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MODHIII - Unit 3 > GI Disorders > Flashcards

GI Disorders Flashcards

1
Q

How can non erosive GERD cause heartburn

A
  • dilated intercellular spaces (spongiosis)

- allows acid to go between cells

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2
Q

Clinical presentation of eosinophilic esophagitis

A
  • food impaction, dysphagia (adults), GERD, feeding intolerance (children)
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3
Q

Endoscopy of eosinophilic esophagitis

A
  • trachealization (felinization)

- linear furrowing

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4
Q

Histology of eosinophilic esophagitis

A
  • > 15 eosinophils per high power field

- eosinophilic microabscesses, superficial layering, BZH, DIS

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5
Q

Reflux esophagitis

A
  • endoscopic or histologic evidence of reflux-associated injury
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6
Q

Histology of reflux esophagitis

A
  • BZH, PE, increased intraepithelial eosinophils, DIS
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7
Q

Endoscopy of reflux esophagitis

A
  • erosion through mucosal breaks or normal
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8
Q

Diagnosis of GERD: clinical and pathological

A
  • clinical symptoms: GERD or asymptomatic; symptoms may improve with BE development
  • pathology: endoscopically evident columnar mucosa proximal to anatomic GEJ with BIOPSY demonstrating intestinal metaplasia (goblet cells); 2 within 1 year to confirm diagnosis and rule out dysplasia
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9
Q

Portal hypertensive gastropathy (PHG) vs. gastric antral vascular ectasia (GAVE): endoscopy, histology, treatment

A
  • endoscopy: PHG-mosaic, snake skin like; GAVE-watermelon stomach
  • histology: PHG-tortuous submucosal veins; fibrin thrombi
  • treatment: PHG-reduction of portal pressure (beta blockers); GAVE-thermal ablation
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10
Q

Complications of helicobacter gastritis

A
  • duodenal ulcer, gastric ulcer, gastric carcinoma, MALT lymphoma
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11
Q

Hypergastrinemia: definition

A
  • increased gastrin production
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12
Q

Cause of hypergastrinemia

A
  • G(astrin) cell hyperplasia
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13
Q

Cause of G(astrin) cell hyperplasia

A
  • proton pump inhibitor use

- causes loss of negative feedback on G cells from acid

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14
Q

Hypergastrinemia causes what

A
  • increased acid release from parietal cells

- this can lead to GERD or ulcers

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15
Q

Whipple’s disease: definition & cause

A
  • systemic infection

- cause: trophyrema whippleii

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16
Q

Symptoms of whipple’s disease

A
  • gastrointestinal: diarrhea, weight loss, malabsorption
  • extraintestinal (can exist for months or years before malabsorption): arthritis/athralgia, fever, lymphadenopathy, neurologic, cardiac, pulmonary disease
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17
Q

Pathology of whipple’s disease

A
  • lamina propria filled with foamy histiocytes
  • PAS-D positive
  • dilated lymphatics (basis of malabsorption)
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18
Q

Micobacterium Avium Intracellulare vs Whipple’s disease

A
  • clinical and histologically the same

- distinguish with an AFB stain

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19
Q

Carcinoid syndrome: symptoms, cause of symptoms

A
  • symptoms: flushing, wheezing, diarrhea

- release of vasoactive peptides into systemic circulation: SEROTONIN

20
Q

Neuroendocrine Tumor: definition, location

A
  • epithelial neoplasms that make peptide hormones or biogenic amines
  • most common site is jejunum/ileum
21
Q

GI neuroendocrine tumors associated diseases

A
  • stomach: autoimmune gastritis
  • duodenum: Zollinger-Ellison syndrome (gastrinoma)
  • jejunum/ileum: none
  • appendix: none
22
Q

GI neuroendocrine tumors: behavior

A
  • stomach: variable
  • duodenum: variable
  • jejunum/ileum: aggressive
  • appendix: rarely aggressive
23
Q

Gi neuroendocrine tumors: location

A
  • stomach: proximal
  • duodenum: periampullary
  • jejunum/ileum: anywhere
  • appendix: tip
24
Q

Celiac disease: process

A
  • immune mediated damage triggered by the ingestion of gluten
25
Clinical presentation of celiac disease
- anemia, chronic diarrhea, bloating, muscle wasting
26
Risks associated with celiac disease
- enteropathy associated T cell lymphoma | - small intestinal adenocarcinoma
27
Serology of celiac disease
- IgA to tissue transglutaminase (TTG) | - IgA or IgG antibodies to deamindated gliadin
28
Useful in ruling out celiac disease
- HLA-DQ2 or HLA-DQ8 (always present in celiac disease)
29
Pathology of celiac disease
- increased intraepithelial lymphocytes (CD8+ T cells) - villous blunting and crypt hyperplasia - loss of mucosa/brush border surface area: flat, NO MORE VILLI
30
What should you check for with a duodenal lymphoma
CELIAC DISEASE
31
Causes of intestinal obstruction
- herniation, adhesions, volvulus, intussusception | - meckel diverticulum, acute appendicitis
32
Meckel diverticulum: rule of 2's
- 2% of population - 2 feet within ileocecal valve - 2 inches long - 2x as common in males - symptomatic by age 2
33
Meckel diverticulum: type
- TRUE diverticulum
34
Meckel diverticulum complications
- bleeding, OBSTRUCTION, tumor
35
Two types of GERD
- erosive | - non erosive
36
Cancer risk in IBD
- UC: high risk; increased with extensive disease, longer duration (>8years), if primary sclerosing cholangitis (PSC) also present - Crohn's: moderate (less colon involved)
37
Colorectal Adenocarcinoma Risks
- majority (>90%) are sporadic - Familial syndromes: familial adenomatous polyposis (.5%), hereditary non polyposis colorectal cancer (2-4%), juvenile polyposis coli (1%) - IBD: 1%
38
FAP cancer risk
- CFAP: 100% lifetime risk | - AFAP: 70% lifetime risk
39
Lynch syndrome
- deficient DNA mismatch repair - susceptible to insertion/deletion loop formation - increase risk of colorectal cancer - prevalence 1:500
40
Adenocarcinoma prevalence
- occurs in 6% of population
41
Acute Colitis cause
- infection
42
Chronic colitis cause
- idiopathic IBD: UC or crohn's disease | - microscopic colitis: lymphocytic or collagenous
43
IBD vs. Microscopic colitis: clinical, endoscopy, histology
- IBD: clinical-pain, bloating, constipation/diarrhea; endoscopy-abnormal; histology-architectural distortion, crypt branching, neutrophils, crypt abscess - MC: clinical-watery diarrhea; endoscopy-NORMAL; histology-normal crypts, increased lymphocytes or thickened collagen layer
44
Crohn's Disease
- segmental/patchy, transmural, anywhere in GI (ILEUM, rectum spared), granulomatous - strictured terminal ileum (CLASSIC) - fissuring (knife like) ulcer
45
Ulcerative Colitis
- diffuse, superficial (mucosa only), colon ONLY | - nearly always involves the rectum
46
Gastritis in Crohn's vs. UC
- Gastritis can be present in BOTH
47
Collagenous colitis histology
- thickened layer of subepithelial collagen

MODHIII - Unit 3 (20 decks)

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