GI pathology

Question 1

autoimmune disease more common in females (4th-5th decades); characterized by dry mouth, dry eyes, or keratoconjunctivitis sicca; intense lymphocytic infiltrate in salivary glands; increased risk for lymphoma (40x)

Answer 1

sjogren syndrome

Question 2

most common neoplasm; 60% occur in the parotid gland; lobulated and firm on palpation; variably encapsulated; epithelial and myoepithelial components; 10% recurrences; may undergo malignant transformation

Answer 2

pleomorphic adenoma (mixed tumor); benign tumor of the parotid gland

Question 3

primarily affects the parotid gland with male predilection; cystic neoplasm with papillary infoldings and lymphoid tissue; 10% bilateral

Answer 3

warthin tumor (papillary cystadenoma lymphomatosum); benign tumor of the parotid gland

Question 4

most common salivary gland malignancy; parotid and minor glands; may note bluish color due to mucin and cystic growth pattern

Answer 4

mucoepidermoid carcinoma (squamous and mucous cells)

Question 5

other salivary gland malignancies include other ____, which include ____ and _____

Answer 5

other carcinomas, which include adenoid cystic and acinic cell

Question 6

type of esophageal obstruction resulting from post-inflammatory fibrosis/stenosis

Answer 6

mechanical obstruction

Question 7

type of esophageal obstruction resulting from discoordinated muscular contractions or spasms; diverticula, achalasia, and/or difficulty in swallowing may result

Answer 7

functional obstruction

Question 8

arise due to portal hypertension; seen in 90% of cirrhotic patients; often asymptomatic, but rupture can result in massive hemorrhage/death

Answer 8

esophageal varices

Question 9

intrinsic cause of esophagitis

Answer 9

GERD (gastroesophageal reflux disorder)

Question 10

intestinal metaplasia within the esophagus squamous mucosa; complication of GERD with increased risk of adenocarcinoma

Answer 10

Barrett esophagus

Question 11

malignant esophageal lesion associated with long-standing GERD or Barrett change; increased in caucasians and males over females (7:1); occurs primarily in the distal third of the esophagus

Answer 11

esophageal adenocarcinoma

Question 12

most common esophageal malignancy worldwide; associated with smoking and alcohol use; occurs primarily in the middle third of the esophagus; very poor prognosis (9% 5 year survival)

Answer 12

squamous cell carcinoma of the esophagus

Question 13

abrupt, transient, reactive lesions of the stomach; pathology is punctate hemorrhage, erosion, edema, acute inflammation

Answer 13

acute gastritis

Question 14

primarily caused by infection with helicobacter pylori in patients with H. pylori (spiral or curved bacilli); 90% of cases; often acquired infection in childhood

Answer 14

chronic gastritis

Question 15

treatment of H. pylori in chronic gastritis is by:

Answer 15

antibiotics and proton pump inhibitors

Question 16

due to H. pylori and NSAID use; characterized by gastric hyperacidicity, recurrent ulcers with intermittent healing

Answer 16

peptic ulcer disease

Question 17

increased in familial adenosis polyposis (FAP) patients and most frequently arise in a background of atrophy and intestinal metaplasia

Answer 17

gastric adenomas

Question 18

90-95% of gastric cancers; marked decrease in the US due to reduced use of smoked and salt-cured meat (nitrites); linitis plastica “leather bottle appearance” markedly thickened stomach wall

Answer 18

gastric adenocarcinoma

Question 19

small intestine malabsorptive diarrhea

Answer 19

celiac disease (gluten allergen)
tropical sprue (aerobic bacteria)
lactase (disaccharidase) deficiency
abetalipoproteinemia (transepithelial transport defect, mono and triglycerides)

Question 20

due to vibrio cholerae; also called travelers diarrhea

Answer 20

infectious enterocolitis

Question 21

arises from inappropriate mucosal immune activation; includes ulcerative colitis and crohn disease

Answer 21

inflammatory bowel disease

Question 22

severe ulcerating inflammatory disease that is limited to the colon and rectum; extends only to the mucosa and submucosa

Answer 22

ulcerative colitis

Question 23

regional enteritis; may involve any area of the GI tract and is frequently transmural

Answer 23

crohn disease

Question 24

clinical aspects of malabsorption

Answer 24

1. anemia
2. osteopenia, tetany
3. amorrhea, impotence, and infertility
4. deficiencies in vitamin A and B12

Question 25

if severe, initial oral sign of malabsorption can be ______; patchy or involvement of entire dorsum surface of tongue; overt tongue lesions are usually tender; _____ is a common compliant

Answer 25

atrophic glossitis (bald, reddish tongue) ; burning sensation (glossopyrosis)

Question 26

extensions into the colonic lumen

Answer 26

colon polyps

Question 27

4 types of colon polyps

Answer 27

hyperplastic (increased # of cells)
inflammatory
hamartomatous (increase in tissue normally at this site)
adenomatous (neoplastic, tumor)

Question 28

most important predictor of malignant change in a colonic adenoma

Answer 28

size

Question 29

most common malignancy of the GI tract

Answer 29

adenocarcinoma of the colon

Question 30

in the US, colorectal cancer is responsible for causing ____ of all cancer deaths, and is second only to ____ in cancer deaths

Answer 30

15% ; lung cancer

Question 31

most common polyposis syndrome of the GI tract that entails mutations of the APC gene

Answer 31

familial adenomatous polyposis

Question 32

the risk of patients affected with FAP developing ____ approaches ____

Answer 32

colon cancer; 100%

Question 33

FAP + extraintestinal lesions with oral manifestations including unerupted teeth, supernumerary teeth, dentigerous and mandibular cysts, CHRPE

Answer 33

gardener’s syndrome

Question 34

second most common polyposis syndrome; GI hamartomatous polyps (intussusception) and melanin deposits around nose, lips, buccal mucosa, hands and feet, genitalia, and perianal region; develops in early childhood

Answer 34

Peutz Jegher Syndrome

Question 35

chronic intermittent diarrhea with or without blood, colickly abdominal pain; presents in young adulthood; pathology includes noncaseating granulomas and “skip lesions”

Answer 35

crohn disease