GI - FA, Pathoma Flashcards
Can a pleomorphic adenoma become cancerous?
How do you know?
YES
Facial nerve damage
Why will the Left heart not get any valvular fibrosis?
Bc the lung has MAO which breaks the serotonin down
Colon cancer progression?
What protects against it?
Risk –> loss of APC (ch.5) –> KRAS mutation –> loss p53 and INC COX
ASA presents against it
Who does angiodysplasia occur in? Where?
Presents how?
Adult in their 70’s, cecum and right colon
Hematochezia
What are the greatest prognostic factors of adenoma to become cancer after biopsy?
1 size > 2cm
Sessile growth
Villous histology
When does carcinoid syndrome show symptoms?
What can it cause?
When it metastasizes to the liver
Carcinoid heart disease –> Right-sided valvular fibrosis and TR w/pulmonary valve stenosis
What causes appendicitis?
MC complication?
Lymphoid hyperplasia
Fecalith
Periappendiceal abscess
Rupture of pud may lead to bleeding from what?
What location?
Gastroduodenal artery or acute pancreatitis
Posterior duodenum (ant MC)
Hirschsprung disease is due to what?
Dx?
Failure of ganglion cells to descend into myenteric and submucosal plexus
Rectal suction biopsy
Peak incidence of colorectal cancer?
60-70
Where is a pleomorphic adenoma located?
Describe how?
Arises where?
Angle of jaw
High recurrence, mobile, painless, circumscribed
Parotid gland
Gastric ulcer presents how?
Located where?
Risk?
Epigastric pain that worsens w/meals
Lesser curvature of antrum
Bleeding from left gastric artery
What is associated w/increased risk for Streptococcus bovis endocarditis?
Colonic carcinoma
Kids w/pyloric stenosis when?
How?
Tx?
2 weeks after birth
Projectile nonbilious vomiting, olive-like mass in abdomen, visible peristalsis
Myotomy
What is hamartomatous polyps, mucocutaneous hyperpigmentation on lips, oral mucosa, and genital skin?
Inheritance?
Inc risk for what?
Peutz-Jeghers
AD
Colorectal, breast, gynecological cancer
Complications of diverticula?
Hematochezia
Diverticulitis
Fistula –> colovesicular fistula
Sialadenitis MC leads to what infection?
B/l or u/l?
S.aureus
U/l
P-ANCA is (+) in what IBD?
Called what else?
UC
MPO-ANCA
When does esophageal carcinoma present? Prognosis?
What CFs?
Late - poor prognosis
Dysphagia, hematemesis, weight loss, pain
What are outpouchings of mucosa and submucosa through the muscularis propria?
Related to what?
Diverticula
Wall stress
What is an AR deficiency of B48 and B100?
CF?
Abetalipoproteinemia
Absent VLDL and LDL, malabsorption (B48)
Upper 1/3 of esophagus cancer affects what LNs?
Mid 1/3?
Lower?
Cervical nodes
Mediastinal
Celiac and gastric
Hereditary hemorrhagic telangiectasia CFs?
inheritance?
Presents how?
Thin-walled blood vessels in mouth and GI tract
AD
Bleeding
Gross appearance of UC?
Pseudopolyps w/loss of haustra (lead pipe sign)
Cobblestoning and fistula seen in what?
Barium shows what?
Crohn’s
String sign
What is achalasia?
What sign?
Due to what?
disordered esophageal motility and inability to relax LES
Bird-beak
Damage ganglion cells in myenteric plexus
How does left-sided carcinoma present?
Due to what?
Napkin-ring lesion
Dec stool caliber, LLQ pain, blood-streaked stool
Adenocarcinoma
What is FAP w/fibromatosis and osteomas?
Gardner syndrome
LLQ pain and bloody diarrhea means what?
UC
What is ASCA+?
Crohn’s
MC of polyp is what?
B9 or Mal?
Arises where?
Hyperplastic polyp
B9 w/NO Mal potential
Left colon
Double bubble sign seen with what?
Duodenal atresia
Celiac disease is what type HS?
Assoc w/what HLAs?
How is damage mediated?
Type 4
DQ2, DQ8
Helper T cells
How does tropical spruce arise? Tx?
Damage is where?
What deficiency may occur?
After infectious diarrhea, give antibiotics
Jejunum and ileum
B12 or B9 def
Warthin tumor arises where?
Describe
Parotid gland
B9 cystic tumor w/abundant LN tissue
What is recurrent aphthous ulcers, genital ulcers, and uveitis?
Behcet syndrome
What is Boerhaave syndrome?
What sign can detect it?
Rupture of esophagus –> air in mediastinum and subcutaneous emphysema
Hamman’s sign (crunching sound)
MC causes of intussesception in adults?
Kids?
Tumor
Lymphoid hyperplasia (rotavirus), arises in terminal ileum
Are duodenal ulcers malignant?
Almost never
B9 looked punched out
What is the most common cause of ischemic colitis? Due to what?
Where?
Presents how?
Atherosclerosis of SMA
Splenic flexure
Postprandial pain and weight loss, infarction –> pain and bloody diarrhea
Chronic H.pylori gastritis involves which site MC?
Presents how?
Inc risk for what?
Antrum
Abdominal pain
ulceration
MALT lymphoma
Adenocarcinoma
complications of UC are what?
Toxic megacolon
Carcinoma based on (colonic involvement, duration > 10 years)
Right-sided carcinoma seen in what pts?
Presents how?
MS instability pathway, older adult w/Fe def anemia
Bleeding and vague pain
What is FAP w/CNS tumors (medulloblastoma and glial tumors)?
Turcot syndrome
Turban – head cancer
What signs or symptoms can indicate underlying gastric carcinoma?
