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GI - FA, Pathoma Flashcards

1
Q

Can a pleomorphic adenoma become cancerous?

How do you know?

A

YES

Facial nerve damage

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2
Q

Why will the Left heart not get any valvular fibrosis?

A

Bc the lung has MAO which breaks the serotonin down

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3
Q

Colon cancer progression?

What protects against it?

A

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

ASA presents against it

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5
Q

Who does angiodysplasia occur in? Where?

Presents how?

A

Adult in their 70’s, cecum and right colon

Hematochezia

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6
Q

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

A

1 size > 2cm

Sessile growth
Villous histology

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9
Q

When does carcinoid syndrome show symptoms?

What can it cause?

A

When it metastasizes to the liver

Carcinoid heart disease –> Right-sided valvular fibrosis and TR w/pulmonary valve stenosis

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10
Q

What causes appendicitis?

MC complication?

A

Lymphoid hyperplasia
Fecalith

Periappendiceal abscess

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15
Q

Rupture of pud may lead to bleeding from what?

What location?

A

Gastroduodenal artery or acute pancreatitis

Posterior duodenum (ant MC)

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16
Q

Hirschsprung disease is due to what?

Dx?

A

Failure of ganglion cells to descend into myenteric and submucosal plexus

Rectal suction biopsy

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17
Q

Peak incidence of colorectal cancer?

A

60-70

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18
Q

Where is a pleomorphic adenoma located?

Describe how?

Arises where?

A

Angle of jaw

High recurrence, mobile, painless, circumscribed

Parotid gland

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20
Q

Gastric ulcer presents how?

Located where?
Risk?

A

Epigastric pain that worsens w/meals

Lesser curvature of antrum
Bleeding from left gastric artery

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21
Q

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

A

Colonic carcinoma

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22
Q

Kids w/pyloric stenosis when?

How?

Tx?

A

2 weeks after birth

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

Myotomy

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24
Q

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

Inheritance?

Inc risk for what?

A

Peutz-Jeghers

AD

Colorectal, breast, gynecological cancer

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25
Q

Complications of diverticula?

A

Hematochezia
Diverticulitis
Fistula –> colovesicular fistula

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26
Q

Sialadenitis MC leads to what infection?

B/l or u/l?

A

S.aureus

U/l

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28
Q

P-ANCA is (+) in what IBD?

Called what else?

A

UC

MPO-ANCA

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29
Q

When does esophageal carcinoma present? Prognosis?

What CFs?

A

Late - poor prognosis

Dysphagia, hematemesis, weight loss, pain

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30
Q

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

Related to what?

A

Diverticula

Wall stress

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31
Q

What is an AR deficiency of B48 and B100?

CF?

A

Abetalipoproteinemia

Absent VLDL and LDL, malabsorption (B48)

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32
Q

Upper 1/3 of esophagus cancer affects what LNs?

Mid 1/3?

Lower?

A

Cervical nodes

Mediastinal

Celiac and gastric

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33
Q

Hereditary hemorrhagic telangiectasia CFs?

inheritance?

Presents how?

A

Thin-walled blood vessels in mouth and GI tract

AD

Bleeding

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36
Q

Gross appearance of UC?

A

Pseudopolyps w/loss of haustra (lead pipe sign)

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37
Q

Cobblestoning and fistula seen in what?

Barium shows what?

A

Crohn’s

String sign

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38
Q

What is achalasia?

What sign?

Due to what?

A

disordered esophageal motility and inability to relax LES

Bird-beak

Damage ganglion cells in myenteric plexus

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40
Q

How does left-sided carcinoma present?

Due to what?

A

Napkin-ring lesion
Dec stool caliber, LLQ pain, blood-streaked stool

Adenocarcinoma

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42
Q

What is FAP w/fibromatosis and osteomas?

A

Gardner syndrome

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46
Q

LLQ pain and bloody diarrhea means what?

A

UC

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47
Q

What is ASCA+?

A

Crohn’s

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49
Q

MC of polyp is what?

B9 or Mal?

Arises where?

A

Hyperplastic polyp

B9 w/NO Mal potential

Left colon

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52
Q

Double bubble sign seen with what?

A

Duodenal atresia

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53
Q

Celiac disease is what type HS?

