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USLME Kiss my ass and pray > GI - Lesions and Disease > Flashcards

GI - Lesions and Disease Flashcards

1
Q

Erythroplakia

A

red plaque, vascularized leukoplakia, suggestive of squamous cell dysplasia

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2
Q

Squamous Cell Carcinoma risk factors

A

Alcohol and tobacco

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3
Q

Oral herpes latency

A

HSV1 in trigeminal nerve

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4
Q

Aphthous ulcer

A

cancor sore, grey base surrounded by erythema, stress associated

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5
Q

Behcet herpes - triad

A

aphthous ulcer, genital ulcers, uveitis

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6
Q

Mumps (4 locations)

A

parotid, orchitis(teens), pancreatitis, aseptic menigitis

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7
Q

Siladentitis

A

inflammation of salivary gland - due to sialolithiasis

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8
Q

pleomorphic carcinoma- location and histo(2)

A

benign, most common tumor of parotid, stromal and epithelial tissue; HIGH rate of recurrence

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9
Q

Warthin tumor - location and histo

A

Benign cystic tumor,
lymphocyte and geminal centers;
parotid gland

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10
Q

Mucoepidermoid carcinoma - location and histo(2)

A

malignant - mutinous and squamous cell, parotid gland w/ facial nerve pain

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11
Q

migratory thrombophlebitis

what is it and what is it associated w/

A

formation and dissolution of clots 2ry to tumor secretions-procoags and platelet aggregating factors

redness and tenderness on palpation of extremities

Trousseaus syndrome

Associated w/ pancreatic carcinoma, may be other adenocarcinomas

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12
Q

diffuse cortical necrosis - what is it? 2 causes

A

acute generalized cortical infarction of BOTH kidneys

Due to DIC and vasospasm

Associated w/ Sepsis and obstetric emergencies

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13
Q

Zenker Diverticulum

A

out pouching of pharyngeal mucosa

-acquired defect

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14
Q

Esophageal web

A

thin profusion of esophageal mucosa into upper esophagus

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15
Q

Plummer Vinvson syndrome (3)

A

Severe iron deficiency
Esophageal web
red beefy lounge - atrophic glossitis

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16
Q

Mallory Weisse Syndrome

A

Laceration due to vomitting

PAINFUL hemataemesis

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17
Q

Air in the mediastinum

A

rupture of esophagus,
Called Boerhaave syndrome
-> subcutaneous emphysema

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18
Q

Esophageal varices is due to what connction

A

L gastric vein w/ portal vein

  • due to portal HTN
  • Presents w/ PAINLESS hematemesis

Common death in cirrhosis

Most blood is azygos and IVC

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19
Q

Achalasia -

MOA

A

Damaged ganglion cells in meteoric plexus ->
disordered motility and relaxing of LES

foods and solids

Bird beak sign

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20
Q

most common secondary cause of Achalasia

A

Chagas Disease - trypanosoma cruzi

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21
Q

GERD cause

A

Reduced LES tone,

-alcohol, tobacoo, obesity, fat rich diet, caffeine, hiatal hernia

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22
Q

Barretts esophagus histology

A

metaplasia of keratinized stratified squamous epithelial to non ciliated colunar cells w/ goblet

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23
Q

Most common type of esophageal cancer in the west

- most likely location

A

adenocarcinoma

in the lower 3rd - Barretts prior

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24
Q

Most common esophageal cancer in the world

- most likely location

A

squamous cell carcinoma
- upper to middle third of the esophagus
primary from irritation: alcohol, smoke, hot tea, webs, injury, achalasia

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25
Q

Gastroschisis

A

congenital malformation

complete exposure of abdominal contents

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26
Q

Omphalocele

A

Persistent herniation of bowel into umbilical cord

Covered by peritoneum and amnion

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27
Q

Pyloric stenosis presentation(3) and timing

A

2 weeks after birth

projectile non bilious vomiting
visible peristalsis
Olive like mass

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28
Q

Acute Gastritis causes - 3 generic

A

not enough mucin
not enough bicarb
lack of normal blood supply

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29
Q

Risk factors for acute gastritis (6)

