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GI- pathology Flashcards

1
Q

Where are salivary gland tumors most often located?

A

parotid gland

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2
Q

What components are seen in a mucoepidermoid carcinoma?

A

salivary gland
malignant
mucinous and squamous components

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3
Q

What is commonly seen in Warthin tumor

A

salivary gland
bening, cystic
germinal centers

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4
Q

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

A

pleiomorphic adenoma

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5
Q

What is the pathogenesis of achalasia?

A

failure of relaxation of LES- loss fo myenteric plexus

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6
Q

What can cause secondary achalasia?

A

chagas disease

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7
Q

What is Boerhaave syndrome?

A

distal esophageal rupture due to violent retching

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8
Q

What esophageal pathology is associated with lye ingestion?

A

esophageal strictures

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9
Q

Describe esophagitis patterns in HSV-1 vs CMV

A

HSV-1: punched-out ulcers

CMV: linear ulcers

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10
Q

What syndrome is sclerodermal esophageal motility assocated with?

A

CREST syndrome

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11
Q

Compare curling and cushing ulcers of acute gastritis

A

Curling- decr plasma volume, sloughing of gastric mucosa

Cushing- incr vagal tone, incr ACh

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12
Q

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

A

Type A: fundus/body: Autoimmune

Type B: antrum: H pylori

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13
Q

Describe Menetrier disease

A

protein loss, parietal cell atrophy, incr mucous cells

precancerous

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14
Q

What skin condition is associated with stomach cancer

A

acanthosis nigricans

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15
Q

What type of stomach cancer is associated with H pylori

A

intestinal

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16
Q

Describe virchow node, what is it associated with?

A

Virchow node- left supraclavicular, metastasis from stomach

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17
Q

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

A

Gastric ulcer: greater with meals, weight loss

Duodenal ulcer: decreases with meals, weight gaim

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18
Q

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

A

Hemorrhage: posterior>anterior
Perforation: anterior>posterior

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19
Q

What symptoms are associated with Whipple disease?

A

Cardiac symptoms
Arthralgias
neurologic symptoms

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20
Q

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

A

Abetalipoproteinemia

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21
Q

What does the D-xylose absorption test test for

A

normal urinary excretion- pancreat insufficiency

decreased excretion- intestinal mucosa defects or bacterial overgrowth

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22
Q

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

A

Crohns: Th1
UC: Th2

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23
Q

Compare layers in true vs false diverticulum

A

True: 3 layers
False: mucosa and submucosa

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24
Q

Where is a Zenker diverticulum located?

A

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

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25
Q

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

A

Zenker: false
Meckel: true

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26
Q

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

A

infants/children: midgut

elderly: sigmoid

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27
Q

What gene mutations are associated with hirschprung disease?

A

RET gene

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28
Q

How is hirschprung diagnosed?

A

rectal suction biopsy

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29
Q

What presents as a “double bubble” on X-ray?

A

Duodenal atresia

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30
Q

What syndrome is associated with duodenal atresia?

A

Down syndrome

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31
Q

What disease is associated with meconium ileus?

A

CF

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32
Q

Where is ischemic colitis most common?

A

Splenic flexure and distal colon

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33
Q

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

A

Tubular: small, rounded villi, more likely to be benign

Villous- long, finger-like villi

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34
Q

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

A

Peutz-Jeghers syndrome

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35
Q

What is the inheritance of Peutz-Jeghers syndrome?

A

Autosomal dominant

36
Q

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

A

APC gene

Autosomal dominant

37
Q

Compare colonic involvement in FAP vs HNPCC

A

FAP- always involves rectum

HNPCC- always involves proximal colon

38
Q

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

A

Gardner

39
Q

What syndrome involves FAP and malignant CNS tumor?

