GI Path+Micro Flashcards

1
Q

Pathology?

A

small bowel obstruction

dilated loops of small bowel, paucity of bowel gas distally

normal for comparison

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2
Q

Pathology?

A

pneumoperitoneum (free intraperitoneal air)

causes: rupture of hollow viscus, ulcer, tumor, trauma, instrumentation, post-operative (expected up to 5-7 days), necrotizing enterocolitis (neonatal setting)

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3
Q

Pathology/imaging?

A

Meckel’s scan to look for presence of ectopic mucosa in large bowel

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4
Q

H. pylori-induced ulcers are treated with [?]

A

PPI + 2 antibiotics (clarithromycin + ampicillin or metronidazole)

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5
Q

Pathology? (salivary glands)

A

chronic sialadenitis

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6
Q

Pathology?

A

mucocele

due to blockage or rupture of salivary gland duct with leakage of saliva into surrounding CT stroma

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7
Q

Pathology? (salivary glands)

A

Sjogren’s syndrome

lymphoid infiltration of lacrimal and salivary glands by activated CD4+ T cells and B cells

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8
Q

Pathology? (salivary glands)

A

pleomorphic adenoma

most common salivary gland neoplasm; “benign mixed tumor”

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9
Q

Pathology? (salivary glands)

A

pleomorphic adenoma

distinctive magenta-colored fibrils on diff-quik stain when doing fine needle adenoma

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10
Q

Pathology? (salivary glands)

A

Warthin’s tumor

aka papillary cystadenoma lymphomatosum

benign tumor

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11
Q

Pathology? (salivary glands)

A

mucoepidermoid carcinoma

most common malignant neoplasm of salivary gland (46% in minor salivary gland)

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12
Q

Pathology? (salivary glands)

A

adenoid cystic carcinoma

cribriform architectural pattern; malignant

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13
Q

Pathology? (salivary glands)

A

acinic cell carcinoma

malignant

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14
Q

Pathology?

A

achalasia

bird beak sign on barium swallow

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15
Q

Pathology (esophagus)

A

esophageal varices

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16
Q

Pathology? (esophagus)

A

GERD

see basal zone hyperplasia

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17
Q

Pathology? (esophagus)

A

Barrett esophagus

salmon colored, tongue-like area of columnar epithelium

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18
Q

Pathology? (esophagus)

A

adenocarcinoma of esophagus

most arises from Barrett’s esophagus

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19
Q

Pathology? (esophagus)

A

squamous cell carcinoma of esophagus

exposure to dietary/ environmental carcinogens

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20
Q

Pathology? (esophagus)

A

squamous cell carcinoma of esophagus

exposure to dietary/ environmental carcinogens

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21
Q

Pathology? (stomach)

A

ulcers

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22
Q

Pathology? (stomach)

A

H. pylori infection

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23
Q

Pathology? (stomach)

A

ulcer

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24
Q

Pathology? (stomach)

A

Menetrier disease

excess secretion of TGF-alpha => diffuse hyperplasia of body and fundus foveolar epithelium => enlarged rugae

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25
Q

Pathology? (stomach)

A

Zollinger Ellison syndrome

gastric gland hyperplasia due to excessive gastrin secretion by pancreas

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26
Q

Pathology? (stomach)

A

diffuse adenocarcinoma

see signet ring cells (tumor cells containing mucin); gross thickening of gastric wall due to desmoplastic reaction

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27
Q

Pathology? (stomach)

A

intestinal type adenocarcinoma

predominates in high-risk areas; gland formation on microscopy; bulky tumor

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28
Q

Pathology

A

Meckel’s diverticulum

failure of involution of omphalo-mesenteric duct

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29
Q

Pathology?

A

Hirschsprung disease (congenital aganglionic megacolon)

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30
Q

Pathology? (intestines; left normal)

A

celiac

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31
Q

Pathology? (intestines)

A

abetalipoproteinemia

enterocyte vacuolization

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32
Q

Pathology? (intestines)

A

giardia lamblia

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33
Q

Pathology? (appendix)

A

carcinoid tumor

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34
Q

Pathology? (colon)

A

juvenile polyp

35
Q

Pathology?

A

Peutz-Jegher syndrome

melanotic mucosal and cutaneous pigmentation; hamartomatous polyps throughout GIT

36
Q

Pathology? (colon)

A

Crohn’s disease

skip lesions (not continuous); cobblestone appearance

37
Q

Pathology? (colon)

A

Crohn’s disease

granulomas in colon

38
Q

Pathology? (colon)

A

ulcerative colitis

continuous lesions

39
Q

Pathology? (liver)

A

cirrhosis

40
Q

Pathology? (liver)

A

cholestasis

brown bile pigment inside hepatocytes, feathery degeneration

41
Q

Pathology? (liver)

A

primary sclerosing cholangitis

42
Q

Pathology? (liver)

A

hepatocellular carcinoma

malignant; increased AFP

43
Q

Pathology? (liver)

A

fibrolamellar carcinoma

can see scarring from fibrosing bands of collagen

44
Q

Pathology? (liver)

A

focal nodular hyperplasia

45
Q

Pathology?

A

cholesterosis aka strawberry gallbladder

accumulation of cholesterol esters and triglycerides in macrophages within lamina propria

46
Q

Pathology? (gallbladder)

A

gallbladder carcinoma

47
Q

Pathology?