Assoc w/what HLAs?

How is damage mediated?

A

Type 4

DQ2, DQ8

Helper T cells

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54
Q

How does tropical spruce arise? Tx?

Damage is where?

What deficiency may occur?

A

After infectious diarrhea, give antibiotics

Jejunum and ileum

B12 or B9 def

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57
Q

Warthin tumor arises where?

Describe

A

Parotid gland

B9 cystic tumor w/abundant LN tissue

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59
Q

What is recurrent aphthous ulcers, genital ulcers, and uveitis?

A

Behcet syndrome

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60
Q

What is Boerhaave syndrome?

What sign can detect it?

A

Rupture of esophagus –> air in mediastinum and subcutaneous emphysema

Hamman’s sign (crunching sound)

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61
Q

MC causes of intussesception in adults?

Kids?

A

Tumor

Lymphoid hyperplasia (rotavirus), arises in terminal ileum

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62
Q

Are duodenal ulcers malignant?

A

Almost never

B9 looked punched out

64
Q

What is the most common cause of ischemic colitis? Due to what?

Where?

Presents how?

A

Atherosclerosis of SMA

Splenic flexure

Postprandial pain and weight loss, infarction –> pain and bloody diarrhea

65
Q

Chronic H.pylori gastritis involves which site MC?

Presents how?

Inc risk for what?

A

Antrum

Abdominal pain

ulceration
MALT lymphoma
Adenocarcinoma

66
Q

complications of UC are what?

A

Toxic megacolon

Carcinoma based on (colonic involvement, duration > 10 years)

69
Q

Right-sided carcinoma seen in what pts?

Presents how?

A

MS instability pathway, older adult w/Fe def anemia

Bleeding and vague pain

70
Q

What is FAP w/CNS tumors (medulloblastoma and glial tumors)?

A

Turcot syndrome

Turban – head cancer

71
Q

What signs or symptoms can indicate underlying gastric carcinoma?

A

Acanthosis nigricans
Lesser-Trelat sign
Virchow’s node

72
Q

CF of duodenal atresia?

Assoc w/what?

A

Polyhydramnios, distension of stomach, bilious vomiting

Down syndrome

74
Q

Carcinoid tumor is what kind of cell?

Grade?

+ for what?

MC site?

A

Neuroendocrine

Low-grade Mal

Chromogranin

Small bowel

75
Q

What are the associated conditions w/Crohn’s?

A

AS
Migratory polyarthritis
Erythema nodosum
Uveitis

77
Q

What has PSC association?

78
Q

UC involves what parts?

Key histologic hallmark?

A

Continuous from rectum to cecum

Crypt abscess w/neutrophils

79
Q

How does small bowel infarction present?

A

Abomdinal pain, bloody diarrhea, decreased bowel sounds

80
Q

CF of Whipple?

PAS demonstrates what?

A

Arthritis, cardiac valve involvement, LNs, CNS

Foamy macrophages in PAS

81
Q

2nd MC type of polyp?

b9 or Mal?

A

Adenomatous polyp

B9 but has malignant potential

85
Q

MC site of Crohn’s?

Histo hallmark?

A

Terminal ileum

Non-caseating granulomas

86
Q

What is a tumor marker used for assessing treatment response and detecting recurrence of colonic cancer?

91
Q

Duodenal atresia due to what?

A

Failure of duodenum to canalize

93
Q

What causes bowel sounds in lower lung field and pts may have lung hypoplasia?

A

Paraesophgeal hernia

96
Q

HNPCC has increased risk for what other cancers?

A

Ovarian

Endometrial

97
Q

What can cause calcium oxalate nephrolithiasis?

98
Q

Where is the MC metastasis from stomach?

99
Q

What lab can be increased in mumps?

A

Serum amylase

100
Q

Zenker diverticulum due to what?

A

Acquired defect in muscular wall (false)

104
Q

What has a NOD2 mutation?

105
Q

What is the main finding of achalasia?

Inc risk for what?

A

High LES pressure on esophageal manometry

Esophageal SCC

106
Q

Who has increased risk of getting intestinal type gastric carcinoma?

Produces what?

A

H.pylori
Nitrosamines in smoked food
blood type A

Ulcer

110
Q

What can induce production of acid?

