sclerosing cholangitis patient at an increased risk for?

A

cholangiocarcinoma

Pathology III (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions