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EXAM 4 Patho > GI > Flashcards

GI Flashcards

1
Q

What is CEA

A

Tumor marker:
Used to test recurrence of tumor in pts.
CEA is increased in the blood of 1/4 of patients with advanced gastric cancer (helps monitor mets). Gastric & Colon cancer.

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2
Q

AFP is used for what?

A

is useful for early diagnosis of primary malignant liver cell tumors. Tumor marker for HCC

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3
Q

Which disease:

  • Segmental R side
  • Transmural inflam with fistula formation.
  • Non-Caseating granulomas
  • Rubber-hose Fibrosis
  • Creeping fat
  • Cobblestone
  • Skip Lesion
A

Crohn’s

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4
Q

Which Disease:

  • L side of the colon
  • Rectal lesion with inflam spreading proximally
A

CUC

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5
Q

Which disease:

  • Diffuse with no skip lesions
  • Limited to the Mucosa and Submucosa
A

CUC

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6
Q

Which disease:

  • Prone to bleeding
  • Toxic megacolon
  • Crypt abscesses
  • Pseudopolyps
A

CUC

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7
Q

Most common non-neoplastic polyp types ALWAYS Benign

A

Hyperplastic Colon Polyps

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8
Q

Where do Hyperplastic Colon Polyps usually occur

A

80% in rectosigmoid area L side. Composed of hyperplastic glands rich in goblet cells and mucin.

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9
Q

Which Adenocarcinoma?

- Incidence high in Japan and Chile 7-9 x more than U.S.

A

Stomach

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10
Q

Risk Factors for Stomach Adenocarcinoma

A
  • Dietary factors: Starch, smoked fish (benzpyrene and carcinogens)and meats and pickled veggies.
  • Age and Sex: uncommon less 30 and sharp incidence in greater than 50 slight male predominance.
  • Nitrosamines:
  • Genetic: Blood type A found in half of the pts with gastric cancer.
  • Low socioeconomic settings
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11
Q

Risk factors for Colon cancer

A

-Red Meat: .
-Fat:
-Foods rich in refined carbs and low in fiber: Low fiber= less feces & slower colonic peristalsis. Prolonged transit time in the lg intestine means longer contact between carcinogens & mucosa.
Genetics:

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12
Q

Cancer of which side of the colon?

  • fungating masses or Ulcerated shallow like craters
  • chronic blood loss with dark red feces (melena) may cause anemia.
A

Right side

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13
Q

Cancer of which side of the colon?

  • 45% in rectosigmoid area
  • narrow the intestine
  • Napkin-ring lesions.
  • Annular. Infiltrate intestine circumferentially
  • pencil-like feces,
  • red blood in the feces
A

Left side

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14
Q

Risk Factors for Gastric ulcers

A 
Environmental factors 
Cigarette smoking
Alcohol 
Hydrochloric acid
H pylori
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15
Q

Risk Factors for duodenal Ulcers

A 
Environmental factors
Alcohol
Genetic 3-fold inc 0
Type O blood 30% higher 
Hydrochloric acid
H plylori
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16
Q

How does a gastric ulcer look

A

edges sharply punched out w/ overhanging margins. Flat base is gray & indurated.

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17
Q

How does a duodenal ulcer look

A

lesions usually solitary but kissing also can be present.

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18
Q

Where is the most common locations of the Gastric Ulcers?

A

Most arise in the lesser curvature of the stomach, in the antral and prepyloric regions.

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19
Q

What is referred to as a kissing Ulcer?

A

paired ulcers on both walls seen in duodenal ulcers.

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20
Q

Risk factors related to blood type, stress, h. pylori?

A
  • Blood type O 30% duodenal ulcers
  • Stress is directly related to acid production in the stomach.
  • H Pylori found in 75% of gastric ulcer pts and has been isolated from gastric antrum of all pts with duodenal ulcers
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21
Q

General features and risk factors for oral squamous cell carcinomas in general

A

Features: involves the tongue, followed by the floor of the mouth, palate and buccal mucosa. male > female 2:1, 50-70 yrs old and most common cancer in men of india.

22
Q

Two most common etiologies for oral SCC

A 
Alcohol 
Tobacco use (cig smoking)
23
Q

Def of Barrett’s esophagus and what cell adaptation is involved?

A

The metaplastic epithelium extends up the distal esophagus with thickened red-brown circumferential tissue

24
Q

What type of cancer is most associated with Barrett’s esophagus?

A

Adenocarcinoma

25
Q

Know the #1 cancer of the oral cavity is squamous cell carcinoma! Risk factors:

A
  • Leukoplakia
  • Erythroplakia.
  • Cigarette smoking (tobacco use)
  • Alcohol
  • Local irritation (cheek biting or malformed dentures)
  • poor oral hygiene
  • HPV
  • Betal nuts
  • Physical and chemical irritant.
26
Q

locations for squamous cell carcinomas of the esophagus

A

Half the cases involve the lower third, and the middle and upper thirds account for the remainder.

