GI Flashcards
1
Q
Untreated esophageal SCC complications include
A
mediastinal invasion, tracheoesophageal fistula, regional lymph node metastasis, vascular invasion
1
Q
Spontaneous Bacterial peritonitis occurs in
A
children w/ nephrotic syndrome, adults w/ alcoholic cirrhosis
2
Q
Sialadenitis
A
inflammation of salivary glans d/t sialolithiaisis (stone)
3
Q
Nerve plexus w/in the esophageal wall
A
Myenteric (Auerbach) Plexus
3
Q
Barrett Esophagus
A
Metaplasia of the distal esophagus from squamous to non-ciliated columnar epithelium w/ Goblet cells (d/t acid injury & ulceration)
3
Q
Temporary arrest of intestinal ileum peristalsis
A
Adynamic Ileus (Paralytic Ileus)
3
Q
Anal neoplasm
A
SCC & condyloma acuminatum d/t HPV
4
Q
Causes of Secondary Achalasia
A
Chagas, Polio, surgery, diabetes, infiltrative disease
6
Q
Oral candidiasis
A
white plaques, often on the tongue, that easily scrapes off, associated w/ immunocompromise
6
Q
esophageal atresia often arises at the level of the
A
tracheal bifurcation
7
Q
Microscopic features of the duodenum
A
prominent villous epithelium w/ numerous goblet cells, + submucosal Brunner’s glands
7
Q
Preschooler w/ small bowel obstruction
A
intussusception
8
Q
5 regions of the stomach
A
cardia, fundus, body, antrum, pylorus
9
Q
Hairy Leukoplakia
A
white, rough/hairy patch on lateral sides of tongue, d/t EBV and associated w/ immunocompromise (AIDS)
10
Q
A
10
Q
Bile & pancreatic digestive enzymes enter the small intestine via
A
the ampulla of Vater
10
Q
foamy macrophages in sm. intestine lamina propria w/ PAS+ granules
A
Whipple Disease
10
Q
Acalculous cholecystitis
A
gallbladder stasis, inflammation and edema, cystic duct obstruction due to sludge
11
Q
Gallbladder Carcinoma risk
A
F, >70, gallstones, porcelain gallbladder, irritative trauma, chronic inflammation, carcinogenic derivatives of bile acids
12
Q
Metastasize from upper esophagus is to
A
cervical lymph nodes
13
Q
SPINK1 or PSTI
A
Trypsin inhibitors
14
Q
Non-neoplastic pancreatic cysts
A
thick-walled, cuboidal or flattened (stretching) epithelium
15
Q
Complications of Ulcerative Colitis
A
toxic megacolon, adenomatous polyps -> dysplasia -> risk of carcinoma
16
Q
Veins involved in portal HTN -> esophageal varices
A
distal esophageal vv -> left gastric v -> portal v
17
Peyer's patches are found
lymphoid follicles scattered throughout the ileum
17
Peptic ulcer disease risk factors
EtOH use, NSAID use, COPD, hyperthyroidism, chronic gastritis, severe burns, stress, hypovolemia
18
Gallbladder Adenocarcinoma
infiltrating, fundus/neck, well-differentiated
18
acinar cell injury
Blockage, alcoholism → edema → impaired blood flow, ischemia → acinar cell injury → activated enzymes
19
Flat, firm, irregular, rigid, gastric malignancy
Diffuse Adenocarcinoma - Linitis Plastica
19
Acute Pancreatitis Risks
Gallstones & EtOH
20
Most important prognostic feature of colon cancer is
cancer stage
21
Chronic Pancreatitis acinar cell injury causes
production of pro-fibrotic cytokines (TGF-β and PDGF)
22
Bloody mucoid stools w/ skip lesion stenosis
Crohn Disease
23
Most common malignancy arising in the esophagus
SCC
23
Chronic Pancreatitis Pathogenesis
oxidative stress d/t alcohol → AP-1, NF-KB pathways; IL-8 and monocyte chemo-attractant protein
24
increased # of eosinophils w/in the esophageal epithelium, hyperplasia of the basal zone, elongation of the epithelial papilla
Uncomplicated GERD
24
Causes of chemical esophagitis
Alkali & acidic chemicals, pill esophagitis
24
Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) Microscopically
“Poorly formed glands present in densely fibrotic stroma”
25
Mesocolon
adipose tissue that attaches to the serosa to the abdominal cavity
25
Right-sided Adenocarcinoma
hemoccult test (+), no gross blood in stool
26
Linitis Plastica
highly malignant, DIFFUSE adenocarcinoma that infiltrates the underlying stroma & fibromuscular wall creating a rigid, thick, leather-like gastric mucosa & wall
27
Diverticula above the LES or diaphragm
Epiphrenic Diverticula
28
Most common location for a peptic ulcer
proximal dudoenum
28
Pancreatic enzymes
enzymes secreted in inactive state (except: amylase, lipase)
29
Celiac Sprue
AI disease, flattened villi, duodenum, malabsorption, lymphocyte infiltrate in lamina propria
30
Pancreatic Cystic neoplasms - Serous cystadenoma
lined by cuboidal epithelium without atypia
31
High LES pressure
achalasia
31
Rokitansky-Aschoff sinus –
herniation of gallbladder mucosa into muscular layer
32
Complications of Crohn Disease include
fistulas, strictures
33
Angiodysplasia
severe gastrointestinal bleeding, site of mucosal bleeding cannot be identified
34
Epiploic appendices
finger-like projections of the mesocolon
34
Omentum
sheath of adipose tissue over the intestines
35
Acute Cholecystitis
enlarged, tense, bright red or blotchy/violaceous/green-black (subserosal hemorrhages), serosa has fibrin exudate , cloudy bile
35
Pancreatic Cystic neoplasms - Mucinous cystadenoma
lined by columnar epithelium w/ dense “ovarian” stroma
36
Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma)
in head, hard, stellate, gray-white, poorly defined, somewhat resemble normal ductal epithelium by forming glands and secreting mucin, invade early, elicit intense desmoplastic response
37
Colon cancer has a high
5-year survival rate
37
Metastasize from middle esophagus is to
mediastinum, peritracheal, & tracheobronchial nodes
37
Most common malignancy of the stomach
carcinomas
38
Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) Genetics
oncogene KRAS mutation → inactivation of p16 tumor suppressor gene → inactivation of other tumor suppression genes (TP53, SMAD4, BRCA2)
39
Obstruction of the proximal duodenum
PUD
40
Most common location of diverticular disease
sigmoid colon along the tenia coli
41
Choledocholithiasis
pigmented stones and ass. w/ biliary tract infections; often w/ ascending cholangitis
43
Most common benign tumor of the salivary glands
Pleomorphic adenoma - stromal & epithelial tissue, in parotid w/o n. involvement; mobile, painless, circumscribed mass at angle of jaw
44
Myenteric plexus of the D, J, I is found in which layer
submucosa
44
Cholangitis Sx
sepsis (high fever and chills), abdominal pain, jaundice
45
Pseudomembranous Colitis infiltrate
segmented neutrophil infiltrates
46
Hypertrophic Gastropathy
prominent enlargement of gastric rugal folds d/t hyperplasia of mucosal epithelial cells
46
Pancreatic Cystic neoplasms - Intraductal papillary mucinous neoplasms (IPMN)
extend into ductal system
47
Most common malignancy of the appendix
