GI- pathology Flashcards by Laura Yockey

Where are salivary gland tumors most often located?

parotid gland

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What components are seen in a mucoepidermoid carcinoma?

salivary gland
malignant
mucinous and squamous components

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What is commonly seen in Warthin tumor

salivary gland
bening, cystic
germinal centers

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This salivary gland tumor presents as a painless mobile mass at the corner of the jaw. Composed of chodnromyxoid stroma and epithelium

pleiomorphic adenoma

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What is the pathogenesis of achalasia?

failure of relaxation of LES- loss fo myenteric plexus

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What can cause secondary achalasia?

chagas disease

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What is Boerhaave syndrome?

distal esophageal rupture due to violent retching

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What esophageal pathology is associated with lye ingestion?

esophageal strictures

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Describe esophagitis patterns in HSV-1 vs CMV

HSV-1: punched-out ulcers

CMV: linear ulcers

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What syndrome is sclerodermal esophageal motility assocated with?

CREST syndrome

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Compare curling and cushing ulcers of acute gastritis

Curling- decr plasma volume, sloughing of gastric mucosa

Cushing- incr vagal tone, incr ACh

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Compare location and causes of Type A and Type B chronic gastritis

Type A: fundus/body: Autoimmune

Type B: antrum: H pylori

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Describe Menetrier disease

protein loss, parietal cell atrophy, incr mucous cells

precancerous

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What skin condition is associated with stomach cancer

acanthosis nigricans

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What type of stomach cancer is associated with H pylori

intestinal

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Describe virchow node, what is it associated with?

Virchow node- left supraclavicular, metastasis from stomach

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Compare pain pattern and weight changes in gastric vs duodenal ulcers?

Gastric ulcer: greater with meals, weight loss

Duodenal ulcer: decreases with meals, weight gaim

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Where are hemorrhage and perforations most likely to occur? (ant vs post)

Hemorrhage: posterior>anterior
Perforation: anterior>posterior

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What symptoms are associated with Whipple disease?

Cardiac symptoms
Arthralgias
neurologic symptoms

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What presents in childhood as failure to thrive, steatorrhea, acanthocytosis, ataxia, night blindness

Abetalipoproteinemia

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What does the D-xylose absorption test test for

normal urinary excretion- pancreat insufficiency

decreased excretion- intestinal mucosa defects or bacterial overgrowth

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What type of Th responses are typical of Crohns disease and UC?

Crohns: Th1
UC: Th2

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Compare layers in true vs false diverticulum

True: 3 layers
False: mucosa and submucosa

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Where is a Zenker diverticulum located?

Between the thyropharyngeal and cricopharyngeal parts of the inferior pharyngeal constrictor (jxn esophagus and pharynx)

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Compare the types of diverticuli (true vs false) for Zenker and Meckel diverticulum

Zenker: false Meckel: true

What types of volvulus are common in infants/children and elderly?

infants/children: midgut | elderly: sigmoid

What gene mutations are associated with hirschprung disease?

RET gene

How is hirschprung diagnosed?

rectal suction biopsy

What presents as a "double bubble" on X-ray?

Duodenal atresia

What syndrome is associated with duodenal atresia?

Down syndrome

What disease is associated with meconium ileus?

Where is ischemic colitis most common?

Splenic flexure and distal colon

Compare the histology of tubular and villous adenoma. Which is more likely to be benign?

Tubular: small, rounded villi, more likely to be benign | Villous- long, finger-like villi

Presents as hamartomas throughout GI tract and hyperpigmented mouth, lips, hands, genitalia

Peutz-Jeghers syndrome

What is the inheritance of Peutz-Jeghers syndrome?

Autosomal dominant

What is the mutation is involved in FAP? what is the inheritance?

APC gene | Autosomal dominant

Compare colonic involvement in FAP vs HNPCC

FAP- always involves rectum | HNPCC- always involves proximal colon

What syndrome includes FAP, osteoma, fibromatosis, and hypertrophy of retinal pigment epithelium?

Gardner

What syndrome involves FAP and malignant CNS tumor?

Turcot

What genetic finding and inheritance is associated with HNPCC/lynch

DNA mismatch repair (microsatellite instability) | Autosomal dominant

What 3 mutations are associated with the stepwise development of colon cancer?