Acanthosis nigricans
Lesser-Trelat sign
Virchow’s node
CF of duodenal atresia?
Assoc w/what?
Polyhydramnios, distension of stomach, bilious vomiting
Down syndrome
Carcinoid tumor is what kind of cell?
Grade?
+ for what?
MC site?
Neuroendocrine
Low-grade Mal
Chromogranin
Small bowel
What are the associated conditions w/Crohn’s?
AS
Migratory polyarthritis
Erythema nodosum
Uveitis
What has PSC association?
UC
UC involves what parts?
Key histologic hallmark?
Continuous from rectum to cecum
Crypt abscess w/neutrophils
How does small bowel infarction present?
Abomdinal pain, bloody diarrhea, decreased bowel sounds
CF of Whipple?
PAS demonstrates what?
Arthritis, cardiac valve involvement, LNs, CNS
Foamy macrophages in PAS
2nd MC type of polyp?
b9 or Mal?
Adenomatous polyp
B9 but has malignant potential
MC site of Crohn’s?
Histo hallmark?
Terminal ileum
Non-caseating granulomas
What is a tumor marker used for assessing treatment response and detecting recurrence of colonic cancer?
CEA
Duodenal atresia due to what?
Failure of duodenum to canalize
What causes bowel sounds in lower lung field and pts may have lung hypoplasia?
Paraesophgeal hernia
HNPCC has increased risk for what other cancers?
Ovarian
Endometrial
What can cause calcium oxalate nephrolithiasis?
Crohn’s
Where is the MC metastasis from stomach?
Liver
What lab can be increased in mumps?
Serum amylase
Zenker diverticulum due to what?
Acquired defect in muscular wall (false)
What has a NOD2 mutation?
Crohn’s
What is the main finding of achalasia?
Inc risk for what?
High LES pressure on esophageal manometry
Esophageal SCC
Who has increased risk of getting intestinal type gastric carcinoma?
Produces what?
H.pylori
Nitrosamines in smoked food
blood type A
Ulcer
What can induce production of acid?
ACh
Gastrin
Histamine
Where is the MC location of SCC of oral mucosa?
RFs?
Floor of the mouth
Alcohol, smoking
Celiac disease damage is most prominent where?
Complications of disease?
Duodenum
Carcinoma
T-cell Lymphoma (EATL)
Dermatitis herpetiformis is due to what?
IgA deposition at tips of dermal papillae
What are precursor lesions for SCC of oral mucosa?
Leukoplakia
Erythroplakia (vascularized leukoplakia)
Pud presents how?
Biopsy shows what?
Epigastric pain that improves w/meals
Ulcer w/hypertrophy of Brunner’s glands
MC site of Whipple disease?
Stain how?
Results in what?
Small bowel LP
PAS+ macrophages
Fat malabsorption and steatorrhea
How does intussusception present?
Obstruction and disruption of blood supply w/in infarction
Intestinal type gastric cancer metastasizes to what special location?
Diffuse type?
Periumbilical region (Sister Mary nodule)
B/l ovaries (Krukenberg)
What is a volvulus?
MC locations where?
Twisting of bowel along mesentery
Sigmoid colon - elderly
Cecum - young adult
Blood from what vessel backs up in the esophageal vein resulting in dilation?
Left gastric vein
TEF is what?
Baby presents how?
Fistula between trachea and esophagus
Vomiting, polyhydramnios, abdominal distention, aspiration
Transmural infarction of what vessel causes small bowel infarction?
SMA or thrombosis of mesenteric vein
What causes GERD?
RFs?
Reduced LES tone
Alcohol, tobacco, obesity, caffeine, HIATAL HERNIA
CF of chronic autoimmune gastritis?
Atrophy of mucosa w/intestinal metaplasia
Achlorhydria w/increased gastrin levels and antral G-cell hyperplasia
Pernicious anemia
INC risk for gastric adenocarcinoma
What is an esophageal web?
Inc risk for what?
Protrusion of esophageal mucosa
Esophageal SCC
What is characterized by signet ring cells?
Diffuse type gastric carcinoma
What is the most common cancer of esophagus worldwide?
What part of esophagus?
RF?
SCC
Upper or middle third
Irritants –> tobacco, web, achalasia, hot drinks, injury
Severe alcoholism/bulimia can cause what in throat?
Presents how?
Mallory Weiss tear
Painful hematemesis
What produces hour-glass appearance of stomach?
Sliding hiatal hernia
Is leukoplakia or erythroplakia more suggestive of squamous cell dysplasia?
Erythroplakia
What is the change in Barrett’ esophagus?
NKSE (non-kertanized squamous epithelium) to Non-ciliated columnar epithelium w/goblet cells
What are the defenses of the mucosal layer?
Mucin (from foveolar cells), bicarb (from surface epithelium), normal blood supply
What causes a failure of herniated intestines to return to the body cavity during development?
Omphalocele
Increased ICP causing acute gastritis is called what?
How?
Cushing ulcer
Inc stimulation of vagus leads to inc acid - via ACh
What is the MC cause of death in cirrhosis?
Presents how?
Esophageal varices rupture
Painless hematemesis
Where does adenocarcinoma occur in the esophagus?
Lower 1/3 of esophagus
What is a malformation of the anterior abdominal wall leading to exposure of abdominal contents?
Gastroschisis
Grayish base surrounded by erythema is what?
Aphthous ulcer
What is a malignant tumor that usually arises in parotid and involves CN 7?
Mucoepidermoid carcinoma
Pts w/esophageal web may have?
Describe it
Plummer-Vinson syndrome
Fe-def anemia, esophageal web, beefy-red tongue (atrophic glossitis)
