GI Path Flashcards
a thin, noncanalized cord replaces a segement of esophagus; congenital abnormality
atresia
atresia is most commonly at or near …
the tracheal bifurcation
aspiartion, suffocation, pneumonia, and severe fluid and electrolytes imbalances; congenital abnormality
fistula
herniation of the abdominal viscera into the thoracic cavity due to incomplete formation of the diaphargm; pulmonary hypoplasia; congenital abnormality
diaphragmatic hernia
herniation of the abdominal viscera into a ventral membranous sac due to incomplete closure of the abdominal musculature; congenital abnormality
omphalocele
gastric mucosa in esophagus; congenital abnormality
ectopia
a true diverticulum as a blind outpouching of the alimentary tract communicating with the lumen and includes all 3 layers; congenital abnormality
meckel diverticulum
hyperplasia of the pyloric muscularis propria; increased risk with Turner syndrome and trisomy 18; regurgitation, projectile, nonbilious vomiting after feeding; erythromycin and azithromycin exposure and increased incidence; congenital abnormality
pyloric stenosis
idiopathic ledge-like protrusions of mucosa that may cause obstruction; associated with GI reflux, chronic graft vs host disease, or blistering skin diseases; nonprogressive dysphagia; esophagus
esophageal mucosal webs
upper esophagus webs; iron deficiency anemia; glossitis; and cheilosis; increased risk of cancer
plummer vinson syndrome
“failure to relax”; incomplete lower esophageal sphincter relaxation; aperistalsis; dysphagia, difficulty in belching, and chest pain; increased risk of esophageal cancer
achalasia
distal esophageal inhibitory neuronal degeneration
primary achalasia
chagas disease, tyrpanosoma cruzi infection causing myenteric plexus destruction; diabetic autonomic neuropathy; inflitrative disorders; lesions of dorsal motor nuclei; down syndrome; sjogren or autoimmune thyroid disease
secondary achalasia
mucosal tears near the gastroesophageal junction; associated with severe retching or vomiting secondary to acute alcohol intoxication
mallory-weiss tears
herpes simplex virus particularly in immunocompromised and candidiasis
infectious esophagitis
adherent gray-white pseudomembranes covering esophageal mucosa
candidiasis
punched out ulcers
esophagitis, herpes virus
most common cause of esophagitis
reflux of gatric contents into the lower esophagus (GERD)
most common cause of GERD
lower esophageal sphincter relaxation
treatment of GERD
proton pump inhibitors
major complication of GERD
Barrett esophagus
a congested subepithelial and submucosal venous plexi within the distal esophagus and proximal stomach; cause of esophageal bleeding
esophageal varices
most common cause of esophageal varices
portal hypertension
portal hypertension, in cirrhotic patient, most commonly associated with …
alcoholic liver disease
2nd most common cause of esophageal varices
hepatic schistosomiasis
a complication of GERD characterized by columnar metaplasia within the esophageal squamous mucosa; increased risk of esophageal adenocarcinoma
Barret esophagus
most common benign tumor of esophagus
leiomyoma
malignant tumors of esophagus
adenocarcinoma and squamous cell carcinoma
more than 1/2 of all esophageal cancers in US; most cases from Barret esophagus (obesity related GERD)
adenocarcinoma
decreased risk of esopharyngeal adenocarcinoma with … due to gastric atrophy–>decreased acid secretion and reflux–>decreased Barret
Helicobacter pylori
alcohol and tobacco use, poverty, caustic esophageal injury, achalasia, tylosis, plummer-vinson, fruit/veggie deficiency, very hot beverages
squamous cell carcinoma
a mucosal inflammatory process; stomach
gastritis
gastritis in presence of neutrophils
acute
a diverse set of disorders marked by gastric injury or dysfunction with no inflammatory cells
gastropathy
causes of gastropathy
NSAID, alcohol, bile, stress induced injury
most common cause of chronic gastritis
H. pylori
enzyme the causes increase in pH and allows for survival of H. pylori
urease
mutation of which gene in H. pylori results in many different toxins
CagA
histopathologic features of H pylori gastritis
spiral shaped H. pylori, silver stain; neutrophils within epithelium/lamina propria; lymphoid aggregates, subepithelial plasma cells
complication of chronic gastritis; chronic mucosal ulceration affection duodenum/stomach; associated with H pylori, NSAIDs, smoking
peptic ulcer disease
multiple peptic ulcerations in the stomach, duodenum, and even jejunum owing to excess gastrin secretion by a tumor–>excess gastric acid production
Zollinger Ellison syndrome
giant cerebriform enlargement of the rugal folds due to epithelial hyperplasia; no inflammation; excessive growth factor; ex: Zollinger-Ellison
hypertrophic gastropathies
4 causes of gastric polyps
hyperplasia; inflammation; ectopia; neoplasia
most common polyps?
inflammatory or hyperplastic
risk of developing adenocarcinoma in gastric adenomas that are greater than ….
2 cm
distorted, irregular glands lined with epithelium demonstrating crowded, pleomorphic nuclei overlapping with losing of normal polarity; seen in gastric adenomas
epithelial dysplasia
most common malignancy of stomach
gastric adenocarcinoma
risk factors for gastric cancer:
H. pylori; host (genetic background); diet/habit (low vit. C, high salt/nitrate, smoking)
precursor conditions of gastric cancer
hypochlorhidia; atrophic body gastritis; intestinal metaplasia; dysplasia
mitotic figures
gastric adenocarcinoma
main difference between small and large intestine
large intestine has no villi
aggregate lymphoid nodules (peyers patches) found in…
ileum
defective absorption of fats, vitamins, proteins, carbs, electrolytes and minerals, and water; present as chronic diarrhea; steatorrhea as hallmark
malabsorption
most common disorders in US causing malabsorption
pancreatic insufficiency, celiac disease, crohn disease
an important cause of malabsorption and diarrhea following allogenic hematopoietic stem cell transplantation
intestinal graft vs host disease
an immune mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals; loss of villi
celiac disease
a chronic condition resulting from inappropriate mucosal immune activation
inflammatory bowl disease
2 disorders that comprise inflammatory bowl disease
ulcerative colitis; crohn disease
skip lesions; transmural inflammation; ulcerations, fissures
crohn disease
continuous colonic involvement beginning in rectum; pseudopolyps; ulcers
ulcerative colitis
result of immune response in IBD is production of …
TNF
factors involved in IBD
luminal microbial antigens; genetic susceptibility; immune response; environmental triggers
skip lesions; aphthous ulcer as earliest lesion; anti-TNF antibodies for treatment
crohn disease
oral manifestations of crohn disease
lip swelling; linear ulcer/aphthous like ulcer (characteristic in vestibule)
non-caseating granulomatous inflammation (granuloma formation)
crohn disease
ulcers/pseudopolyps; limited to colon/rectum; bloody diarrhea and abdominal pain; no granuloma formation
ulcerative colitis
pyostomatitis vegetans (oral)
ulcerative colitis
most common malignancy of GI tract
adenocarcinoma of colon
low intake unabsorbable vegetable fiber and high intake of refined carbs and fat
increased rates of colorectal cancer
chemoprevention of colorectal cancer–>inhibtion of COX 2—>inhibition of epithelial proliferation
aspirin and NSAIDs
mutation of … early in the neoplastic process in up to 80% of sporadic colon cancers
APC (adenomatous polyposis coli)
2 most important prognostic factors of adenocarcinoma of colon
depth of invasion and presence of lymph node metastases