carcinoid
48
Mucin producing tumors composed of malignant intestinal or signet ring cell types forming glandular structures
Esophageal adenocarcinoma
48
Angiodysplasia is most common
Cecum & right colon d/t high wall tension
49
Parietal cells secrete
HCl & Intrinsic Factor
49
Chronic Ischemic Change
Inflammation, ulceration, fibrosis, & ultimate stricture formation
49
Annular pancreas
pancreas forms a ring around the duodenum → risk of duodenal obstruction
50
Sialadenitis leads to an infection caused by which organism
S. aureus
50
Mucocele:
appendix dilation d/t abdundant mucin secretion
52
SCC of oral mucosa
often on the flood of the mouth w/ leukoplakia (that doesn't easily scrape off) & erythroplakia
53
G-cells secrete
Gastrin
55
Chief cells secrete
pepsinogen I & II
55
Small gray-white plaques in the epithelial surface
esophageal SCC
56
Metastasize from distal esophagus is to
celiac & gastric nodes
57
Lymphoplasmacytic sclerosing pancreatitis
auto-immune pancreatitis with duct-centric inflammatory cell infiltrate, venulitis, ↑IgG4-producing plasma cells – can mimic pancreatic cancer – responds to steroids
58
Complete Metabolic Profile (CMP)
Albumin: 3.9 to 5.0 g/dL ALP/Alkaline phosphatase: 44 to 147 IU/L ALT (alanine aminotransferase): 8 to 37 IU/L AST (aspartate aminotransferase): 10 to 34 IU/L BUN (blood urea nitrogen): 7 to 20 mg/dL Calcium: 8.5 to 10.9 mg/dL Chloride: 96 - 106 mmol/L CO2: 20 to 29 mmol/L Creatinine: 0.8 to 1.4 mg/dL \*\* Glucose test: 70 to 100 mg/dL Potassium test: 3.7 to 5.2 mEq/L Sodium: 136 to 144 mEq/L Total bilirubin: 0.2 to 1.9 mg/dL Total protein: 6.3 to 7.9 g/dL
59
Most common location for a peptic ulcer in the stomach
lesser curvature of the antrum
60
esophageal SCC risk factors
Hx of smoking, EtOH use, tylosis, Plummer-Vinson
61
Krukenberg Tumor
diffuse gastric adenocarcinoma w/ signet ring that metastasizes to bilateral ovaries
61
Signet ring cell infiltrates
diffuse gastric adenocarcinoma - linitis plastica
61
Adenocarcinoma accounts for 50% of
distal esophageal cancers
62
Turcot Syndrome
FAP + CNS tumors (gliomas)
63
base & margins show superficial fibrinoid debris
peptic ulcer
64
Villous Adenoma structure/location
sessile/ sigmoid & rectum
64
periumbilical pain localizing to RLQ, nausea, vomiting, rebound tenderness, fever, peripheral neutrophilic leukocytosis
Acute Appendicitis Sx
65
Chronic Pancreatitis Imaging
see calcifications on CT or U/S, hypoalbuminemic edema, contrast studies show “chain of lakes” pattern d/t dilation of pancreatic ducts
66
Mallory-Weiss Syndrome
Longitudinal lacerations of mucosa at the EGJ d/t the sudden increase in pressure of severe vomiting
66
Diverticulitis
obstruction + inflammation of the diverticula, may lead to pericolonic abscess -\> rupture -\> peritonitis
67
prognosis of esophageal adenocarcinoma
poor
68
Ulcerative Colitis
begins at rectum, continuous spread proximally, mucosa & submucosa, ulcers pseudopolyps crypt abscess w/ loss of haustra
69
Polyp associated w/ rectal bleeding in children
juvenile polyp
69
Biliary Atresia
biliary obstruction w/in first 2mo of life
71
3 factors that promote HCl secretion
neural/vagal ACh, endocrine/gastrin, histamine
72
What would be elevated in a metabolic panel during a mumps infection?