A

severe burn - curling ulcer, hypo volumetric
NSAIDS -PGE2
Alcohol
chemo
increased intracranial pressure - cushing ulcer (vagus nerve stim)
Shock - hypovolumetric

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30
Q

Chronic Gastritis types (2)

A 
Autoimmune
H pylori (most common)
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31
Q

Chronic autoimmune gastritis- location and MOA

A

Fundus and Body

Type 4 hypersensitivity Rxn
see Ab against parietal and intrinsic factor though

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32
Q

Chronic autoimmune gastritis features(3)

A

Atrophy of mucsa w/ metaplasia -> adenocarcinoma (intestinal) risk
Achlorhydria
megaloblastic anemia

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33
Q

Chronic H pylori gastritis - location and MOA

A

Antrum

Acute and chronic inflammation due to urea’s and proteass

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34
Q

H pylori gastritis presents w/(3)

A

epigastric pain - peptic ulcer disease
gastric adenocarcinoma risk (intestinal)
MALT

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35
Q

Peptic Ulcer Disease - location and cause

A 
90% duodenal 
- always H Pylori
-Maybe ZE syndrome
10% stomach
-H pylori
-NSAIDs
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36
Q

Deudenal Ulcer Disease Presentation - 2 locations

A

epigastric pain that IMPROVES w/ meals
endoscope shows ulcer and Brunner Glands

anterior - most
Posterior - gastrododenal artery bleeding and pancreatitis

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37
Q

Gastric Ulcer Presentation and location

A

Epigastric pain that worsens w/ meals

lesser curvature of Antrum
-risk of L gastric artery rupture

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38
Q

gastric Carcinoma (2 types)

A

Intestinal(more common)

Diffuse

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39
Q

Intestinal type gastric carcinoma - location and risk factors(3)

A

lesser curvature

Risk- intestinal metaplasia(autoimmune or H pylori), nitrosamines and smoked fish, blood type A

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40
Q

Diffuse type gastric carcinoma - associations

A

Signet ring cells
desmoplasia (rxn) - > linits plastica (thickening)

NOT h pylori, intestinal metaplasia or nitrosamines

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41
Q

Acanthosis nigricans

A

rare Gastric carcinoma presentation

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42
Q

Leser Trelat sign

A

dozens of suberric keritosis

rare Gastric carcinoma sign

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43
Q

Sister Mary Joseph nodule and type

A

Periumbilical METS of gastric carcinoma

intestinal type

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44
Q

Virchow Node

A

left supraclavicular METS of gastric carcinoma

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45
Q

Kruckenberg Tumor

A

Bilateral Ovaries METS of gastric carcinoma

Diffuse Type

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46
Q

Vit A deficiency

A

Metaplasia

Kereatomalecia (thickening) -> night blindness

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47
Q

Duodenal atresia congenital association

A

Down Syndrome

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48
Q

Duodenal atresia features(3)

A

Polyhydraminos
Distension - dubble bubble sign
Bilios vomiting

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49
Q

Meckels Diverticulum - problem

A

true diverticulum

failure of vital line duct to involute

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50
Q

Rule of 2’s

A 
Meckels diverticulum
2% of the pop
2 inches long w/in 2 feet of illeocecal valve
1st 2 yrs presentation
- bleedfing (heterotopic/pancreatic tissue)
- volvulous
-intersuption
- obstruction
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51
Q

Volvulus - Locations

A

Twisting, infarction
sigmoid (old)
cecum (young)

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52
Q

Intrussception causes

A

young - lymphoid hyperplasia

old tumpr

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53
Q

Small bowel infarction (cause and features)

