GI Pathology Flashcards
What is the main reason of a cleft palate to form?
failure of facial prominences to fold
What is an aphthous ulcer?
painful, ulceration of oral mucosa
What causes Behcet Syndorme?
immune complex vasculitis
Begcet Syndrome is seen after what type of infection?
viral
What are the three areas are effected by Behcet Syndrome?
aphthous ulcer, genital ulcers, uveitis
Which HSV isotype causes oral herpes?
one
Where does oral herpes remaini dormant?
ganglia of trigeminal nerve
What are the two precursor lesions for squamous cell carcinoma (squamous cell dysplasia)?
leukoplakia and erythroplakia
What are the two common risk factors for developing a squamous cell carcinoma?
tobacco and alcohol
Does squamous cell carcinoma effect the floor or the roof of the mouth?
floor
Oral hairy leukoplakia is indicative of what type of cancer?
squamous cell carcinoma
Where on the tongue does oral hairy leukoplakia arise?
lateral side of the tongue
In immunocompromised patients, what virus can drive oral hairy leukoplakia? What type of cellular change is this?
EBV
hyperplasia of squamous cells
What gland does mumps infect?
parotid, bilateral
What are three other presentations that may accompany a mumps infection?
orchitis, pancreatitis, aseptic meningitis
What enzyme can be elevated due to mumps? What two glands could be responsible for this?
amylase
parotid or pancreas
What is inflammation of the salivary gland caused?
sialadenitis
What bacteria can often infect an obstructed salivary gland?
S. aureus
What is the most common tumor of the salivary gland?
pleomorphic adenoma
Is a pleomorphic adenoma benign or malignant?
benign
What two types of tissue makes up a pleomorphic adenoma?
stromal and epithelial
In what gland does a pleomorphic adenoma most often arise?
parotid
How would one know that a pleomorphic adenoma is transforming into a carcinoma?
facial nerve damage
What gland does a warthin tumor arise?
parotid
Are Warthins tumors benign or cystic?
benign
Warthins tumors are filled with what two constituents?
lymphocytes
germinal center
What is the most common malignant tumor of the salivary glands?
mucoepidermoid carcinoma
What gland does a mucoepidermoid tumor most often arise?
parotid
What is the most common type of tracheoesophageal fistula?
atresia of proximal esophagus
distal esopagus arising from trachea
What constellation of symptoms does a tracheoesophageal fistula present with?
polyhydramnios
vomiting
abdominal distension
aspiration
Does an esophageal web arise in the upper of lower part of the esophagus?
upper
Does an esophageal web carry an increased risk of squamous cell carcinoma or adenocarcinoma?
squamous cell carcinoma
What is a Zenker Diverticulum? Acquired or congenital?
outpouching of pharyngeal mucosa
acquired
Is a Zenker DIverticulum a true or false diverticulum?
false
What exact location does a Zenker Diverticulum arise?
junction of esophagus and pharynx
What are the two common presentations with a Zenker-Diverticulum?
dysphagia and halitosis
What is Mallory-Weiss Synrome?
gastro-esophageal laceration
What causes Mallory-Weiss Synrome? Why?
severe vomiting
alcoholism or bulimia
Does Mallory-Weiss Syndrome present with painful or painless hematemesis?
painful hematemesis
What condition does Mallory-Weiss Syndrome have an increased risk of presenting with?
Boerhaave Syndrome
What is Boerhaave Syndrome? What can Boerhaave Syndrome result in?
esophageal rupture leading to air trapped in the mediastinum
subcutaneous emphysema
What vein normally drains the distal esophagus?
left gastric
How does esophageal varices clasically present?
PAINLESS hematemesis
What is the most common cause of death in liver cirrhosis?
esophageal varices rupture
What type of cell is damaged during achalasia? Which plexus?
ganglion
myenteric
What specific parasite can damage the myenteric plexus? What disease? What cells?
Trypanosoma cruzi
Chagas
ganglion
Does achalasia present with dysphagia for solids, liquid or both?
both
What is the characteristic sign of achalasia?
Birds beak
Does achalasia cause an increased risk of developing from squamous cell or adenocarcinoma?
squamous cell
New onset asthma as an adult is indicative of what disease?
GERD
What is the exact metaplasia of Barrett’s esoophagus?
stratified squamous epithelium to nonciliated columnar with goblet cells
What type of cancer can Barrett’s esophagus progress to?
adenocarcinoma
Does esophageal cancer present late or early? What does this mean?
late
poor prognosis
What type of dysphagia does esophageal cancer present with?
progressive (liquids to solids)
Which lymph nodes would cancer from the upper 1/3 of the esophagus drain into?
cervical
Which lymph nodes would cancer from the middle 1/3 of the esophagus drain into?
mediastinal or tracheobronchial
Which lymph nodes would cancer from the upper 1/3 of the esophagus drain into?
celiac and gastric
What is gastroschisis?
congenital malformation leading to exposure of abdominal contents
Is gastroschisis covered by peritoneum?
no
What is omphalocele covered by?
by peritoneum and amnion
Is pyloric stenosis more common in males or females?
males
Clasically, how long after birth does pyloric stenosis present?
two weeks
What type of vomiting does pyloric stenosis present with?
non-bilious
What type of cells produce mucin in the stomach?
foveolar cells
What type of gastric ulcer will develop after a severe burn?