A

Turcot

40
Q

What genetic finding and inheritance is associated with HNPCC/lynch

A

DNA mismatch repair (microsatellite instability)

Autosomal dominant

41
Q

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

A
  1. APC
  2. K-RAS
  3. p53
42
Q

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

A

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

43
Q

What infection is associated with increased amylase

A

mumps

44
Q

Describe the histological findings of cirrhosis

A

Regenerative nodules with bridging fibrosis

45
Q

What is the most specific marker for acute pancreatitis

A

lipase

46
Q

What three disease are associated with ALP

A

obstructive hepatobiliary disease
HCC
bone disease

47
Q

What disease is associated with altered ceruloplasmin?

A

Decreased in Wilson disease

48
Q

What is the molecular pathogenesis of Reye syndrome?

A

decreased b oxidation of mitochondrial enzyme

49
Q

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

A

Reye syndrome

50
Q

What presents as micronodular, irregularly shrunken liver with hobnail apperance

A

alcoholic cirrhosis

51
Q

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

A

Alcoholic hepatitis

intracytoplasmic eosinophilic inclusions

52
Q

What are the treatments of hepatic encephalopathy?

A

Lactulose
low-protein diet
rifaximin

53
Q

What is associated with PAS+ globules in the liver?

A

a1-antitrypsin

54
Q

What is Budd-Chiari syndrome?

A

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

55
Q

What marker is associated with HCC

A

afetoprotein

56
Q

When is a liver biopsy contraindicated?

A

suspect cavernous hemangioma

57
Q

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

A

Hepatic adenoma

58
Q

What does a nutmeg liver indicate?

A

backup of blood in liver

Right-sided heart failure or Budd-Chiari

59
Q

What causes jaundice (specifically)?

A

bilirubin levels >2.5

60
Q

What enzyme is defective in newborns to cause jaundice?

A

UDP-glucuronyltransferase

61
Q

How does phototherapy improve jaundice in newborns?

A

converts unconj bilirubin to water-soluble form

62
Q

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

A

phenobarbital

63
Q

How do Dubin-Johnson and Rotor syndrome differ?

A

Rotor- less severe, no black liver

64
Q

What presents with a black liver?

A

Dubin-Johnson syndrome

65
Q

What is defective in Dubin-Johnson syndrome?

A

Liver excretion of bilirubin

conjugated hyperbilirubinemia

66
Q

What is defective in Crigler-Najjar syndrome?

A

Absent UDP-glucuronyltransferase

67
Q

What gene is defective in Wilson disease?

A

ATP7B

68
Q

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

A

corneal deposits of copper in Wilson disease

69
Q

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

A

Basal ganglia

70
Q

What agents are used to treat Wilson disease?

A

Penicillamine or trientine

71
Q

Presents wiht increased ferritin, iron, decr TIBC

A

Hemochromatosis

72
Q

What gene is mutated in hemochromatosis

A

HFE- C282Y or H63D

73
Q

What are the symptoms associated with primary biliary tract disease?

A

pruritus, jaundice, dark urine, light stools, hepatosplenomegaly

74
Q

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

A

Biliary tract disease

75
Q

Associated with “onion skin” bile duct fibrosis and beading of bile duct

A

Primary sclerosing cholangitis

76
Q

Biliary tract disease associated with hypergammaglobulinemia

A

primary sclerosing cholangitis

77
Q

Biliary disease associated with CREST, Sjogren, RA, celiac

A

Primary biliary cirrhosis

78
Q

What is Charcot’s triad of cholangitis?

A

Jaundice
Fever
RUQ pain

79
Q

What hormone is the cause of biliary colic?

A

CCK

80
Q

What area of the intestine can be obstructed by gallstones?

A

Ileocecal valve

81
Q

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

A

Incr cholesterol and/or bilirubin

Decr bile salts

82
Q

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

A

calcified due to chronic cholecystitis

high rates of gallbladder cancer

83
Q

What is associated with CA-19-9 marker?

A

pancreatic adenocarcinoma

84
Q

What is Trousseau syndrome?

A

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

85
Q

Where do pancreatic adenocarcinomas likely arise

A

pancreatic head- obstructive jaundice

86
Q

What GI disease is associated with a scorpion sting?

A

acute pancreatitis

87
Q

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

A

hypocalcemia- Ca2+ collects in pancreatic calcium soap deposits

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