A

transmural infarct of SMA or mesenteric vein

  • a frib emboli
  • vasculitis, polyarthritis nodosa
  • Polycythemia vera

Features
-ab pain, decreased bowl sounds

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54
Q

lactose intolerance presentation

A

osmotically active undigested lactose -> diarrhea

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55
Q

Celiac immune HLA type

A

DQ2 and DQ8

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56
Q

Ab seen in Celiac(2)

A

endomysum,
tTG (tissue transglutaminase)
gliadin

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57
Q

Associated immune deficiency in celiac

A

IgA

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58
Q

Location of celiac and Histo

A

Primarily the deuodem

Flattening of villi and hypeplasia of crypts, increased lymphocytes

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59
Q

Refractory celiac leads to (2)

A

small bowel carcinoma

T cell lymphoma (rather unique)

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60
Q

Tropical sprue location w/ associated complication

A

jejunum and ileum

folate and B12 deficency

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61
Q

Whipple Disease presentation(2)

A

Fat malabsorbtion and steatorrhea

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62
Q

Pathogenesis of Whipple

A

Macrophages loaded w. tropheryma whippelli compress lacteals in the vili

PAS positive

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63
Q

Abetalipoproteinemia deficiency (2) and presentation

A

Deficency in
B48- chylomicron -> malabsorbtion
B100 - VLDL and LDL

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64
Q

Carcinoid tumor vs Carcinoid syndrome

A

Whether the neuroendocrine tumor of small duodenum METS to liver or not

MAO in liver breaks down serotonin to limit systemic expression - see only 5HIAA metal

Syndrome - bronchospasm, diarrhea, skin flushing

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65
Q

Carcinoid heart disease - presentation

A

METS of carcinoid tumor
Right sided valavular fibroses
MAO in the lung protective of the lung

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66
Q

Causes of acute appendicitis - adults and kids

A

Obstruction:

Kids - lymphoid hyperplasia
adults - fecalith

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67
Q

Inflammatory Bowel Disease (2) - common pricture

A

Ulcerative colitis
Crohns

young women in teens ->30s w/ RECURRENT bloody diarrhea and abdominal pain

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68
Q

UC wall involvement

A

submucosal and mucasal

vs. crohns transmural

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69
Q

Crohns location

A

anywhere mouth to anus sparing the rectum; ileum most common, skips

vs UC-starts in rectum and travels up

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70
Q

Point of pain in UC

A

LLQ -

VS RLQ (iliuem) in Crohns

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71
Q

Histology of UC

A

Crypt abscesses w/ neutrophils

vs - lymphoid aggregates and granulomas in Crohns

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72
Q

Gross Appearance of Crohns(3)

A

Cobblestone Mucose, creeping fat, strictures (string sign imaging)

vs. UC: pseudo polyps and loss of haustrau (lead pipe)

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73
Q

Complications of Crohns(4)

A

Malabsorbtion - small bowel
calcium oxalate nephrolithias ( more absorption)
fistula
carcinoma

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74
Q

Complications of UC(2)

A

Toxic megacolon

Carcinoma ( Duration and extent)

75
Q

Associations w/ UC (2)

A

Primary sclerosing cholangitis

pANCA

76
Q

pANCA (3)

A

UC

Vasculitis
-chrug straus
Microscopic polyangitis

77
Q

Associations w/ Crohns(4)

A

Erythema nodosum
Uveitis
Ankylosing spondylosis
migratory polyarthritis

78
Q

Hirschsprung Disease congenital association

A

Down Syndrome

79
Q

MOA of HIrschsprung

A

congenital failure of ganglion cells (neural crest) to migrate to myenteric and submucosal plexus

80
Q

Features of Hirschsprung (3)

A

Failure to pass meconium
Empty vault on DRE
Massive dilation proximal to obstruction

81
Q

Rectal suction biopsy

A

To assess Hirschsprung, need sub mucosa tissue

82
Q

Colonic Diverticula Pathogenesis

A

Wall stress next to vasa recta traverse the musularis propia -> out pouching of mucosa and submucosa
- constipation, straining, low fiver

