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GI Pathophys > GI Path > Flashcards

GI Path Flashcards

1
Q

Endoscopic finding of Barrett’s esophagus

A

-tongues/islands of salmon-pink mucosa

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2
Q

Esophageal Adenocarcinoma

A

Adenocarcinoma = cancer of a glandular organ- aka the mucous secreting glands of the esophagus

-progression from Barrett’s (metasplasia) –> dysplasia (low or high grade) –> invasive adenocarcinoma

Causes: longstanding GERD, ulcers

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3
Q

Complications of Barrett’s esophagus

A

H-ulcers, strictures, adenocarcinoma

-degree of dysplastic changes correlates to the risk of adenocarcinoma

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4
Q

Are most polyps of the stomach neoplastic?

A

No, 90% are non-neoplastic meaning they have no risk of developing into cancer

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5
Q

Most common gastric malignancy

A

90-95% of gastric malignancies are gastric adenocarcinomas

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6
Q

Describe the progression of cancer progression in GI and gastric tumors

A

Normal –> Metaplasia –> Dysplasia –> Adenocarcinoma (invasive)

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7
Q

Leather bottle appearance

A

Mural thickening in type IV of advanced gastric cancer

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8
Q

What can cause increased risk of carcinoma in different organ than it’s location?

A

Peutz-Jaghers = non-neoplastic hamartomatous polyp

  • can be sporadic or syndromic
  • increases risk of carcinoma in pancreas, breast, lung, ovary, and uterus
  • can possible cause intussusception
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9
Q

What is the most common cystic pancreatic neoplasm?

A

IPMN = intraductal papillary mucinous neoplasm

-however: recall that the majority of pancreatic cystic lesions (75%) are pseudocysts

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10
Q

Which cystic pancreatic neoplasm is in the head of the pancreas?

A

IPMN = intraductal papillary mucinous neoplasm

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11
Q

Which cystic pancreatic neoplasms are in the tail of the pancreas?

A
  • MCN = mucinous cystic neoplasm

- Serous cystadenoma

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12
Q

Which cystic pancreatic neoplasm is inside the duct?

A

IPMN

-not MCN or serous cystadenoma

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13
Q

Which cystic pancreatic neoplasms are mucin producing?

A

IPMN and MCN

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14
Q

Which cystic pancreatic neoplasm has ovarian-like stroma?

A

MCN = mucinous cystic neoplasm

  • contains dense stroma similar to ovarian stroma
  • often associated w/ estrogen hormone dysregulation
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15
Q

Which cystic pancreatic neoplasms can progress to carcinoma?

A

IPMN and MCN

-not serous cystadenoma (no malignant potential)

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16
Q

What is the most common solid pancreatic tumor?

What is the prognosis?

Where in the pancreas is it most commonly seen?

A 
Ductal adenocarcinoma
(adenocarcinoma = tumor of the glandular tissue)
  • poor prognosis
  • 70% in the head of the pancreas => jaundice due to CBD obstruction
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17
Q

How does ductal adenocarcinoma stain on immunohistochemistry

A

Glycoproteins (CA-19-9)

18
Q

How does acinar carcinoma stain on immunohistochemistry?

A

Enzymes: trypsin, lipase, and chymotrypsin

recall the acini are what produce the pancreatic enzymes

19
Q

What solid pancreatic tumor can affect ppl at any age?

A

PEN = pancreatic endocrine neoplasm

-affects ppl 10-80 yoa

20
Q

What is the most common clinical presentation of a pancreatic endocrine neoplasm (PEN)?

A

Hypoglycemia due to the excess insulin of the most common type of PEN = insulinoma (insulin secreting tumor)

21
Q

What is the epithelium of the gall bladder

A

simple columnar

-helpful to absorb electrolytes and water to concentration the bile

22
Q

What are choledochal cysts?

What are the triad of symptoms that accompany it?

A

= cystic dilation of the bile duct
-congenital abnormality

3 Symptoms:

(i) jaundice
(ii) RUQ abdominal mass
(iii) intermittent abdominal pain

23
Q

What are cholelithiasis?

A

Gallstones!

-extremely prevalent (10-20% of adults) but most (80%) are asymptomatic

24
Q

What is the composition of the majority of gallstones?

A

80% of gall stones are cholesterol stones

-most common in US and Europe

25
Q

What is the composition of the minority of gallstones?

A

20% are pigmented stones

-more common in Asian and rural areas

26
Q

2 most common causes of acute pancreatitis

A

Gallstones and alcohol

27
Q

Treatment for acute pancreatitis

A

Supportive

28
Q

Histology of chronic pancreatitis

A
  • fibrosis
  • calcification (sometimes visible on Xray)
  • dilate ducts
29
Q

Key pathological finding of autoimmune pancreatitis

A

sclerosis = hardening

-bulk, firm, and hard gross appearance

30
Q

Key diagnostic feature of autoimmune pancreatitis

A

IgG4 plasma cells

31
Q

What is acute cholecystitis? What are the two most common causes?

A

= acute inflammation of the gall bladder

  • 90% due to obstruction of cystic duct by stones
  • 10% due to cystic artery ischemia
32
Q

What causes chronic cholecystitis

A

chronic gallbladder inflammation always caused by stones

33
Q

Why is it good that tumors of the gall bladder are very rare?

A

b/c there’s insanely poor survival: 1% 5 yr survival

34
Q

Most common primary liver cancer

A

hemangioma = benign tumor of endothelial cells lining the blood vessels

-F > M b/c female hormones promote growth

35
Q

Most common malignancy of the tumor

A

Metastasis

-common sites from colon, lung, and breast

36
Q

Most common hepatocellular nodule

A

FNH = focalnodular hyperplasia

  • hyperplastic (proliferation w/ limits)
  • non-neoplastic
  • has normal hepatocytes, central scar, present portal triads
  • F > M
37
Q

Differentiate hyperplastic and neoplastic lesions

A

Hyperplastic is proliferation w/ limits while neoplastic is proflieration w/o limits

38
Q

What is the most common bile duct tumor?

A

Adenoma

39
Q

If you see HCC w/o cirrhosis what do you think?

A

Hep B

40
Q

Why is HCC mostly seen w/ cirrhosis?

A

B/c it is the chronic inflammation that leads to repeated cycles of cell death and regeneration that allows for the genetic alterations to arise

41
Q

Which liver hyperplastic nodule is associated w/ portal HTN?

A

NRH = nodular regenerative hyperplasia

  • multiple small diffuse lesions
  • benign, hyperplastic
  • associated w/ abnormal bloodflow (so is FNH)

GI Pathophys (4 decks)

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