A

acute pancreatitis

48
Q

Pathology? (pancreas)

A

intraductal papillary mucinous neoplasm

can progress to invasive cancer

49
Q

LFT abnormalities: predominant hepatocellular injury

A

increased transaminases (ALT, AST)

ALP increased 2-3 times ULN

50
Q

LTF abnormalities: predominant cholestatic pattern

A

ALP increased 3-5x ULN

minor transaminase increase

51
Q

Gilbert’s syndrome

A

benign AD disorder; partial defect in BRN conjugation and decreased uptake of conjugated BRN by hepatocytes

52
Q

Crigler-Najjar syndrome

A

impaired conjugation of BRN; rare; AR (much more deadly) or AD

53
Q

congenital causes of conjugated hyperbilirubinemia

A

Dubin-Johnson syndrome, Rotor’s syndrome, progressive familial intrahepatic cholestasis/Byler’s disease

all are AR

54
Q

[?] naked, segmented ds RNA virus; most common cause of infantile diarrhea

A

rotavirus

55
Q

[?] small, round, naked, ss RNA virus; 60% of non-bacterial diarrhea in adults

A

norovirus/norwalk virus

56
Q

organisms that grow green-black colonies with metallic sheen on eosin-methylene blue agar

A

strong lactose fermenters: E. coli

57
Q

organisms that grow pink-purple colonies on eosin-methylene blue agar

A

intermediate lactose fermenters: Klebsiella, Enterobacter

58
Q

organisms that grow colorless, transparent colonies on eosin-methylene blue agar

A

non-lactose fermenters: Salmonella, Shigella

59
Q

Guillain-Barre syndrome is often preceded by an infection with [?]

A

campylobacter jejuni

60
Q

[?] most common roundworm in temperature zones; fecal-oral transmission; diagnosed with scotch-tape test (egg ID)

A

Enterobius vermicularis (pinworm)

treatment = pyrantel pamoate or mebendazole

61
Q

[?] football-shaped eggs in feces; heavy infections can show ulceration and hemorrhage

A

Trichuris trichiuria (whipworm)

treatment = mebendazole

62
Q

[?] common in tropical or subtropical regions; pneumonitis, GI perforation, bowel obstruction; do not attach to bowel wall

A

Ascaris lumbricoides (large roundworms)

treatment = mebendazole

63
Q

[?] cause pneumonia and eosinophilia as larva migrates; may live in host for 8-16 years

A

hookworms (Nectar americansus, Ancylostoma dudenale)

treatment = mebendazole

64
Q

[?] filariform larvae infiltrate through skin, migrate through lungs, and eventually to small intestine

A

Strongyloides stercoralis (small roundworms)

65
Q

[?] lemon shaped; presents with diarrhea and muscle paralysis (due to larvae converting muscle cells to nurse cells); spread from eating pork

A

Trichinella spiralis

66
Q

[?] nematode parasite of cats and dogs; most infections are asymptomatic

A

Toxocara

67
Q

[?] filarial nematodes that cause tropical pulmonary eosinophilia and elephantiasis due to lymphatic obstruction

A

Wuchereria bancroftii, Brugia malayi

68
Q

[?] filarial nematode spread by Simulium black flies; causes river blindness

A

Onchocerca volvus

69
Q

[?] filarial nematode spread by Chrysops mango flies; migration is not painful but is noticed when they transverse conjunctival tissue

A

loa loa (African eye worm)

70
Q

[?] crustacean intermediate; huge quantities of larvae released when worm contacts water through ulcer

A

Dracunculus medinensis

71
Q

[?] snails release cercariae, which penetrate skin and develop in veins

A

Schistosomes (S. mansoni, S. japonicum, S. hematobium)

treated with praziquantel

72
Q

[?] scrolex and proglottids; cause anorexia and diarrhea; spread by undercooked beef

A

Taenia saginata (tapeworm)

73
Q

[?] scrolex and proglottids; cause anorexia, diarrhea, blindness, and neurological disorders; spread by undercooked pork

A

Taeniea solium (tapeworm)

74
Q

[?] scrolex and proglottids; cause fluid-filled cysts in liver and lungs; contain hydatid sand

A

Echinococcus granulosus (rarely in North America)

75
Q

[?] scrolex and proglottids; spread by eating undercooked fish; can cause vitamin B12 deficiency

A

Diphyllobothrium lattum (fish tapeworm)

76
Q

[?] parasite; causes diarrhea, flatulence, cramps, pneumonia, empyema, peritonitis, chronic pericardial infection; cyst disintegrates in small intestine and releases 8 trophozoites

A

Entamoeba histolytica

treatment = metronidazole, iodoquinol

77
Q

[?] parasite; binucleated flagellate with 4 pairs of flagella; cause sudden onset explosive diarrhea, greasy foul-smelling stools, large amounts of gas; water-borne epidemics

A

Giardia lamblia

treatment: metronidazole, quinacrine

78
Q

[?] obligatory intracellular parasites that cause explosive, perfuse, watery diarrhea, weight loss, wasting, and death in the immunocompromised

A

Cryptosporidium

no treatment available

79
Q

[?] causes food poisoning via enterotoxins A-D, which induce intestinal peristalsis and stimulate vomit reflex => nausea, vomiting, cramps, watery non-bloody diarrhea, profuse sweating, headache 1-6 hours after eating

A

Staph aureus

80
Q

[?] form spores that can survive on grain foods (rise) and some meet dishes

A

Bacillus cereus

81
Q

the emetic type of Bacillus cereus food poisoning is caused by [?], while the diarrheal type is caused by [?]

A

the emetic type of Bacillus cereus food poisoning is caused by heat-stable enterotoxin, while the diarrheal type is caused by heat-labile enterotoxin

heat-labile has longer incubation period (24 hours) and involves increased cAMP production

82
Q

[?] germination of spores in alkaline foodstuffs causes food-borne illness (12-36 hour incubation) and descending paralysis

A

C. botulinum

83
Q

[?] ingestion of spore-contaminated meat dishes results in production of heat labile enterotoxin => diarrhea within 18 hours of ingestion

A

Clostridium perfringes