27
Q

Squamous cell carcinomas of the esophagus Features

A

The bulky polypoid tumors tend to obstruct early, and the infiltrating tumors gradually narrow the lumen by concentric compression.

  • Range from well-differentiated with keratin pearls to poorly-differentiated tumors.
  • Dysphagia, most common sxs usually not recognized until the diameter of the lumen in reduced by 30-50%. Cachetic
  • Very poor prognosis
28
Q

Squamous cell carcinomas of the esophagus Incidence

A

High incidence in China, Iran and South Africa.

29
Q

Strongest risk factor for Pancreatic Cancer ?

A

Smoking

30
Q

What are the two most common conditions leading to acute hemorrhagic pancreatitis?

A
  • Gallstones causing obstruction of the main pancreatic duct: An important cause of pancreatitis that can occur in association with biliary disease.
  • Alcohol abuse.
31
Q

Demographics and risk factors of Cirrhosis of the liver?

A
  • The most important cause of cirrhosis in the U.S. is alcohol abuse, and is the fourth most common cause of death in men 40-60 yrs.of age
  • HEP B and C also important causes
32
Q

General features of colon cancer?

A

L Rectosigmoid 45% tend to be annular, in the R cecum are more polypoid.

33
Q

Know which gastric disorders can be pre malignant.

A

Leukoplakia
Erythroplakia
Barrett’s Esophagus
Gastric Ulcers.

34
Q

Most common complication of peptic ulcer disease?

A

Hemorrhage, in many cases bleeding is occult pt manifest iron deficiency anemia b/c of it.

35
Q

What are the 3 diff types of hepatocellular carcinomas that you can have?

A
  • Diffuse infiltrative lesion: Poor prognosis
  • Solitary Mass limited to a lobe of the liver
  • Multiple nodules
36
Q

Treatment for tubulovillous adenomas

A

Tubular and Tubulovillous: Can be readily resected through an endoscope because of stalk

37
Q

Treatment for villous adenoma

A

Cannot be resected through an endoscope. Segmental resection of the involved intestine is curative if performed before the malignant transformation takes place.

38
Q

What is Leukoplakia

A

more common than erythroplakia and shows up as white plaques. Less incidence of malignant transformation

39
Q

What is Erythroplakia

A

less common, BUT, highly malignant greater than 50% risk of malignant transformation. Velvety red in appearance.

40
Q

What is a Pseudopolyps

A

False tumors, only in Ulcerative Colitis. small remnants of inflamed mucosa that appear to be elevated over the base of the surrounding ulcerations. Represent foci of mucosal regeneration that may undergo malignant transformation, which is the most significant late complication of CUC

41
Q

what is Cobblestone

A

Only in Crohn’s. Skip lesions interspersed between more normal appearing mucosa.

42
Q

Why do we call it a mixed tumor?

A

has connective tissue elements as well as epithelial elements. Biphasic appearance, an admixture of epithelial and stromal elements.

43
Q

MC loc of mixed tumor

A

65-85% of neoplasms occur in the Parotid.

44
Q

What is Courvoisier’s Sign? What condition would you see that in ?

A

Gall bladder dilation and may even be palpable on P.E.

Seen in adenocarcinomas of the pancreas

45
Q

What is the pathogenesis of acute hemorrhagic pancreatitis.?

A

Reflux of bile into the pancreas in the intrapancreatic pressure & can activate the proenzymes, causing autodigestion.

  • —-Trypsinogen, the inactive form of Trypsin, leads to necrosis of tissues.
  • —-Pseudocysts
  • —-necrotic tissue attracts Calcium salts and undergo calcification.
46
Q

S/S of acute hemorrhagic pancreatitis?

A

Sudden onset occurs in pts with history of gallstones and alcoholism. Abdominal pain & distention and N/V. Pts have great distress and sweat profusely. Pain is uncontrollable. Pancreas appears swollen and permeated with blood. Yellow areas of necrosis appear 2-3 days after onset.

47
Q

Acanthosis

A

thickening of the stratum spinosum that results from chronic external irritation. i.e. Formation of a callus

48
Q

Hyperkeratosis

A

thickening of the stratum corneum. i.e. common wart

49
Q

Parakeratosis

A

the retention of the keratocyte nuclei in the stratum corneum. i.e. pemphigus vulgaris

50
Q

Spongiosis

A

intercellular edema of the epidermis. i.e. inflammatory disorders.

EXAM 4 Patho (4 decks)

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