Seen in older adults

83
Q

Diverticulitis - cause and location

A

Due to obstruction of fecal material

Pain (~apendicitis) in LLQ

84
Q

Diverticum Symptoms

A

Usually asymptomatic

Maybe hematochezia (bright red blood)
Fistula - bladder
Diverticulitis

85
Q

Angiodysplasia

A

~Diverticulum in on the RIGHT side
- cecum and R colon

Bleeding w/ disordered capillary beds
Hemochezia in older adult

86
Q

Hereditary hemorragic telangiectasia

A

AD disease
Thin walled blood vessels - Mouth to GI
Prone to bleeding

87
Q

Ischemic Colitis common location and artery

A

Splenic flexure, watershed of SMA

88
Q

cause of Ischemic colitis

A

Athersclerosis of SMA

89
Q

Presentation of ischemic colitis (2)

A 
Postprandial pain (~CAD and PAD w/ exercise)
Weight loss

Sudden onset of pain (infarction) and blood loss

90
Q

Irritable bowel syndrome presentation(4) and etiology

A 
Relapsing abdominal pain
- improves w/ defication
bloating
flatulence
∆bowel habits

Unknown etiology in mostly middle age females, give fiber

91
Q

Colonic polyps - 2 types

A

Hyperplastic

  • benign, no risk of carcinoma
  • most common

Adenomatous
-benign, pre malignant

92
Q

Hyperplastic polyp - location and histology

A

Bening, no risk of carcinoma
L side

serrated (sawtooth) appearance on micro

93
Q

Adenoma-carcinoma sequence (3 steps)

A

Adenomatous polyp

APC mutation - loss of tumor regulator (2 hit)
K ras mutation - formation of polyp
p53 and increased COX -> carcinoma progression

94
Q

Prophylactic treatment for adenoma -> carcinoma progression

A

Aspririn,

95
Q

High Risk adenoma features (3)

A 
Size >2 cm
Sessile growth (vs pedunculated)
villous histo (vs tubular)
96
Q

FAP -

  • what is it
  • look like?
A

AD loss of of 1 APC

  • Adenoma -carcinoma sequence likely
  • 100s to 1000s polyps early on, cancer by 40
97
Q

Gardener Syndrome (3)

A

FAP
fibromatosis - prolif of fibroblasts arising from retroperitoneum
Osteoma- benign bone tumor (skull)

98
Q

Turcot Syndrome (2)

A

FAP

CNS tumor - medulloblastoma and glial tumors

99
Q

Juvenile poylp

A

kids <5
Benign solitary poly that is sporadic and hamartomatous (Normal yet disorganized)

-Polyposis when large # (stomach and colon)and increase carcinoma risk

100
Q

Peutz jegher Syndrome -
2 features

Increase risk of?

A
  • Hamartomatous polyps throughout GI
  • mucocutaneous hyperpigmentation on lips, oral mucosa, genital

AD disorder

Risk colorectal, breast and GYN cancer

101
Q

Colorectal Carcinoma (2 ways)

A

Adenoma- carcinoma sequence
-Sporadic or FAP

Microsatellite instability sequence
-HNPCC

102
Q

Hereditary nonpolyposis colorectal carcinoma

- what is it and associated w/ carcinomas (3)

A

Loss of DNA mismatch repair mech
- de novo cancer at early age (not due to polyps)

Colorectal, endometrial and ovarian

103
Q

Screen for colorectal carcinoma at?

A

age 50

peak incidence 60-70

104
Q

Left sided carcinoma cause and presentation(3)

A

Adenoma-carcinoma progression

Napkin ring lesion
- obstruction, LLQ pain and blood streaked stool

105
Q

Right sided carcinoma cause and presentation(2)

A

Microsatellite instability

Iron deficiency anemia and vague pain

106
Q

Common bacterial association w/ colorectal carcinoma

A

Streptococcus bolvis endocarditis

107
Q

CEA is?

