GI - FA, Pathoma Flashcards by Alex Hamidi

Can a pleomorphic adenoma become cancerous?

How do you know?

YES

Facial nerve damage

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Why will the Left heart not get any valvular fibrosis?

Bc the lung has MAO which breaks the serotonin down

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Colon cancer progression?

What protects against it?

Risk –> loss of APC (ch.5) –> KRAS mutation –> loss p53 and INC COX

ASA presents against it

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Who does angiodysplasia occur in? Where?

Presents how?

Adult in their 70’s, cecum and right colon

Hematochezia

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What are the greatest prognostic factors of adenoma to become cancer after biopsy?

1 size > 2cm

Sessile growth
Villous histology

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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

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What causes appendicitis?

MC complication?

Lymphoid hyperplasia
Fecalith

Periappendiceal abscess

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Rupture of pud may lead to bleeding from what?

What location?

Gastroduodenal artery or acute pancreatitis

Posterior duodenum (ant MC)

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Hirschsprung disease is due to what?

Dx?

Failure of ganglion cells to descend into myenteric and submucosal plexus

Rectal suction biopsy

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Peak incidence of colorectal cancer?

60-70

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Where is a pleomorphic adenoma located?

Describe how?

Arises where?

Angle of jaw

High recurrence, mobile, painless, circumscribed

Parotid gland

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Gastric ulcer presents how?

Located where?
Risk?

Epigastric pain that worsens w/meals

Lesser curvature of antrum
Bleeding from left gastric artery

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What is associated w/increased risk for Streptococcus bovis endocarditis?

Colonic carcinoma

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Kids w/pyloric stenosis when?

How?

Tx?

2 weeks after birth

Projectile nonbilious vomiting, olive-like mass in abdomen, visible peristalsis

Myotomy

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What is hamartomatous polyps, mucocutaneous hyperpigmentation on lips, oral mucosa, and genital skin?

Inheritance?

Inc risk for what?

Peutz-Jeghers

Colorectal, breast, gynecological cancer

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Complications of diverticula?

Hematochezia
Diverticulitis
Fistula –> colovesicular fistula

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Sialadenitis MC leads to what infection?

B/l or u/l?

S.aureus

U/l

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P-ANCA is (+) in what IBD?

Called what else?

MPO-ANCA

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When does esophageal carcinoma present? Prognosis?

What CFs?

Late - poor prognosis

Dysphagia, hematemesis, weight loss, pain

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What are outpouchings of mucosa and submucosa through the muscularis propria?

Related to what?

Diverticula

Wall stress

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What is an AR deficiency of B48 and B100?

CF?

Abetalipoproteinemia

Absent VLDL and LDL, malabsorption (B48)

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Upper 1/3 of esophagus cancer affects what LNs?

Mid 1/3?

Lower?

Cervical nodes

Mediastinal

Celiac and gastric

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Hereditary hemorrhagic telangiectasia CFs?

inheritance?

Presents how?

Thin-walled blood vessels in mouth and GI tract

Bleeding

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Gross appearance of UC?

Pseudopolyps w/loss of haustra (lead pipe sign)

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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?

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 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)