GI Flashcards
ATP7B
Excretes copper in bile or transports copper in the blood as ceruloplasmin
Mutated in Wilson’s disease
Liver, brain, cornea, kidney, and joint damage
Hemochromatosis Mut
C282Y in HFE gene
Leads to unregulated iron absorption
GERD
Decreased tone of lower esophageal sphincter
Increased risk in pregnancy, pregnancy, alcohol, smoking
Lymph drainage for esophagus
Upper: cervical nodes
Middle: mediastinal nodes
Lower: celiac and gastric nodes
Causes of esophagitis
Candida: white membranes with pseudohyphae
HSV-1: punched out ulcers
CMV: linear ulcers in AIDs patients
Eosinophilic esophagitis: dysphagia with poor response to GERD treatment
Achalasia
Failure to relax LES (birds beak)
Caused by loss of ganglion cells in Auerbach’s plexus (Chronic Chagas)
Dysphagia to solids and liquids and bad breath
Plummer Vinson syndrome
Iron deficiency anemia
Beefy red tongue
Esophageal web
Pyloric stenosis
Presents 2 weeks after birth
Nonbilious projectile vomiting, olive mass, and visible peristalsis
Diffuse type of gastro-carcinoma
Signet ring cells
Desmoplasia –> thickening of stomach wall (linitis plastica)
Krukenburg tumor
Metastasis of diffuse-type gastric carcinoma to both ovaries
Duodenal atresia associations
Down Syndrome
Polyhydramnios
Double bubble sign
Chrons disease
Terminal ileum most common with skip lesions
Granulomas
Cobblestone mucosa, creeping fat, strictures
Associated with fistulas, strictures, vasculitis, and seronegative arthropathies
Ulcerative colitis
Starts in rectum and continuously works its way back
Crypt abscess with neutrophils
Psuedopolyps and lead pipe appearance
Associated with primary sclerosing cholangitis (P-ANCA +), toxic megacolon, carcinoma
Hirschsprung disease
Failure of ganglion cells to descend
Lack of peristalsis and relaxation of rectum
Associated with Down syndrome
Most common cause of ischemic colitis
Atherosclerosis of the SMA
Occurs at the splenic flexure
Hyperplastic polyp
Usually arises in the left colon
Benign with NO malignant potential
Serrated appearance
Adenomatous poly
Benign with malignant potential
Risks: size >2 cm, sessile growth, villous histology
Adenoma carcinoma sequence
APC mut risk for development of polyps
KRAS mut leads to polyp formation
P53 mut and increase COX leads to cancer
Associated with cancer in left colon
Pancreatic tumor marker
CA-19-9
Gilbert Syndrome vs
Crigler-Najjar syndrome
Deficiency in UGT –> Jaundice during stress
Absent UGT –> Kenicterus usually fatal
Dubin-Johnson syndrome
Deficiency in canicular transport protein
Increased conjugated bilirubin in blood
Pitch black liver
Biliary tract obstruction labs
Increased conjugated bilirubin
Decreased urine urobilinogen
Increased alkaline phosphatase
Increased bile acids –> pruritis and hypercholesterolemia
Hepatitis E
Causes fulminant hepatitis in pregnant women
Histology of Alcoholic Hepatitis
Mallory bodies which are damaged intermediae filaments
Primary biliary cirrhosis marker
Anti-mitochondrial antibodies
Primary Sclerosing Cholangitis
Periductal fibrosis with onion skinning
String of pearl appearance
Associated with ulcerative colitis
Increases risk of hepatic adenoma
Birth control
Budd-Chiari syndrome
Thrombosis of the hepatic vein
Presents with painful hepatomegaly and ascites
Marker for liver carcinoma
Alpha-fetoprotein