A

Colorectal tumor marker

Useful for gauging response and recurrence to Rx, not for screening

108
Q

Annular pancreas

A

developmental ring around the duodeum

109
Q

Acute Pancreatitis commonly due (2)

Other causes

A

Common: alcohol and gallstones

Other: trauma, hypercalcemia, hyperlipidemia, drugs, scorpions, mumps and rupture of posterior duodenal ulcer

110
Q

Pancreatitis has 2 types of necrosis

A

Liquefactive hemorrhagic of pancreas

Fat necrosis of perinephric fat -> hypocalcemia

111
Q

Common premature pancreatic enzyme in pancreatitis

A

Trypsin

112
Q

Clinical features of Acute pancreatits (5)

A 
epigastric pain radiating to the back
N/V
periumbilical and flank hemorrhage
elevated lipase and amylase
hypocalcemia
113
Q

Complications of pancreatitis (4)

A

shock
pancreatic psuedocyst - fibrous wall around enzymes
pancreatic abscess - E coli
DIC and ARDS

114
Q

Causes of Chronic Pancreatitis (2)

A

Alcohol and cystic fibrosis

many idiopathic

115
Q

Features of Chronic Pancreatitis(5)

A 
Epigastric Pain
Pancreatic insufficiency
Dystrophic calcification
Secondary DM
Carcinoma risk
116
Q

Risk Factors for Pancreatic Carcinoma(2)

A

smoking and chronic pancreatitis

117
Q

Old thin women presenting with diabetes for the first time

A

think pancreatic carcinoma possibility

obstructive jaundice - another complication of pancreatic carcinoma -> pale stools and palpable gallbladder

118
Q

CA 19-9

A

Tumor marker for Pancreatic Carcinoma

119
Q

Biliary Atresia seen w/in

A

2 months of life

failure to form or early destruction of extra hepatic billiard tree

120
Q

Cholesterol drug associated w/ stone formation

A

Cholestyramine

121
Q

Cholelithiasis causes (2 main) and 3 mechanisms

A

precipitation of cholesterol
precipitation of bilirubin

Supersaturation
decreased phospholipids and bile salts (solubilize)
stasis - bacteria decongugate bilirubin

122
Q

Cholesterol stone Risk Factors

A 
Fat
Forty
Fertile
Female
(estrogen)

Also Native america, Crohns, clofibrate, and cirrohisis,

123
Q

Bilirubin stone Risk factors(2)

A

Extravascular hemolysis

Biliary tract infection

124
Q

Complications of gall stones (6)

A 
Biliary colic
Acute and Chronic cholesystitis
ascending chongitis
gallstone illeus
gallstone cancer
125
Q

RUQ pain Radiating to right scapula

See what associated lab value increase?

A

Acute cholecystitis

- also see increase serum alkaline phophatase

126
Q

Rokitasnky Aschoff sinus

A

herniation of gallbladder mucosa into the muscular wall as seen in chronic cholesystitis

127
Q

Porcelain gallbladder

A

Chronic cholesystitis

-late complication, dystrophic calcificaiton

128
Q

Gallstone illeus

A

Fistula forms between gallbladder and duodenum -> obstruction

129
Q

Elderly woman w/ cholecystits symptoms

A

Think Gallbladder Carcinoma,
-an adenocarcinoma

normally only 40s-50s

130
Q

Scleral icterus def

A

yellow eyes

131
Q

Jaundice noticed at?

