GI Flashcards
Pleomorphic adenoma
Most common salivary gland tumor
Painless, mobile mass
Composed of chondromyxoid stroma and epithelium
Warthin tumor
Benign cystic salivary gland tumor with germinal center
VIPoma
Secrete vasoactive intestinal polypeptide
Associated with MEN I
Copious watery diarrhea, hypokalemia, and achorhydria (WDHA syndrome)
Mucoepidermoid carcinoma
Most common MALIGNANT salivary gland tumor
Mucinous and squamous components
Painless slow growing mass
Gastroschisis
Extrusion of abdominal connotes through abdominal folds, not covered by peritoneum
Omphalocele
Persistence of herniation of abdominal content into umbilical cord, SEALed by peritoneum
Plummer-Vinson syndrome
Triad of dysphagia (due to esophageal webs), iron deficiency anemia, and glossitis
Acute gastritis
Disruption of mucosal barrier leading to inflammation
Caused by stress, NSAIDS, alcohol, burns (Curling ulcer w/ sloughing of gastric mucosa), and brain injury (Cushing ulcer, increased H+ production due to increased vagal tone)
Chronic gastritis
Type A (fundus body): autoimmune, autoantibodies, anemia, achloryhydria
Type B (antrum): H pylori infection, increased risk of MALT lymphoma and gastric adenocarcinoma
Menetrier disease
Gastric hypertrophy w/ protein loss, parietal cell atrophy, and increased mucous cells
Precancerous
Tropical sprue
Acute diarrhea, fever, malaise leading to malabsorption
Affects small bowel
Recent visitors to tropic
Responds to antibiotics
Whipple disease
Infection w/ Tropheryma whipplei
Foamy macrophages
Diarrhea leading to malabsorption, cardiac symptoms, arthralgias, and neurologic symptoms
Celiac sprue
Autoimmune mediated intolerance of wheat leading to malabsorption and steatorrhea
Labs show anti-endomysial, anti-tissue transglutaminase, and anti-glaidin (wheat) antibodies
Blunting of villi
Lymphocytes in the lamina propria
Affect distal duodenum and/or proximal jejunum
Crohns dieseas
Autoimmune, possible due to disordered response to intestinal bacteria
Involves any portion of GI tract, skip lesions, rectal sparing usually
Transmural inflammation, cobblestone mucosa, bowel wall thickening (string sign)
Noncaseating granulomas (Th1) and lymphoid aggregates
Can cause strictures leading to obstruction, fistulas, colorectal cancer
Often manifest w/ diarrhea (non-bloody usually), polyarthritis, kidney stones, erythema nodosum
Treat w/ steroids, infliximab, adalimumab
Ulcerative colitis
Autoimmune
Continuous colonic lesion always starting from rectum
Mucosal and submucosal inflammation w/ friable mucosa and loss of haustra “lead pipe”
Crypt abscesses and ulcers, no granulomas (Th2)
Can cause sclerosing cholangitis, toxic megacolon, colorectal carcinoma
Present w/ bloody diarrhea, uveitis
Treat w/ ASA, colectomy
Reye syndrome
Rae but often fatal childhood hepatocencephalopathy
Mitochondrial abnormalities leading to fatty liver, hypoglycemia, hepatomegaly
Associated w/ viral infections especially VZV and influenza that has bent rested w/ aspirin
Mechanism: aspirin metabolites decrease beta oxidation by reversibly inhibiting mitochondrial enzymes
Cavernous hemangioma
Common benign liver tumor
Typically occurs between age 30-50
Biopsy contraindicated because of risk of hemorrhage
Hepatic adenoma
Rare, benign tumor, often related to oral contraceptive or anabolic steroid use
May regress spontaneously or rupture (abdominal pain and shock)
Hepatic angiosarcoma
Malignant tumor of endothelial origin
Associated w/ exposure to arsenic, vinyl chloride
Budd-Chiari syndrome
Occlusion of IVC or hepatic veins w/ centrilobular congestion and necrosis leading to congestive liver disease (ascites, liver failure)
Can develop varicose and visible veins w/ absence of JVD
Associated w/ hyper coagulable states, polycythemia vera, pregnancy, and HCC
Gilbert syndrome
Mildy decreased UDP-glucuronsyltransferase conjugation activity leading o decreased bilirubin intake by hepatocytes
Asymptomatic or mild jaundice
Elevated unconjugated bilirubin w/o overt hemolysis
Crigler-Najja syndrome
Absent UDP-glucuronosyltransferase
Presents early in life w/ pts die within a few years
Jaundice, kernicterus (bilirubin deposits in brain), increased unconjugated bilirubin
Treat w/ phototherapy and plasmapheresis
Dubin-Johnson syndrome
Conjugated bilirubinemia due to defective liver excretion of conjugated bilirubin
Benign
Grossly black lier
Sulfasalazine
Combination of slufapyridine (anti-bacterial) and 5-aminosalicycl acid (anti-inflammatory)
Activated by colonic bacteria
Treat UC and CD
Metoclopramide
D2 receptor antagonist
Increase resting tone, LES tone, motility
Treat diabetic and post-surgery gastroparesis, antiemetic
Can increase parkinsonian effects, restlessness, drowsiness
Octreotide
Long acting somatostatin analog
Treat acute variceal bleeding, acromegaly, VIPoma, and carcinoid tumors
Misoprostol
Prostaglandin E1 analog Increase production and secretion of gastric mucous barrier Decrease acid production Prevent NSAID induced peptic ulcers Also used to induce labor