Serum amylase; d/t pancreatitis & salivary gland involvement
74
Type of polyp - greatest risk for colorectal adenocarcinoma
villous adenomatous polyp
75
Flattened villi and non-specific inflammation that improves w/ ABX
Tropical sprue
76
Gallstones & Gallbladder Carcinoma
ONLY 0.5% OF PTS. W/ GALLSTONES DEVELOP GALLBLADDER CARCINOMA, but 90% of cases of gallbladder carcinoma have gallstones
77
Mallory-Weiss Syndrome occurs in
alcoholics & bulemics commonly
78
benign neoplasms of the esophagus
mesenchymal origin
79
Epithelial benign tumors of the stomach
polyps & adenomas
81
Primary carcinoma is least often seen in which segment of the GIT
small intestine
82
Invasive Diarrhea (Destruction & dysentery) agents w/ Heavy infiltrates of segmented neutrophils
Salmonella typhimurium, Salmonella typhi, Invasive E. coli & Shigella
83
Mucosal atrophy & intestinal metaplasia + infiltrates of segmented neutrophils
Chronic superficial active gastritis
85
Type of polyp - lowest risk for colorectal adenocarcinoma
tubular adenomatous polyp
86
Hyperplastic Polyps
areas of hyperplastic colonic epithelium
88
Chronic superficial active gastritis caused by
H. pylori infection - focal infiltrates of segmented neutrophils
89
Juvenile Polyps
Hamartomatous, associated w/ Juvenile Polyposis Syndrome, prolapse or rectal bleeding in children
89
Cholangitis
Bacterial infection of the bile ducts, d/t obstruction often Choledocholithiasis
90
Appendix is a residual portion
of the cecum found adjacent to the ileocecal valve
91
Acute Cholecystitis S/S
acute RUQ or epigastric pain, mild fever, anorexia, tachycardia, sweating, nausea, vomiting, mild-moderate leukocytosis, ↑AP
93
Crohn Disease
Creeping fat distribution, Skip lesions, Aphthous Ulcers, Cobblestone mucosa, Fistula, non-caseating granuloma, transmural
95
Flattening of villi w/ non-specific infiltrates
celiacs or tropical sprue
96
Chronic Pancreatitis leads to pancreatic insufficiency & DM
malabsorption, weight loss, steatorrhea, fat-soluble vit deficiencies
97
Menetrier Disease
Hyperplasia of the surface mucus cells w/ glandular hypertrophy
99
Flattened villi, lymphocytes in lamina propria
Celiacs or Tropical Sprue
100
Protective mechanisms of the stomach
mucin, HCO3, tight junctions, blood flow
101
Gastric mucosa consists of
columnar epithelium lined by mucus producing foveolar cells
102
Acinar cell carcinoma
Acinar cell differentiation w/ zymogen granules containing, may develop metastatic fat necrosis
103
Risk Factors for SCC of oral mucosa
Tobaccoa & EtOH
103
Peutz-Jeghers Syndrome
benign hamartomatous polyps
104
Pancreas Divisum
Duct of Wirsung is separated from the rest of the pancreatic ductal system
105
Location of G-cells
Antrum of the stomach, pylorus & duodenum
106
Chief cells are found in which region of the stomach
Body of the stomach
108
Esophageal mucosa is lined by
stratified squamous
109
Tumor marker for colon Adenocarcinoma
CEA
109
Pancreatoblastoma
Children 1-15 y/o; Squamous islands admixed w/ acinar cells
111
Causes of infectious esophagitis
Candidiasis, CMV, HSV
111
Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) in the tail
silent
112
acute necrotizing pancreatitis
acinar/ductal tissues and islets are necrotic, red-black hemorrhagic areas, foci of yellow-white chalky fat necrosis, extra-pancreatic and extra-abdominal fat involved
113
Appendix wall layers
mucosa + submucosa
115
Patients w/ large intestine resections are prone to
dehydration
116
Hereditary disorders of Cholelithiasis
ATP Binding Casette (ABC) transporters, genes ABCG5 & ABCG2 or D19H
117
Zollinger-Ellison Syndrome
Gastric gland hyperplasia secondary to ectopic tumor
119
How does PGE play a protective role in the stomach?