A

> 2.5mg/dL

132
Q

Protopophyrin

A

derived from heme (RBC breakdown)

Converted to unconguated bilirubin

133
Q

Urubilinogen

A

Conjugated bilirubin that is converted by intestinal flora in duodenum

Oxidized to
-stercobilin - brown stool
urobilin - yellow pee

134
Q

Increased unconguated bilirubin (5)

A 
Extravascular hemolysis 
Physiologic jaundice of newborn
Gilbert syndrome
Crigler Najjar Syndrome
Viral hepatitis (see increased CB as well)
135
Q

Increased conjugated bilirubin (3)

A 
Biliary tract obstruction
Dubin Johnson Syndrome
Viral hepatitis (see increased UCB as well)
136
Q

Extravascular hemolysis and dark urine?

Increased risk of what?

A

Due to excess urine urobinogen
(UCB is not water soluble and thus not in urine)

-pigmented bilirubin gallstones

137
Q

Uridine glucuronyl transferase (UGT)?

Rx for neonatal deficiency?

A

hepatocyte enzyme that conjugates bilirubin

phototherapy which make UCB water soluble

138
Q

Kernicterus

A

UCB deposits in the basal ganglia of newborns due to excess -neuro deficits
- fat soluble

seen in Crigler najjaar and physiologic jaundice

139
Q

Dark liver w/ increased Conjugated bilirubin and no other symptoms

A

Dubin Johnson syndrome

- bilirubin canalicular transport protein deficit

140
Q

Dark urine and pale stool w/ gallstones

Associated complications (3)

A

Obstructive Jaundice - Increased conjugated bilirubin
Bilirubinuria causes dark urine

Puritus - plasma bile acids in serum
hypercholesterolemia - block tract leaks out
Steatorrhea - bile acids can’t help

141
Q

Normal urobilinogen with viral hepatitis

A

due to tract outlet problems and bacteria can’t act on it as fast - instead have increased CB that is leaking out -> dark urine

inflammed hepatocyte and small bile ductules

  • High UCB and CB respectfully
  • > dark urine w/ bilirubin
142
Q

ALT>AST

A

Acute viral hepatitis

143
Q

infectious liver inflammation causes(3)

A

hepatitis
CMV
EBV

144
Q

Part of the liver hepatitis normally attacts and pathogenesis

A

Portal Tracts

Infected hepatocytes express MHC I -> CD8 cytotoxic aoptosis

145
Q

Acute hepatitis timeline

A

< 6 months

Chronic >6 months

146
Q

Acute only infectious agents

A

HAV and HEV

147
Q

HEV acquired through and importance?

A

contaminated water/seafood

fulminant hepatitis in pregnant females
No vaccine

148
Q

Tests for HCV progression

A

HCV -RNA tests

Chronic disease more common than in HBV

149
Q

HDV Superinfection and meaning?

A

HDV infection after already having HBV and more significant response

vs. coinfection

150
Q

HBsAG

A

first seromarker in HBV to rise

- presence after 6 months indicates chronic tate

151
Q

indicates infectivity in HBeAG

A

HBeAG
envelope antigen

  • acute phase,
    +/- chronic phase
152
Q

Immunity in HBV

A

IgG to HBsAB
surface antigen

also have in vaccination

153
Q

HBcAB meaning

A

core antibody
battle maker
IgM - acute and window (only one)
IgG in resolved and Chronic

154
Q

Cirrosis histology

A

disruption of normal hepatic parenchyma w/ bands of fibrosis

155
Q

Stellate Cell release what in cirrhosis

A

Releases TGF beta -

leading to fibrosis

156
Q

Portal hypertension -> 4 things

A

Ascities
congestive splenomegaly
Portosytemic shunts - varices, hemmorids, caput medusa
Hepatorenal syndrome - rapid renal failure

157
Q

Reversible mental status in cirrhosis due to

A

decreased detoxification of liver capacity and increased ammonia

158
Q

Gynectomastia, spider angiomata and palmar erythema seen in liver cirrhosis due to

A

reduced estrogen removal by the liver

159
Q

Lower protein synthesis of the liver leads to (2)

A

Hypoalbuminemia - edema

Coagulopathy - decreased clotting factors

160
Q

AST>ALT

A

alcoholic hepatitis
- a scotch and tonic
due to direct toxic on mitochondria (acetaldehyde)