A

ACh
Gastrin
Histamine

111
Q

Where is the MC location of SCC of oral mucosa?

RFs?

A

Floor of the mouth

Alcohol, smoking

112
Q

Celiac disease damage is most prominent where?

Complications of disease?

A

Duodenum

Carcinoma
T-cell Lymphoma (EATL)

114
Q

Dermatitis herpetiformis is due to what?

A

IgA deposition at tips of dermal papillae

119
Q

What are precursor lesions for SCC of oral mucosa?

A

Leukoplakia

Erythroplakia (vascularized leukoplakia)

122
Q

Pud presents how?

Biopsy shows what?

A

Epigastric pain that improves w/meals

Ulcer w/hypertrophy of Brunner’s glands

124
Q

MC site of Whipple disease?

Stain how?

Results in what?

A

Small bowel LP

PAS+ macrophages

Fat malabsorption and steatorrhea

125
Q

How does intussusception present?

A

Obstruction and disruption of blood supply w/in infarction

126
Q

Intestinal type gastric cancer metastasizes to what special location?

Diffuse type?

A

Periumbilical region (Sister Mary nodule)

B/l ovaries (Krukenberg)

127
Q

What is a volvulus?

MC locations where?

A

Twisting of bowel along mesentery

Sigmoid colon - elderly
Cecum - young adult

128
Q

Blood from what vessel backs up in the esophageal vein resulting in dilation?

A

Left gastric vein

129
Q

TEF is what?

Baby presents how?

A

Fistula between trachea and esophagus

Vomiting, polyhydramnios, abdominal distention, aspiration

130
Q

Transmural infarction of what vessel causes small bowel infarction?

A

SMA or thrombosis of mesenteric vein

131
Q

What causes GERD?

RFs?

A

Reduced LES tone

Alcohol, tobacco, obesity, caffeine, HIATAL HERNIA

132
Q

CF of chronic autoimmune gastritis?

A

Atrophy of mucosa w/intestinal metaplasia
Achlorhydria w/increased gastrin levels and antral G-cell hyperplasia
Pernicious anemia
INC risk for gastric adenocarcinoma

133
Q

What is an esophageal web?

Inc risk for what?

A

Protrusion of esophageal mucosa

Esophageal SCC

138
Q

What is characterized by signet ring cells?

A

Diffuse type gastric carcinoma

141
Q

What is the most common cancer of esophagus worldwide?

What part of esophagus?

RF?

A

SCC

Upper or middle third

Irritants –> tobacco, web, achalasia, hot drinks, injury

143
Q

Severe alcoholism/bulimia can cause what in throat?

Presents how?

A

Mallory Weiss tear

Painful hematemesis

146
Q

What produces hour-glass appearance of stomach?

A

Sliding hiatal hernia

148
Q

Is leukoplakia or erythroplakia more suggestive of squamous cell dysplasia?

A

Erythroplakia

150
Q

What is the change in Barrett’ esophagus?

A

NKSE (non-kertanized squamous epithelium) to Non-ciliated columnar epithelium w/goblet cells

151
Q

What are the defenses of the mucosal layer?

A

Mucin (from foveolar cells), bicarb (from surface epithelium), normal blood supply

155
Q

What causes a failure of herniated intestines to return to the body cavity during development?

A

Omphalocele

157
Q

Increased ICP causing acute gastritis is called what?

How?

A

Cushing ulcer

Inc stimulation of vagus leads to inc acid - via ACh

158
Q

What is the MC cause of death in cirrhosis?

Presents how?

A

Esophageal varices rupture

Painless hematemesis

159
Q

Where does adenocarcinoma occur in the esophagus?

A

Lower 1/3 of esophagus

160
Q

What is a malformation of the anterior abdominal wall leading to exposure of abdominal contents?

A

Gastroschisis

162
Q

Grayish base surrounded by erythema is what?

A

Aphthous ulcer

177
Q

What is a malignant tumor that usually arises in parotid and involves CN 7?

A

Mucoepidermoid carcinoma

178
Q

Pts w/esophageal web may have?

Describe it

A

Plummer-Vinson syndrome

Fe-def anemia, esophageal web, beefy-red tongue (atrophic glossitis)

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