regulates mucin production
120
Acalculous cholecystitis S/S
more insidious, symptoms obscured by underlying conditions, early recognition is critical otherwise complications quickly develop
122
Most significant risk factor for adenomatous polyps to transition to adenocarcinoma
polyp type (villous)
123
FAP
Inherited polyposis syndrome (mutated APC gene)
124
Tubulovillous Adenoma
Villous component has epithelial cells that form pointed fronds projecting form the polyp surface; Intermediate risk of malignancy
125
2 types of gastric adenocarcinomas
linitis plastica (diffuse w/ signet ring cells) & intestinal (intestinal gland)
127
Ileocecal valve is not a sphincter bc
it is not surrounded by SM that contracts/relaxes, rather it opens as pressure builds
129
Mumps infection may involve which organs
parotid gland, orchitis, pancreatitis, and aseptic meningitis
130
Chronic Pancreatitis features
dilation of pancreatic ducts, protein plugs in lumens, decreased # of acini
130
Pancreatic Pseudocyst
collections of necrotic-hemorrhagic material rich in pancreatic enzymes after acute pancreatitis
131
Behcet Syndrome
recurrent aphthous ulcers, IC-vasculitis (maybe d/t viral inf)
131
Omentum function
protective, may help wall off infections or ruptured appendix, etc
132
Distended mucosal crypts w/ mucopurulent exudate streaming from crypts into the pseudomembrane
Pseudomembranous Colitis
133
Major risk of Mumps in teenagers
Sterility d/t orchitis
135
how do afferent neurons play a protective role in the stomach
cause vasodilation when toxins & secretions breach the epithelium
136
Tx for Tropical sprue
broad-spectrum ABX
137
Barretts esophagus develops as
Complication of long-standing GERD (~10% of pts)
139
Diaphragmatic hernia
Absence of a portion of the diaphragm (usually on the L) w/ Herniation of the stomach, small bowel, or liver
140
hemorrhagic pancreatitis
extensive parenchymal necrosis w/ dramatic hemorrhage within the pancreas
142
Most common tumor of the vermiform appendix
Carcinoid
142
dilation of the deep esophageal glands; Numerous, saccular, flask-shaped, diverticula
Diffuse Intramural Diverticulosis
144
Linitis plastica commonly metastasize to the _____ & are called
ovaries; Krukenberg tumors
145
Most common malignant tumor of the salivary glands
Mucoepidermoid carcinoma - mucinous & squamous cells, in parotid w/ facial n. involvement
145
Pyloric stenosis Sx
2-6 wks after birth, non bilious projectile vomiting, olive mass
147
Menetrier Disease
Hyperplasia of the surface mucus cells w/ glandular hypertrophy -\> large rural folds
149
Hyperplasia of the parietal & chief cells
Hypertrophic-Hypersecretory Gastropathy
150
Gardner Syndrome
FAP + osteomas, fibromatosis, & epidermal cysts
151
Pseudomucocele Peritonei:
abundant mucin secretion into the peritoneal cavity d/t peritoneal implants of malignant cells
151
Agents causing Cholangitis
enteric gram-negative bacteria: E. coli, Klebsiella, Enterococcus, Enterobacter, Clostridium + Bacteroides mixed infection
152
Mucin production protects the stomach from
effects of pepsin
153
Acute Pancreatitis Hereditary Risks
Mutations in cationic trypsinogen gene (PRSS1) or Mutations in serine protease inhibitor Kazal type I (SPINK1)
155
Pathognomonic finding in mumps infection
b/l parotid gland inflammation
157
Gastrin causes
increased H+ secretion, growth of the gastric mucosa, and increased gastric motility
158
Pancreatic carcinoma tumor antigens
CEA and CA19-9 antigen tests
159
Achalasia
absence of myenteric plexus in esophagus (LES fails to relax + proximal dilation of esophagus)
160
Plummer-Vinson (Paterson-Kelly) Syndrome
Esophageal web + Severe iron deficiency anemia + Glossitis
162
esophageal ring
distal esophagus, circumferential, thick hypertrophied ring -\> stenosis
163
failed migration of neural crest cells
Congenital Aganglionic Megacolon (Hirschsprung Disease)
164
PUD is more likely to result in carcinoma if
