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M2015/16 > GI p. 367-371 > Flashcards

GI p. 367-371 Flashcards

1
Q

Pt older than —- who consuming mostly hot dogs and cold-cuts are at high risk of what type of ca?

A

50 years

Colorectal ca

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2
Q

“Apple core” lesion are seen at part of the colon?

A

Seen in sigmoid colon.

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3
Q

T or F? CEA tumor marker is good for monitoring recurrence and useful for screening.

A

F. not for screaning

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4
Q

Colorectal ca rarely, presents with which bug?

A

Streptococcus bovis bacteremia.

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5
Q

Which part of the colon is prone to iron def anemia in colorectal ca?

A

Ascending

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6
Q

Hematochezia is associated with which 2 paths?

A

Descending colon in clolorectal ca

hemorrhoids

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7
Q

order from most common to least common sites of colon ca?

A

Rectosigmoid > ascending > descending.

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8
Q

Xeroderma pigmentosum, colorectal cancer and Serrated have what kind of molecular pathology in common?

A

Microsatellite instability

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9
Q

What needs to happen for Adenoma turning into Carcinoma?

A

Loss of tumor suppressor gene(s) (p53, DCC)

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10
Q

T or F? Genetic/ metabolic disorders can cause cirrhosis.

A

T

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11
Q

Name 3 paths with KRAS mutation?

A

Colorectal ca
Adenocarcinoma
Adenomatous polyps

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12
Q

Failure to regulate and destroyed β-catenin is by which protein will cause —- ca?

A

(APC) protein, encoded by the APC tumour-suppressing gen.

Sporadic colorectal ca

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13
Q

Fetor hepaticus refers to what in cirrhosis pts?

A

breath smells musty

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14
Q

Alkaline phosphatase (ALP) is elevated in which 4 kinds of disorders?

A 
Cholestatic and obstructive hepatobiliary disease,
HCC, 
infiltrative disorders
bone disease (pagets)
Semino (placental APL)
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15
Q

Cirrhosis pts should refrain from operating machinery do to what?

A

coarse hand tremor (asterixis = Liver “flap”)

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16
Q

Which cells play a big role in cirrhosis of the live?

How do they cause fibrosis?

A

stellate cells disrupts normal architecture of liver by causing diffuse bridging fibrosis and nodular regeneration.

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17
Q

T or F? Reye syndrome causes macrovascular fatty change in liver.

A

F. microvesicular fatty change

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18
Q

What causes melena and what causes Hematemesis in cirrhosis?

A

peptic ulcer - melena

Esophageal varices - Hematemesis

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19
Q

intracytoplasmic eosinophilic inclusions of damaged keratin filaments in the hepatocytes describes what?

A

Mallory bodies (twisted rope appearance)

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20
Q

Amylase is elevated in what 2 dz?

A

Acute pancreatitis, mumps

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21
Q

Hepatic steatosis Macrovesicular or Microvascular fatty change?

A

Macrovesicular fatty change

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22
Q

fatty infiltration of hepatocytes Žcausing cellular “ballooning” and eventual necrosis is seen in what path?

A

Non-alcoholic fatty liver disease

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23
Q

Parents tend to treat their kids with aspirin for which viral infections?

A

VZV and influenza B

causing Reye syndrome

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24
Q

incr NH3 production and absorption is due to?

A

dietary protein,
GI bleed,
constipation,
infection

25
Q

In which disorder/s is ALP elevated where γ-glutamyl transpeptidase (GGT) is not?

A

in bone disease

26
Q

insulin resistance and a finding of ALT > AST can cause what hepatic path?

A

Non-alcoholic fatty liver disease

27
Q

rifaximin is for Tx of what condition?

A

Hepatic encephalopathy

28
Q

What is the most specific Dx for Acute pancreatitis?

A

lipase

29
Q

Name 2 carcinogens that can cause HCC?

