GI p. 367-371 Flashcards
Pt older than —- who consuming mostly hot dogs and cold-cuts are at high risk of what type of ca?
50 years
Colorectal ca
“Apple core” lesion are seen at part of the colon?
Seen in sigmoid colon.
T or F? CEA tumor marker is good for monitoring recurrence and useful for screening.
F. not for screaning
Colorectal ca rarely, presents with which bug?
Streptococcus bovis bacteremia.
Which part of the colon is prone to iron def anemia in colorectal ca?
Ascending
Hematochezia is associated with which 2 paths?
Descending colon in clolorectal ca
hemorrhoids
order from most common to least common sites of colon ca?
Rectosigmoid > ascending > descending.
Xeroderma pigmentosum, colorectal cancer and Serrated have what kind of molecular pathology in common?
Microsatellite instability
What needs to happen for Adenoma turning into Carcinoma?
Loss of tumor suppressor gene(s) (p53, DCC)
T or F? Genetic/ metabolic disorders can cause cirrhosis.
T
Name 3 paths with KRAS mutation?
Colorectal ca
Adenocarcinoma
Adenomatous polyps
Failure to regulate and destroyed β-catenin is by which protein will cause —- ca?
(APC) protein, encoded by the APC tumour-suppressing gen.
Sporadic colorectal ca
Fetor hepaticus refers to what in cirrhosis pts?
breath smells musty
Alkaline phosphatase (ALP) is elevated in which 4 kinds of disorders?
Cholestatic and obstructive hepatobiliary disease, HCC, infiltrative disorders bone disease (pagets) Semino (placental APL)
Cirrhosis pts should refrain from operating machinery do to what?
coarse hand tremor (asterixis = Liver “flap”)
Which cells play a big role in cirrhosis of the live?
How do they cause fibrosis?
stellate cells disrupts normal architecture of liver by causing diffuse bridging fibrosis and nodular regeneration.
T or F? Reye syndrome causes macrovascular fatty change in liver.
F. microvesicular fatty change
What causes melena and what causes Hematemesis in cirrhosis?
peptic ulcer - melena
Esophageal varices - Hematemesis
intracytoplasmic eosinophilic inclusions of damaged keratin filaments in the hepatocytes describes what?
Mallory bodies (twisted rope appearance)
Amylase is elevated in what 2 dz?
Acute pancreatitis, mumps
Hepatic steatosis Macrovesicular or Microvascular fatty change?
Macrovesicular fatty change
fatty infiltration of hepatocytes causing cellular “ballooning” and eventual necrosis is seen in what path?
Non-alcoholic fatty liver disease
Parents tend to treat their kids with aspirin for which viral infections?
VZV and influenza B
causing Reye syndrome
incr NH3 production and absorption is due to?
dietary protein,
GI bleed,
constipation,
infection
In which disorder/s is ALP elevated where γ-glutamyl transpeptidase (GGT) is not?
in bone disease
insulin resistance and a finding of ALT > AST can cause what hepatic path?
Non-alcoholic fatty liver disease
rifaximin is for Tx of what condition?
Hepatic encephalopathy
What is the most specific Dx for Acute pancreatitis?
lipase
Name 2 carcinogens that can cause HCC?
aflatoxin, ethanol
—- decr β-oxidation by reversible inhibition of mitochondrial enzymes causing —-
aspirin metabolites causing Reyes synd
Sclerosis around what zone happens in Cirrhosis?
zone III
“hobnail” appearance refers to what path? is it Micro or Macronodular?
Micronodular due to irregularly shrunken liver in Cirrhosis.
decr NH3 removal is due to?
due to renal failure
diuretics
bypassed hepatic blood flow post-TIPS (btw portal-hepatic vein)
HCC may lead to which syndrome?
Budd-Chiari syndrome (hepatic vein)
Biopsy in which liver path is contraindicated because of risk of hemorrhage?
Cavernous hemangioma (soft blue compressive mass)
Accumulation of —- hyperbilirubinemia in —- part of brain causes kernicterus.
unconjugated
basal ganglia
Diagnostic lab for HCC?
incr α-fetoprotein
Name path with incr α-fetoprotein?
- Neural tube defects (annencephay)
- abdominal wall defects,
- Hepatocellular carcinoma
- hepatoblastoma
- yolk sac (endodermal sinus) tumor
- mixed germ cell tumor
Pts in the business of furniture and automobile upholstery are at risk of liver tumor?
Angiosarcoma (PCAM-1, CD31) due to vinyl chloride
Pts in poultry, swine production and farmers are at risk of liver tumor?
Angiosarcoma due to Arsenic
Budd-Chiari syndrome causes inc or no JVD?
Absence of JVD
Misfolded gene product protein aggregates in hepatocellular ER causing cirrhosis with
PAS ⊕ globules describes what path?
α1-antitrypsin deficiency
Bilirubin levels that cause jaundice?
> 2.5 mg/dL
Mixed (direct and indirect) hyperbilirubinemia is seen in what 2 paths?
Hepatitis
cirrhosis
A young female on OCP and an athlete can have which benign liver tumor in common?
Hepatic adenoma
“nutmeg liver” is seen in what 2 paths?
Right heart failure
Budd-Chiari syndrome
T or F? Unconjugated hyperbilirubinemia is seen in 1° sclerosing cholangitis and 1° biliary cirrhosis.
F. Conjugated (direct) hyperbilirubinemia
Elastase is regulates by what?
α1-antitrypsin
Most common overall cause of liver tumor?
Metastasis from GI malignancies, breast and lung cancer.
Budd-Chiari syndrome is associated with what 4 pths?
hypercoagulable states (factor 5, protein c/s def, antithrobin def. prothrombin)
polycythemia vera
postpartum state
HCC
Pt with pancreatic ca complains of what physical apparent findings?
Jaundice with puritis
Hereditary harmless jaundice is due to?
Gilbert syndrome, benign congenital unconjugated hyperbilirubinemia
Pt’s liver has turned dark. what pathophys is the cause?
Excretion defect of Conjugated (direct) hyperbilirubinemia in Dubin-Johnson syndrome (EP metabolites in lysosomes cause the blackness)
The Tx of plasmapheresis and phototherapy is needed in what path that has incr unconj. hyperbil.?
Crigler-Najjar
TTP
Thorotrast as a dye causes what path?
Angiosarcoma of liver
Plasmaphorasis is used for?
Crigler-Najjar
TTP
Gullian Barre
KRAS is a
GTPase
Microsatellite instability (MSI)
is the condition of genetic hypermutability that results from impaired DNA mismatch repair (MMR).
What prophylaxis of colorectal ca?
Aspirin