large diameter, exophytic
165
Pseudomembrane
plaque-like fibropurulent necrotic adhesions & mucus to the surface of damaged colonic mucosa (lacks epithelium
167
sharply demarcated infarcts
acute arterial occlusion (SMA, IMA)
168
Tubular Adenoma
cells form tubules w/in the polyp; Lowest risk for malignancy
169
Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) in the head
biliary obstruction
171
Mucosal atrophy & intestinal metaplasia (not erosive) w/ lymphocyte & plasma cell infiltrates
Chronic gastritis
172
how does the muscularis mucosa play a protective role in the stomach
limits inflammation to the superficial mucosa
173
carcinoid of the appendix
neuroendocrine, appendectomy is curative
174
Chronic cholecystitis
supersaturation of bile, or inflammation d/t microbes resulting in fibrosis, adehesions, fairly clear, green/yellow, mucous bile, usually stones, ROKITANSKY-ASCHOFF sinus
176
Most common malignancy in the sm. intestine
Non-Hodgkin Lymphoma \> Carinoid \> Adenocarcinoma
178
Inflammatory Polyps
Pseudopolyp: epithelial proliferation in response to ulceration &/or inflammation of adjacent tissue causes prominence of the mucosal folds
179
Pepsin acts to
digest proteins
180
Sequelae to fibrosing mediastinal reaction
Traction diverticula
181
ulceration of the esophageal epithelium, which may become infected
Complicated GERD
182
most common malignancy of extra-hepatic biliary tract
Carcinoma
183
Chronic Pancreatitis Risks
Alcoholic, Cystic Fibrosis in kids, obstruction, hereditary
184
Acute Pancreatitis Complications
pancreatic abscess, pancreatic pseudocyst, infection of necrotic material, DIC, fluid sequestration, ARDS, diffuse fat necrosis, peripheral vascular collapse, acute tubular necrosis, periumbilical and flank hemorrhage
186
Ileocecal valve function
prevent reflux of digested liquid back into sm bowel & prevent colonic bacteria from entering
187
Myenteric plexus maintains
unidirectional peristalsis
188
Erosion: loss of superficial epithelium + segmented neutrophil infiltrate
acute gastritis
190
linitis plastica
diffuse, signet ring cell, invasive, rigid, thick, leathery gastric wall
192
Acute peritonitis agents
E. coli, S. aureus, C. perfringens
193
Pleomorphic adenoma has a high rate of
recurrence d/t incomplete resection bc of irregular margins
194
Intestinal adenocarcinoma
ulcer + intestinal metaplasia
195
Complications of Chronic cholecystitis
Porcelain gallbladder – shrunken, hard gallbladder d/t chronic inflammation, fibrosis, and dystrophic calcification, Xanthogranulomatous cholecystitis, Hydrops of gall bladder
196
Migratory thrombophlebitis (Trousseau sign)
Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma)
197
Strong risk factor for Crohn Disease is
Smoking
198
Chronic cholecystitis S/S
recurrent attacks of nonspecific mild RUQ pain esp. after eating, intolerance for fatty/fried food, +/- nausea and vomiting
200
pyloric stenosis presents how & most commonly in who?
1st born male 2-6 weeks after birth
201
Chronic Pancreatitis Labs
↑amylase, ↑AP
203
esophageal SCC S/S
weight loss, progressive dysphagia w/ diet change from solids to liquids
204
Most common death in cirrhosis
ruptured esophageal varices
205
Labs for Acute Pancreatitis
↑amylase (
206
W/in the gastric crypts are neck cells which are
progenitors of foveolar cells and gastric gland cells
208
Erythematous gastric mucosa, segmented neutrophils in lamina propria & gastric crypts, muscularis mucosa intact
Chronic Superficial active gastritis
209
Hyperplastic polyp
is not neoplastic, not associated w/ risk for carcinoma
210
Development of diverticula require:
Focal weakness + Increased luminal pressure
212
hypertrophy of the pylorus
Pyloric stenosis
213
Spontaneous Bacterial peritonitis agents
E. coli, pneumococci
214
LES fails to relax + proximal dilation of esophagus
achalasia
215
Function of the large colon
water reabsorption & fecal storage
216
Complications of Acute Appendicitis
