GI pathology (6) Flashcards
What is Sjogren syndrome
an autoimmune disorder that destroys the lacrimal and salivary glands, causing dry eyes and mouth.
it is a systemic disease that can lead to lymphoma
Which disease is warthins tumor associated with
Sjogren syndrome
How is Sjogren syndrome treated
adequate oral hydration and careful hygene. as well as cholinergic agents (stimulate saliva)
Lubricating solutions for the eye
steroids for the systemic problems
What is a mucoepidermoid carcinoma
a common malignant salivary gland tumor that is often in the parotid gland
What is a hiatal hernia
a dilated portion of the stomach protrudes above the diaphragm which can cause ulceration and bleeding.
what are the manifestations of a hiatal hernia
heartburn, regurgitation of chyme, GERD progressing to reflux esophagitis
What are the two types of hiatal hernias
sliding (most common)
paraesophageal -rolling-
What is mallory-weiss syndrome
GE junction tears that are caused by vomiting and manifest through bleeding, pain, and infection.
how is mallory-weiss syndrome treated
cauterization, it usually heals but can sometimes be fatal
what is barrett esophagus
replacement of squamous epithelium by columnar epithelium with goblet cells that is caused by chronic reflux esopahgitis
What is the danger with barrett esophagus
it can drastically increase your risk of adenocarcinoma
what is the treatment for barrett esophagus
you screen for high grade dysplasia
What are the two types of esophageal carcinomas, and how do they differ
Adenocarcinoma and squamous cell carcinoma
how do the risk factors for adenocarcinoma and squamous cell carcinoma differ
risk factors for adenocarcinoma is barretts esophagus
risk factors for squamous cell carcinoma is esophagitis, smoking, alcohol, genetics
how does the location of adenocarcinoma and squamous cell carcinoma differ
adenocarcinoma is found in the distal 1/3 of esophagus
squamous cell carcinoma is in the middle 1/3 of the esophagus
what are the symptoms for adenocarcinoma and squamous cell carcinoma
both and insidious onset and late obstruction
What is gastritis
an inflammatory disorder of the gastric mucosa that can lead to erosion
what is acute gastritis
superficial erosion of the mucosa due to H. Pylori, or NSAIDS, Alcohol, and smoking
What are the types of chronic gastritis
chronic fundal gastritis (autoimmune)
Chronic antral gastritis (more common)
gastritis can lead to intestinal metaplasia
what is the difference between erosion and an ulcer
erosion is when erosion only occurs in the mucosa, ulcers are when the erosion goes all the way through the mucosa and into the submucosa
What are the causes of Stomach ulcers
H. Pylori, NSAIDS
what are the manifestations of stomach ulcers
GI bleeding, perforation, and epigastric pain
What can be seen in upper gastrointestinal bleeding (esophagus, stomach, duodenum)
Hematamesis (vomiting blood)
Melena (dark sticky, partially digested blood in stool)
what can be seen in lower GI bleeding (jejunum, iluem, colon, rectum)
Hematochezia (stool with fresh, red blood)
How can you diagnose if an ulcer is in the stomach or the duodenum
by how long it takes for you to feel pain after eating. immediately = stomach
few hours = duodenum
What is a gastrinoma (Zollinger-Ellison syndrome)
a tumor in the pancreas or duodenum that secretes excess gastrin which leads to ulcers
What is a polyp
nodules that project above the level of the surrounding mucosa, that are usually accompanied by chronic gastritis, and can be precancerous if larger than 1.5 cm
What are the characteristics of intestinal type carcinoma
- arises in intestinal metaplasia
- tend to be bulky
- caused by chronic gastritis and poor diet
- glandular morphology
- asymptomatic
what are the characteristics of diffuse type carcinoma
- arises from gastric glands
- results in thick GI wall
- undefined risk factors
- singlet ring morphoplogy
- asymptomatic
What is diverticulitis
mucosa and submucosa in the sigmoid colon herniate through the muscle wall and become infected.
What is diverticulosis
mucosa and submucosa in the intestines herniate through the muscle wall and aren’t infected
What are the two types of inflammatory bowel disease
crohn disease and ulcerative colitis
compare crohn disease and ulcerative colitis
- location
- lesions
- depth
- treatment
- risk of cancer
- cause
crohn disease Ulcerative colitis
- anywhere - colon only
- patchy lesions - continuous lesions
- transmural - superficial
- poor response - good response to surgery
- both of them increase cancer risk
- genetics and environment - autoimmune
What is irritable bowel syndrome
an intestinal disorder causing pain, cramps, gas, diarrhea
what can cause IBS
abnormal motility
allergies/sensitivities
Gut bacteria
What is celiac disease
autoimmune disorder of the small intestine caused by gliadin (a gluten protein) that causes damage of small intestinal villi, mouth ulcers, pain, thinning hair, and diarrhea
what is hirschprung disease
a congential disorder caused by a section of aganglionic colon, that section has no peristalsis which leads to obstruction, and a swollen colon
What is colorectal carcinoma
carcinoma in the colon/rectum area caused by adenoma (polyp)
what are the symptoms of colorectal carcinoma
fatigue, iron-deficient anemia, occult bleeding
What are the manifestations of diarrheal disease
increased frequency of bowel movements
increased volume, fluidity and weight of feces
hemodynamic changes if prolonged
What are the three types of diarrhea
osmotic diarrhea - undigested lactose
secretory diarrhea - cholera
motility diarrhea - post GI surgery
what causes secretory diarrhea
when toxins (cholera) enhance colonic Cl- secretion
how is cholera treated
oral rehydration therapy
What is maldigestion
failure of the chemical processes of digestion
what is malabsorption
failure of the intestinal mucosa to absorb digested nutrients
What are the four main malabsorption/maldigestion insufficiencies
pancreatic insufficiencies
lactase insufficiencies
bile salt insufficiencies
fat soluble vitamin insufficiencies
What is pancreatic insufficient malabsorption
insufficient pancreatic enzyme production caused by pancreaitis, pancreatic carcinoma, cystic fibrosis that can lead to fat maldigestion, fatty stools, and weight loss
What is a lactase deficiency (maldigestion)
inability to breakdown lactose into monosaccharides, fermetation of lactose leads to gas and osmotic diarrhea
What is a bile salt deficiency (maldigestion)
liver disease and bile obstructions that cause insufficient bile salts, so that fats can’t be emulsified and absorbed. this can lead to fatty stools, diarrhea, and loss of fat soluble vitamins
What is caused by vitamin A deficiency
night blindness
what is caused by vitamin D deficiency
decreased calcium absorption, bone pain, osteoporosis, fractures
what is caused by vitamin K deficiency
prolonged prothrombin time, purpura (bruising), petechia (spots)
what is caused by vitamin E deficiency
slow growth, muscle weakness
What are obesogens
compounds that can increase weight gain
Bisphenol A
DES
MSG
What are bariatric surgeries
they are surgeries that work to restrict food comsumption and/or nutrient malabsorption. all of which lead to weight loss and improve metabolic health
what is gastric bypass dumping syndrome
a complication of a partial gastrectomy or pyloroplasty surgery, in which chyme rapidly emptys into the small intestine causing increased osmotic pressure in the gut causing plasma volume decreases, increased pulse rate, hypotension, loss of consciousness. Motility diarrhea
