GI path Flashcards
what condition produces periodic, simaltaneous, non-perisataltic contractions on esophogeal manomatry and a “cockscrew” appearance on barium swallow?
diffuse esophageal spasm
pts can present with liquid/solid dysphagia and chest pain due to inefficient propulsion of food into stomach
Elderly man presents with dysphagia and foul breath (halitosis) and food regurgitation. It’s found that he has a mucosal outpouching through an area of muscle weakness located in the wall of the hypopharynx (killian triangle). What is the Dx?
Zenker’s diverticulum
pt presents with progressive solid food dysphagia and unintentional weight loss. Hx reveals heavy alcohol use. What is the Dx?
esophogeal squamous cell carcinoma
Pt pt presents with progressive solid food dysphagia and unintentional weight loss. Hx reveals barretts, GERD, smoking and obesity. What is the Dx?
esophogeal adenocarcinoma
Pt. presents with esophageal smooth muscle atrophy and gut wall fibrosis in lower two thirds of the esophagus with dysphagia with acid reflux. Manometry shows absent peristaltic waves with decreased esophageal sphincter tone. Hx is significant for restrictive lung disease. What test would reveal the Dx?
test for Anti-Scl-70 (anti-topoisomerase 1) antibody
pt has diffuse scleroderma
what is the difference between primary billiary serosis and acute sclorosing cholangitis?
primary biliary sclerosis - autoimmune with + anti-mitochondiral antibody classically seen in middle-aged females
primary sclerosing cholangitis - 60% associated with positive pANCA, seen primarily in males over 40, associated with ulcerative colitis and cholangiocarcinoma, alternating beading and stricturing
what disease is associated with mucocutaneous pigmented lesions around the mouth/lips and oral buccal mucosa? Presents with multiple GI harmartomatous polyps and abdominal pain +/- bleeding due to intussesception or obstruction or malignant transformation.
Peutz-Jegers syndrome
serine/threonin kinase 11 mutation on chromasome 19
what are the associated HLA markers for celiacs disease?
HLA-DQ2 and HLA-DQ8
What is hte mallignancy risk for celiacs?
T-cell lymphoma
What are the associated demographics or conditions with celiacs?
european dissent
dermatitis herpetiformis
what are two cutaneous manifaestations of chron disease?
erythema nodosum and pyoderma gangrinosum
what is the cause of gilbert syndrome?
reduced bilirubin UDP glucoronosyltransferase activity
presents with unconjugated hyperbilirubinemia that is provoked by hemolysis fasting physical exertion, fever stress or fatigue
pt has atrophic glossitis and shuffling broad - based gate due to loss of prprioception from dosrolateral degeneration of the spinal cord. What is the cause?
pernicious anemia
2 year old with brisk, painless rectal bleeding - what is the cause?
THINK MECKEL DIVERTICULULM - failed obliteration of the vitelline duct (omphalomesteric duct)
normally regresses before 8th week of gestation
if not obliterated completely, HETEROTOPIC TISSUE persists in the ileum - can consist of gastric or pancreatic tissue in the midst of normal intestinal mucosa
2 year old with brisk, PAINFUL abdomain with palpable mass and rectal bleeding - what is the cause?
intussesception - probably associated with a meckel diverticulum which actas ass a lead point for bowel telescoping