Suppurative Appendicitis, Gangrenous Appendicitis, Rupture -\> Peritonitis
218
Colonic carcinoma frequently metastasizes to the
liver
220
Type of polyp - juvenile
hamartoma
221
Villous Adenoma
Villous fronds w/in the polyp Sessile, large (10cm), velvety consistency, friable, & fragment w/ ease; Highest risk of malignancy
222
Organism enters the Peyer patches in submucosa & replicates w/in
Yersinia
223
Acute Pancreatitis S/S
abdominal pain referred to upper back/left shoulder, anorexia, nausea, vomiting
224
Charcteristic tumor cell associated w/ linitis plastica
signet ring cell
225
Primary carcinoma is most often seen in which segment of the GIT
Large intestine
226
Schatzki ring
encircles lower esophagus just superior to the gastroesophageal junction; Under surface of the ring is lined by columnar epithelium
227
Gallbladder Adenocarcinoma Prognosis
Poor - At diagnosis most have invaded liver, cystic duct, portal-hepatic lymph nodes
228
Absorption in the small intestine occurs via
specialized epithelial cells lined by microvilli
229
Adenocarcinoma S/S
fatigue, weakness, iron-deficient anemia
230
Order of Esophageal CT layers from outside to inside
Stratified squamous epithelium, submucosa, muscularis propria, & adventitia (lacks serosa)
231
Congenital Aganglionic Megacolon (Hirschsprung Disease)
Functional obstruction w/ colonic dilation & hypertrophy proximal to the affected segment
232
Gastric adenomas are most common
in the antrum
234
Warthin Tumor
Benign cystic tumor w/ lymphocytes & germinal centers in parotid
235
Toxic Diarrhea (preformed toxins) agents
S. aureus, Vibrio cholera, C. perfringens – produce preformed toxins Enterotoxigenic E. coli – secrete toxins in vivo
236
semi circumferential thin protrusion of vascularized squamous epithelium
esophageal web
238
Left-sided Adenocarcinoma
gross blood in stool
239
duodenal atresia is associated w/
Downs
240
Pleomorphic adenoma has a low rate of
transformation to carcinoma
241
Lymphoid Polyps
Hyperplastic lymphoid follicles d/t inflammation or other stimuli creating the appearance of a polyp
242
Meconium Ileus
associated w/ Cystic Fibrosis
243
MALT lymphomas are associated w/
H. pylori infections
244
Peptic ulcer disease description
sharply demarcated, punched out ulceration (extends through muscular is mucosa)
245
Infarcted bowel with sharply demarcated area
acute arterial occlusion -\> transmural infarct
246
pyloric stenosis S/S
non-bilious projectile vomiting, peristalsis, olive-mass in abdomen
247
Premature activation of pancreatic enzymes -\>
→ inflammation and edema + proteolysis + fat necrosis + hemorrhage → acute pancreatitis
248
Distal colon Adenocarcinoma
annular ring w/ “napkin ring” constriction; “apple core” lesion on x-ray
249
Parietal cells are found in which region of the stomach
fundus of the stomach
250
Meckel Diverticulum
Failure of the vitelline duct to involute; ileum; True diverticulum
251
Hematemesis following severe vomiting
Mallory-Weiss Syndrome
252
Basic Metabolic Profile (BMP)
BUN: 7 to 20 mg/dL CO2: 20 to 29 mmol/L Creatinine: 0.8 to 1.4 mg/dL Glucose: 64 to 128 mg/dL Serum chloride: 101 to 111 mmol/L Serum K+: 3.7 to 5.2 mEq/L Serum Na+: 136 to 144 mEq/L
253
Gallbladder Adenocarcinoma S/S
mild cholecystitis in elderly women
254
Biliary Atresia pathogenesis
inflammation and fibrosis of inter/extra-hepatic bile ducts, cirrhosis
255
Type 1; Type 2 Biliary Atresia
1 – obstruction at level of common bile duct 2 – obstruction at level of common hepatic duct
256
Biliary Atresia S/S
Jaundice, normal stools → acholic (pale) stools; ↑bilirubin, ↑aminotransferase and AP
257
Choledochal Cysts
dilatations of the common bile duct
258
Choledochal Cysts Sx
jaundice, recurrent abdominal pain/biliary colic
259
Choledochal Cysts Complications
predisposes pt. to stone formation, stenosis, structure, pancreatitis, obstructive biliary complications in liver, ↑ risk of bile duct carcinoma (in older pts.)
