GI Pathology

Question 1

Gastric hypertrophy with protein loss, parietal cell atrophy, and increased mucosal cells. A precancerous lesion. Rugae hypertrophies that they look like brain gyri.

Answer 1

Menetrier’s Disease

Question 2

Salivary gland tumor!

Small, well-encapsulated, round mass. Transaction reveals mucin containing cystic spaces. Histo reveals two characteristic features:

1. Two-tiered epithelial layer lining the spaces
2. Well-developed lymphoid tissue sometimes forming germinal centers

Answer 2

Papillary cyst adenoma lymphomatosum

Aka warthins tumor

Question 3

How does CKD and hyperparathyroidism cause peptic ulcers?

Answer 3

Hypercalcemia stimulates gastric production and acid secretion

Question 4

What is the major cause of PUD in persons who do not have H pylori infection.

Answer 4

NSAIDs.

Prostaglandins are protective!

1. Increase acid production
2. Reduce bicarbonate and mucin production
3. Reduce glutathione

Question 5

What is the pathogenesis of Cushing’s ulcers?

Answer 5

Increased ICP stimulates vagal nuclei and cause gastric acid hypersecretion.

Question 6

Second leading cause of cancer related deaths in the world

Answer 6

Gastric Ca

Question 7

What are stercoral ulcers? Where is it found?

Answer 7

Found in the mucosal lining of the distended portion in hirschsprung. Produced by impacted, insippated feces

Question 8

Diverticulosis affects which segment of the colon in 90% of cases

Answer 8

Sigmoid

Question 9

Retro peritoneal hernias may occur at this site.

Answer 9

Ligament of treitz

Question 10

The most common strain of E. coli in America preferentially affects ___.

Answer 10

O157:H7

Right colon

Question 11

Major cause of childhood diarrhea and accounts for as much as 20% of all cases of childhood diarrhea in developing countries

Answer 11

Cryptosporidium

Question 12

Occurring primarily in males, presents with malabsorption syndrome, hyperpigmentation, poly arthritis, and CNS complaints

Answer 12

Whipple’s disease

Question 13

What gene is normally mutated in inflammatory bowel disease? What is it for?

Answer 13

NOD2 gene.

The protein is an intercellular receptor for muramyl dipeptide, a component of bacterial cell walls. It is usually expressed in Paneth cells.

Question 14

IBD Quiz

1. Serositis
2. Fistulas
3. Good response to surgery

Answer 14

Crohn - 1,2

UC - 3

Question 15

Almost universal finding in UC

Answer 15

Diffuse mononuclear infiltrate in the lamina propria

Question 16

Which common drug has shown benefit in preventing colorectal cancer?

Answer 16

Aspirin and NSAIDs

Question 17

Solid, yellow tan appearance on transection, exceedingly firm. Neoplastic cells form discrete islands, trabecular and sheet; monotonously similar with scant cytoplasm and round nucleus. Absent or infrequent mitoses

Answer 17

Carcinoid

Question 18

Risk of morbidity and mortality of appendiceal perforation

Answer 18

2%

Question 19

What gene is normally mutated in inflammatory bowel disease? What is it for?

Answer 19

NOD2 gene.

The protein is an intercellular receptor for muramyl dipeptide, a component of bacterial cell walls. It is usually expressed in Paneth cells.