A

aflatoxin, ethanol

30
Q

—- decr β-oxidation by reversible inhibition of mitochondrial enzymes causing —-

A

aspirin metabolites causing Reyes synd

31
Q

Sclerosis around what zone happens in Cirrhosis?

A

zone III

32
Q

“hobnail” appearance refers to what path? is it Micro or Macronodular?

A

Micronodular due to irregularly shrunken liver in Cirrhosis.

33
Q

decr NH3 removal is due to?

A

due to renal failure
diuretics
bypassed hepatic blood flow post-TIPS (btw portal-hepatic vein)

34
Q

HCC may lead to which syndrome?

A

Budd-Chiari syndrome (hepatic vein)

35
Q

Biopsy in which liver path is contraindicated because of risk of hemorrhage?

A

Cavernous hemangioma (soft blue compressive mass)

36
Q

Accumulation of —- hyperbilirubinemia in —- part of brain causes kernicterus.

A

unconjugated

basal ganglia

37
Q

Diagnostic lab for HCC?

A

incr α-fetoprotein

38
Q

Name path with incr α-fetoprotein?

A
  • Neural tube defects (annencephay)
  • abdominal wall defects,
  • Hepatocellular carcinoma
  • hepatoblastoma
  • yolk sac (endodermal sinus) tumor
  • mixed germ cell tumor
39
Q

Pts in the business of furniture and automobile upholstery are at risk of liver tumor?

A

Angiosarcoma (PCAM-1, CD31) due to vinyl chloride

40
Q

Pts in poultry, swine production and farmers are at risk of liver tumor?

A

Angiosarcoma due to Arsenic

41
Q

Budd-Chiari syndrome causes inc or no JVD?

A

Absence of JVD

42
Q

Misfolded gene product protein aggregates in hepatocellular ER Žcausing cirrhosis with
PAS ⊕ globules describes what path?

A

α1-antitrypsin deficiency

43
Q

Bilirubin levels that cause jaundice?

A

> 2.5 mg/dL

44
Q

Mixed (direct and indirect) hyperbilirubinemia is seen in what 2 paths?

A

Hepatitis

cirrhosis

45
Q

A young female on OCP and an athlete can have which benign liver tumor in common?

A

Hepatic adenoma

46
Q

“nutmeg liver” is seen in what 2 paths?

A

Right heart failure

Budd-Chiari syndrome

47
Q

T or F? Unconjugated hyperbilirubinemia is seen in 1° sclerosing cholangitis and 1° biliary cirrhosis.

A

F. Conjugated (direct) hyperbilirubinemia

48
Q

Elastase is regulates by what?

A

α1-antitrypsin

49
Q

Most common overall cause of liver tumor?

A

Metastasis from GI malignancies, breast and lung cancer.

50
Q

Budd-Chiari syndrome is associated with what 4 pths?

A

hypercoagulable states (factor 5, protein c/s def, antithrobin def. prothrombin)
polycythemia vera
postpartum state
HCC

51
Q

Pt with pancreatic ca complains of what physical apparent findings?

A

Jaundice with puritis

52
Q

Hereditary harmless jaundice is due to?

A

Gilbert syndrome, benign congenital unconjugated hyperbilirubinemia

53
Q

Pt’s liver has turned dark. what pathophys is the cause?

A

Excretion defect of Conjugated (direct) hyperbilirubinemia in Dubin-Johnson syndrome (EP metabolites in lysosomes cause the blackness)

54
Q

The Tx of plasmapheresis and phototherapy is needed in what path that has incr unconj. hyperbil.?

A

Crigler-Najjar

TTP

55
Q

Thorotrast as a dye causes what path?

A

Angiosarcoma of liver

56
Q

Plasmaphorasis is used for?

A

Crigler-Najjar
TTP
Gullian Barre

57
Q

KRAS is a

A

GTPase

58
Q

Microsatellite instability (MSI)

A

is the condition of genetic hypermutability that results from impaired DNA mismatch repair (MMR).

59
Q

What prophylaxis of colorectal ca?

A

Aspirin

M2015/16 (27 decks)

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