Curling ulcer
What type of ulcer arises due to increased intracranial pressure? Why?
Cushing
increased vagal tone leads to increased acid secretion
What is Cushing’s Triad?
wide pulse pressure
bradycardia
irregular respiration
What two parts of the stomach are parietal cells located?
fundus and body
What type of gastric adenocarcinoma does H. pylori cause?
intestinal
Achlorhydria due to gastric chronic gastric inflammation present with what two symtoms?
increased gastrin levels
G-cell hyperplasia
What is the most common site of H. pylori infection in the stomach?
antrum
What two types of cancer does chronic H. pylori infection present with?
gastric adenocarcinoma
MALT Lymphoma
What is the reason for almost all duodenal ulcers? What else is a less common but possible cause?
H. pylori
ZE syndrome
What is the classic presentation for a duodenal ulcer?
epigastric pain that improves with meals
What gland hypertrophies during a duodenal ulcer?
Brunner glands
Are duodenal ulcer more common in the anterior or posterior portion of the duodenum?
anteior
What two things can happen if a duodenal ulcer is in the posterior portion of the duodenum?
eat away at gastroduodenal artery
acute pancreatitis
What is the classic presentation for a gastric ulcer?
pain the worsens with meals
Where are gastric ulcers most commonly located?
lesser curvature of the antrum
Rupture of an ulcer in the lesser curvature of the antrum can lead to increased bleeding from what vessel?
left gastric
Are duodenal ulcer commonly malignant or benign?
almost never malignant
What type of cancer is gastric cancer most commonly?
adenocarcinoma
What type of gastric carcinoma is more common, intestinal or mucosal type?
intestinal
Where does the intestinal type of gastric carcinoma normally arise?
lesser curvature of antrum
What type of cell is found in a diffuse gastric carcinoma?
signet ring cells
What do signet ring cell do to the gastric wall? What two things is this called?
thicken it
linitis plastica and desmoplasia
Which form of gastric carcinoma is associated with nitrosamines? Where are nitrosamines found? What country?
intestinal
smoked food
Japan
Which form of gastric carcinoma is associated with H. pylori infection?
intestinal
Which blood type is associated with Intestinal Gastric Carcinoma?
Blood A
Which lymph nodes does gastric carcinoma spread to?
Virchows
What is a Sister Mary Joseph Nodule?
gastric carcinoma invading periumbilical region
Which type of gastric carcinoma can produce a Sister Mary Joseph Nodule?
intestinal type
Where does gastric carcinoma most commonly metastisize?
liver
Where does a Krukenberg tumor metastisize? Is this associated with intestinal or diffuse type of gastric carcinoma?
bilateral ovaries
diffuse
What type of intestinal carcinoma metastisizes to the ovaries?
diffuse
What condition is duodenal atresia associated with?
Downs Syndrome
What feature would suggest duodenal atresia in utero?
polyhydramnios
What sign does duodenal atresia produce on Xray?
double bubble
Is Meckel’s a true or false diverticulum? What makes it this way?
true
outpouching of all three layers
Meckel’s diverticulum results in a failure of what duct to retract fully? What is another name for this duct?
Omphalomesenteric
Vitelline
What are the four ‘twos’ of Meckels Diverticulum?
two years old
two inches long
two percent of population
two feet from ileocecal valve
What is a volvulus?
twisting of bowel along the mesentery
What does a volvulus result in?
infarction
Where does a volvulus commonly arise in the elderly?
sigmoid
Where does a volvulus commonly arise in the young?
cecum
What is intussusception?
when a proximal portion of the bowel telescopes into a forward part
What pulls the telescoped section forward during intussusception? What does this result in?
peristalsis
infarction
In children what is the most common cause of intussusception? What cause this?
lymphoid hyperplasia
rotavirus
What section of the GI tract are involved with the most common cause of intussesception?
ileum into cecum
What is the most common cause of intussesception in adults?
tumor
What does the stool look like in intussusception?
red currant jelly
What two HLA haplotypes are associated with Celiac Disease?
HLA-DQ2 and HLA-DQ8
What is the most potent component of gluten?
gliadin
What sort of enzymatic processing happens to gliadin? What enzyme?
Deamidation
tissue transglutaminase
Which MHC molecule presents gliadin?
MHC II
What skin lesion can form from celiac disease?
dermatitis herpetiformis
What specific structure of the skin is involved in dermatitis herpetiformis? Which immunogloulin?
dermal papillae
IgA
What three proteins have antibodies against them in celiac disease? Which immunoglobulin?
gliadin, endomysium and tTP
IgA
What section of the GI tract is most severly effected by celiac disease?
Duodenum
What two cancers can arise due to long-term celiac disease?
small bowel carcinoma
T-cell lymphoma
What two sections of the GI tract are most affected by tropical sprue?
jejunum and ileum
When does tropical sprue arise? What does tropical sprue respond to?
after diarrhea
antibiotics
What species causes Whipple Disease?
Tropheryma whippeli
What cell gets infected during Whipple disease?
macrophages
Where is the classic layer of involvement of Whipple Disease?
small bowel lamina propria
