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Histopath > GI Pathology > Flashcards

GI Pathology Flashcards

1
Q

CCK produced by?

A

I cells in duodenum causing release of digestive enzymes

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2
Q

How much secretion does pancreas produce per day?

A

2 litres

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3
Q

Alpha cells produce?

A

Glucagon

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4
Q

Insulin produced by?

A

Beta cells

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5
Q

Delta cells produce

A

Somatostatin

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6
Q

Pancreatic polypeptide has what role?

A

Self regulates secretions in pancreas

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7
Q

Criteria for metabolic syndrome?

A 
Fasting glucose >6
BP >140/90
Central obesity
Dyslipidaemia
Microalbuminaemia
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8
Q

Diagnosis diabetes:

Fasting glucose?

Random glucose?

A

Fasting > 7.0

Random >11.1 mmol /L

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9
Q

Impaired fasting glucose?

A

Fasting glucose 6.0-6.9

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10
Q

Impaired glucose tolerance?

A

Glucose 7.8-11 after 2hr OGTT

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11
Q

Most common causes of acute pancreatitis?

A

Gallstones

Alcohol

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12
Q

Histology of acute pancreatitis?

A

Coagulative necrosis

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13
Q

What is alcoholic pancreatitis associated with?

A

Formation of pseudocyst (collection of fluid)

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14
Q

Top causes of chronic pancreatitis?

A

Alcohol

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15
Q

Neoplastic epithelial cells with eosinophilia granular cytoplasm?

A

Acinar cell carcinoma

*positive immunoreactivity for lipase, trypsin and chymotrypsin

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16
Q

Most common pancreatitis cancer?

A

Invasive Ductal adenocarcinoma

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17
Q

Most common site of pancreatic Ca?

A

Head of pancreas

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18
Q

Risk factors for pancreatic cancer?

A

Smoking, diet, genetic (FAP/HNPCC)

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19
Q

Features of pancreatic Ca?

A

Courvoisier’s:

PainLESS jaundice and palpable gallbladder

+pruritis
+steatorrhoea
+diabetes

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20
Q

Trousseau’s syndrome?

A

Recurrent superficial thrombophlebitis in pancreatic Ca due to hypercoagulabilty

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21
Q

What cancers more commonly in tail of pancreas?

A

Neuroendocrine (islet cell)

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22
Q

Tumour marker for pancreatic Ca?

A

CA19.9

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23
Q

Zollinger Ellison syndrome?

A

Gastrinoma -> high acid output

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24
Q

Necrolytic migrating erythema?

A

Glucagonoma

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25
Q

Men 1?

A

PPP

Parathyroid hyperplasia
Phaeochromocytoma
Pituitary adenoma

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26
Q

Men 2a?

A

PPM

Parathyroid hyerplasia
Phaeochromocytoma
Medullary thyroid cancer

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27
Q

Men 2b?

A

PMM

Phaeochromocytoma
Medullary thyroid cancer
Marfanoid

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28
Q

Surgery for pancreatic Ca?

A

Whipples

29
Q

VIPomas cause?

A

Diarrhoea

30
Q

Hypoglycaemic attacks?

A

Insulinoma

31
Q

Ectopic pancreas sites?

A

Stomach, small intestine

32
Q

Failure of fusion of dorsal and ventral buds?

A

Pancreas divisum

33
Q

Annular pancreas risk?

A

Duodenal obstruction around age 1

34
Q

In liver lobule which zone is most metabolically active?

A

Zone 3 - near central hepatic vein

35
Q

Which zone receives most oxygen and nutrients?

A

Zone 1 (periportal)

36
Q

Most common benign lesion of liver?

A

Haemangioma

37
Q

Most common malignant liver tumour?

A

Metastasis

38
Q

Most common primary liver tumour?

A

HCC

39
Q

Major causes of cirrhosis?

A

Alcoholic liver disease
NAFLD
Hep B/Hep C

40
Q

Most common location of cholangiocarcinomas?

A

Perihilar

41
Q

Cholangio Ca assoc?

A

PSC and UC

42
Q

Causes of micronodular cirrhosis (<3mm)?

A

Alcoholic liver disease
Haemochromatosis
Biliary tract disease

43
Q

Mallory bodies

A

Alcoholic liver disease

44
Q

Causes of macronodular cirrhosis? (>3mm)

A

Viral hepatitis
Wilsons
a1AT deficiency

45
Q

Child Pugh score <7 indicates?

A

Child Pugh A

45% 5 yr survival

46
Q

Child’s Pugh 7-9

A

Child’s Pugh B

20% 5 yr survival

47
Q

Child’s Pugh 10+

A

Child’s Pugh C

<20% 5 yr survival

48
Q

Most common cause of chronic liver disease in West?

A

NAFLD

49
Q

Anti Smooth Muscle antibodies for type 1

Anti LKM for type 2?

A

Autoimmune hepatitis

50
Q

Anti mitochondrial ab

A

Primary Biliary Cirrhosis

*histology: bile duct loss with granulomas

51
Q

ERCP shows beading of bike ducts due to multi focal strictures?

A

Primary sclerosing cholangitis

52
Q

Inheritance for haemochromatosis?

A

Autosomal recessive

53
Q

Incidence rate haemochromatosis?

A

1 in 400

*1 in 10 caucasians is a carrier

54
Q

HFE gene on chromosome?

A

6

55
Q

Stain used for iron deposits in liver?

A

Prussian Blue

56
Q

Features of haemochromatosis?

A

Grey skin

‘Bronze’ diabetes

Hepatomegaly (microbod cirrhosis)

Joint pain

57
Q

Investigations for haemochromatosis?

Iron?
Ferritin?
TIBC?
Transferrin sat?

A

High Fe
High ferritin
Low TIBC
High transferrin sat

58
Q

Treatment for haemochromatosis?

A

Venesection + desferrioxamine

59
Q

Wilson’s disease inheritance?

A

Autosomal recessive

60
Q

Gene in wilsons?

A

ATP7B on ch 13

61
Q

Stain in wilsons?

A

Rhodanine stain for copper

62
Q

Features of wilsons?

A

Liver disease

Neuro - Parkinsonism, psychosis

Kayser Fleischer rings

63
Q

Alpha 1 antitrypsin deficiency leads to accumulation of a1AT in intracytoplasmic inclusions which stain with?

A

Periodic acid schiff

64
Q

Secretin produced by?

A

S cells of duodenum

65
Q

Mucinous hyperplasia in pancreatic ductal system suggests?

A

Metaplastic change

66
Q

Mutation associated wi h hereditary pancreatitis?

A

PRSS1

67
Q

Autoimmune pancreatitis demonstrates a raised……?

A

IgG4

68
Q

Why are pseudocysts not true cysts?

A

True cysts surrounded by epithelial cells whereas pseudocysts lined by fibrotic tissue

Histopath (5 decks)

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