1. APC 2. K-RAS 3. p53

Compare AST and ALT levels for viral and alcoholic hepatitis and nonalcoholic fatty liver disease?

Viral: ALT>AST alcoholic: AST>ALT NAFLD: ALT>AST

What infection is associated with increased amylase

mumps

Describe the histological findings of cirrhosis

Regenerative nodules with bridging fibrosis

What is the most specific marker for acute pancreatitis

lipase

What three disease are associated with ALP

obstructive hepatobiliary disease HCC bone disease

What disease is associated with altered ceruloplasmin?

Decreased in Wilson disease

What is the molecular pathogenesis of Reye syndrome?

decreased b oxidation of mitochondrial enzyme

Presents with Mitochondrial abnormalities, fatty liver, hypoglycemia, vomiting, hepatomegaly , and coma in children

Reye syndrome

What presents as micronodular, irregularly shrunken liver with hobnail apperance

alcoholic cirrhosis

What liver disease is associated with Mallory bodies? What are Mallory bodies?

Alcoholic hepatitis | intracytoplasmic eosinophilic inclusions

What are the treatments of hepatic encephalopathy?

Lactulose low-protein diet rifaximin

What is associated with PAS+ globules in the liver?

a1-antitrypsin

What is Budd-Chiari syndrome?

Liver infarct secondary to HCC invasion of hepatic vein (also pregnancy, hypercoagulable state, PV)

What marker is associated with HCC

afetoprotein

When is a liver biopsy contraindicated?

suspect cavernous hemangioma

What liver tumor is associated with oral contraceptive and anabolic steroid use

Hepatic adenoma

What does a nutmeg liver indicate?

backup of blood in liver | Right-sided heart failure or Budd-Chiari

What causes jaundice (specifically)?

bilirubin levels >2.5

What enzyme is defective in newborns to cause jaundice?

UDP-glucuronyltransferase

How does phototherapy improve jaundice in newborns?

converts unconj bilirubin to water-soluble form

What is used to treat Type II Crigler-Najjar syndrome?

phenobarbital

How do Dubin-Johnson and Rotor syndrome differ?

Rotor- less severe, no black liver

What presents with a black liver?

Dubin-Johnson syndrome

What is defective in Dubin-Johnson syndrome?

Liver excretion of bilirubin | conjugated hyperbilirubinemia

What is defective in Crigler-Najjar syndrome?

Absent UDP-glucuronyltransferase

What gene is defective in Wilson disease?

ATP7B

What are Kayser-Fleischer rings? What disease do they indicate?

corneal deposits of copper in Wilson disease

What part of the brain is damaged in Wilson's disease

Basal ganglia

What agents are used to treat Wilson disease?

Penicillamine or trientine

Presents wiht increased ferritin, iron, decr TIBC

Hemochromatosis

What gene is mutated in hemochromatosis

HFE- C282Y or H63D

What are the symptoms associated with primary biliary tract disease?

pruritus, jaundice, dark urine, light stools, hepatosplenomegaly

What do incr conj bilirubin, incr cholesterol, and incr ALP indicate?

Biliary tract disease

Associated with "onion skin" bile duct fibrosis and beading of bile duct

Primary sclerosing cholangitis

Biliary tract disease associated with hypergammaglobulinemia

primary sclerosing cholangitis

Biliary disease associated with CREST, Sjogren, RA, celiac

Primary biliary cirrhosis

What is Charcot's triad of cholangitis?

Jaundice Fever RUQ pain

What hormone is the cause of biliary colic?

CCK

What area of the intestine can be obstructed by gallstones?

Ileocecal valve

What cholesterol, bilirubin, and bile salt levels predispose to cholelithiasis?

Incr cholesterol and/or bilirubin | Decr bile salts

What is a porcelain gallbladder? What is at increased risk?

calcified due to chronic cholecystitis | high rates of gallbladder cancer

What is associated with CA-19-9 marker?

pancreatic adenocarcinoma

What is Trousseau syndrome?

migratory thrombophelbitis- redness and tenderness on palpation of extremities indicate underlying cancer (eg pancreatic, gastric)

Where do pancreatic adenocarcinomas likely arise

pancreatic head- obstructive jaundice

What GI disease is associated with a scorpion sting?

acute pancreatitis

How are calcium levels affected in acute pancreatitis? What causes this?

hypocalcemia- Ca2+ collects in pancreatic calcium soap deposits