GI Pathology (Quiz) Flashcards
stratified squamous epithelium found in what part of the digestive tract
what color is it
- esophagus
- anus
- white
simple columnar epithelium found in what part of the digestive tract
what color is it
- stomach
- small intestine
- large intestine
- rectum
- red/tan
squamous carcinomas affect which layer
- epithelium (squamous layer)
adenocarcinomas affect which layer
- epithelium (columnar and intestinal)
what is metaplasia
- conversion of one normal cell type to another
infectious and inflammatory processes affect what layer
- epithelial layer (mucosa)
bleeding affects what layer
- submucosa
motility disorders affect what layer
- muscularis externa
squamous cell carcinoma composed of
- solid clusters of cancer cells
- keratin pearls
adenocarcinoma composed of
- glands of cancer cells
erosion is what type of necrosis
involves
heals by
- superficial
- mucosa
- regeneration
ulcer is what type of necrosis
involves
heals by
- deeper necrosis
- mucosa + deeper layers
- granulation tissue and scar
gross morphology digestive tract malignancies
- fungating - protrudes into lumen
- infiltiration - spreads down and out
- ulcerating - invaginations
what is one danger with forming a scar in the GI tract
- contraction of scar - stricture
esophagus is surrounded by which nerves
- vagus
- recurrent laryngeal
what is another name for the hiatus of the diaphragm
- gastroesophageal junction
inner muscularis propria is ______ muscle
outer muscular propria is ________ muscle
- circular
- longitudinal
clinical name for heartburn
- pyrosis
clinical name for painful swallowing
- odynophagia
problems that cause achalasia
- lack of peristalsis in esophageal body
- non relaxation of LES
what disease can mimic achalasia
- Chagas
what does the barium swallow of achalasia look like
- bird beak
- dilated esophagus
- narrowing at distal esophagus
treatment of achalasia
- botox injection
- pneumatic dilation
- esophageal myotomy
MOA of botox injection for treatment of achalasia
- blocks presynaptic Ach release
what happens in jackhammer esophagus
- hyper contractile peristalsis
what happens in ineffective esophageal motility
seen in association with
- weakened peristalsis
- reflux disease
scleroderma esophagus affects which portion of esophagus
- lower 2/3
infectious esophagitis is most common in what patient population
other predisposing conditions
- immunocompromised
- diabetes
- alcohol use
- increased age
- lots of antibiotics
what is the most common esophageal pathogen
- candida
pathogenesis of esophageal candidiasis
- normal GI growth + predisposing conditions
gross path of esophageal candidiasis
- superficial white plaques
herpetic esophagitis is due to
- HSV I
herpetic esophagitis affects which cells
- epithelial
what do you see in histopath of herpetic esophagitis
- ground glass nuclear inclusions
- margination due to chromatin pushed to edges
- multinucleate cells with nuclear molding
CMV effects what cells
- endothelial cells
- fibroblasts
what do you see in the histopath of CMV
- nuclear inclusions
- nuclear and cytomegaly
causes of chemical esophagitis in adults and children
- adults - suicide
- children - accidental
between acid solutions, alkaline solutions, and alkaline solids, which are worse for ingestion
- alkaline solutions > acid solutions > alkaline solids
alkali solutions cause what
- liquefactive necrosis
acidic solutions cause what
- coagulative necrosis
eosinophilic esophagitis affects what in the esophagus
- intraepithelial mucosa
cause of eosinophilic esophagitis
- environmental allergen
diagnosis of eosinophilic esophagitis
- upper endoscopy and biopsy
what is a hiatal hernia
cause
- herniated of stomach into thorax through enlarged diaphragmatic hiatus
types of hiatal hernias
which is most common
- sliding - most common
- paraesophageal
what can hiatal hernia lead to
- incompetent LES
- GERD
reflux of gastric contents causes what problems
- chemical injury of mucosa
where do reflux contents enter into the esophagus
- distal esophagus
what do you see on histopath of GERD
- intraepithelial inflammation of PMNs and eosinophils
important pathophysiology of GERD
- transient lower esophageal sphincter relaxations
clinical presentation of GERD
- erosive esophagitis
- esophageal stricture
empiric therapy for GERD
who do you use this for?
- try proton pump inhibitors and see if they help
- patients with low risk of significant complications and no alarm symptoms
red flags of GERD
- lots of weight loss
- recurrent vomiting
- bleeding
- anemia
- dysphagia
- jaundice
- abdominal mass
- older age at onset
how to diagnose GERD
- see if the PPI test worked
- upper endoscopy
meds for GERD
- antacids
- H2 receptor antagonists
- proton pump inhibitors
surgical treatments for GERD
- Nissen fundoplication
what is barret’s esophagus
what tissue does it turn into
- metaplasia of normal esophageal stratified squamous epithelium
- intestinal columnar epithelium
big risk factors for squamous cell carcinoma
- tobacco
- alcohol
big risk factors for adenocarcinoma
- GERD/Barrett’s esophagus
how does Barrett’s become adenocarcinoma
- Barrett metaplasia -> dysplasia -> adenocarcinoma
- continued reflux and injury
what do dysplastic cells look like
- large
- hyperchromatic - darker
- pleomorphic - different size
how can esophageal malignancies lead to dysphagia
- circumferential growth leads to obstruction and stenosis
how to diagnose esophageal cancer
- upper endoscopy
big symptoms of esophageal cancer
- dysphagia
- weight loss
symptom of local infiltration of recurrent laryngeal nerve
- hoarseness