161
Q

Fatty liver disease due to alcohol

A

heavy greasy liver, resolves w/ abstinence

162
Q

Mallory Bodies

A

damaged cytokeratin filaments seen in alcoholic hepatitis

Swelling of hepatocytes

163
Q

Nonalcoholic fatty liver disease

A

diagnosis of exclusion
-associated w/ obesity
ALT>AST

164
Q

hemosiderous

A

deposition of Fe in tissues

165
Q

hemochromatosis

A

organ damage due to Fe accumulation

166
Q

Pathogenesis of Hemochromatosis and common causes (2)

A

Free radical formation of Fe

Primary - AR defect
Secondary - chronic transfusions

167
Q

HFE gene; usually C282Y

A

Primary hemochromatosis

- loss of regulation by enterocytes releasing Fe into the blood vessel

168
Q

Triad of hemochromatosis

Associated findings:

A

“Bronze diabetes”

  • Cirrhosis
  • secondary DM
  • bronze skin

Also - dilated Cardiomyopathy, arrhythmia and gonadal dysfunction

169
Q

Prussian blue stain

A

Differentiates brown inclusions in hepatocyte

  • Lipofuscin - wear and tear
  • Fe - stains
170
Q

ATP7B gene - autosomal recessive

name?
Problem?

A

Wilson’s Disease

ATP mediated hepatocyte Cu transport

  • lack of Cu into bile
  • lack of Cu onto ceruoplasmin
171
Q

Presentation of Wilson’s Disease(3)

Age?

A

Childhood

Cirrhosis
Neurologic manifestations - parkinsons, dementia, chorea
Kayser Fleishner rings in cornea

172
Q

Labs in hemochromatosis

A

Ferritin, Serum Fe and % Sat are all up

TIBC is down (opposite of Ferritin)

173
Q

Antimitochondral antibody

A

Primary Biliary Cirrhosis

174
Q

Primary Biliary cirrhosis - presentation and cause

A

Seen in women around 40
Autoimmune yet unknown etiology attacking intrahepatic bile duct

Obstructive Jaundice-> cirrhosis

175
Q

Biliary problem associated w/ UC and pANCA

Presents as?

A

Primary Sclerosing Cholangitis

obstructive jaundice -> cirrhosis

176
Q

inflammation and fibrous of intrahepatic and extra hepatic bile ducts?

looks like on histology and imaging?

A

Primary Sclerosing Cholangitis

seen as periductal fibrosis -> “onion skin”
“dilated bead” appearance on contrast

177
Q

Primacry Sclerosing Cholangitis risk for

A

cholangiocarcinoma

178
Q

Hepatic adenoma ?

Rx association?

A

benign tumor

oral contraceptive increases size

179
Q

Reye Syndrome mechanism

A

Fulminant liver failure and encephalopathy

Mitochondrial damage to hepatocytes

180
Q

Hepatocellular Carcinoma Risk Factors (3)

A

Chronic hepatitis (viral)
Cirrhosis (Alcohol, NAFLD, wilsons, A1T1, hemachomatosis)
Aflatoxins - Aspergillus derived (induce p53)

181
Q

Budd Chiari Syndrome pathogenisis and common cause

A

liver infarction due to hepatic vein occusion

-hepatocellular carcinoma commonly causes -> painful hepatomegaly and ascites

182
Q

Hepatocellular carinoma tumor marker?

A

alpha fetoprotein

183
Q

METS to liver (4)

A

more common than primary
multiple nodes, hepatomegaly

Colon
pancreas
lung
breast

184
Q

necrosis of intestinal mucosa and possible perforation in a 1 week infant called

presents w/? (3)

A

necrotizing enterocolitis - more common in premies, bottle fed

feeding intolerance, ab distenstion and bloody stools

ischemia microbial multi-etology

USLME Kiss my ass and pray (33 decks)

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