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Kaplan: GI system > GI pathology: stomach; exocrine pancreas; appendix > Flashcards

GI pathology: stomach; exocrine pancreas; appendix Flashcards

1
Q

what can cause acute gastritis (erosive)?

A

can be caused by alcohol, aspirin, smoking, shock, steroids, uremia

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2
Q

signs and Sx of acute gastritis

A

heartburn, epigastric pain, nausea, vomiting, hematemesis

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3
Q

What are the 2 types of chronic gastritis based on location?

A

fundal (type A)

antral (type B)

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4
Q

what is most common cause of chronic gastritis in US?

A

H. pylori

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5
Q

Where would autoimmune chronic gastritis be found?

A

fundus or body of stomach

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6
Q

What is associated w/ autoimmune chronic gastritis?

A

pernicious anemia, achlorhydria (decreased acid), IF deficiency

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7
Q

risk factors for gastric carcinoma?

A

genetic predisposition; diet, hypochlorhydria, pernicious anemia, nitroasmines

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8
Q

How will gastric carcinoma present?

A

A-Sx until late => anorexia, weight loss, anemia, epigastric pain;

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9
Q

What is the common site of mets for gastric carcinoma?

A

Virchow node => left supraclavicular lymph node

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10
Q

Where do a majority of gastric carcinomas arise?

A

antrum and pylorus

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11
Q

What associated pathology is found w/ gastric carcinoma? describe it

A

linitis plastica => infiltrating gastric CA w/ diffuse fibrous response

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12
Q

How does gastric carcinoma present on histology?

A

signet ring cells

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13
Q

What are 3 pathologies associated with hypertrophic gastropathy?

A

Menetrier disease;
hypertrophic-hypersecretory gastropathy;
excessive gastrin secretion (ZE syndrome)

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14
Q

Menetrier disease presents how when associated w/ hypertrophic gastropathy?

A

markedly thickened rugae due to hyperplastic superficial mucus glands w/ atrophy of deeper glands

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15
Q

hypertrophic-hypersecretory gastropathy presents how when associated w/ hypertrophic gastropathy?

A

hyperplasia of parietal and chief cells in gastric glands

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16
Q

excessive gastrin secretion presents how when associated w/ hypertrophic gastropathy?

A

produces gastric gland hyperplasia => increases peptic ulcer disease

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17
Q

What are the common locations of peptic ulcers?

A

proximal duodenum, stomach, esophagus

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18
Q

H. pylori infections are important etiologically in PUD. How is this treated?

A

modification of acid secretion coupled w/ antibiotic therapy that eradicates H pylori is curative in most

19
Q

How will PUD present? what are complications?

A

episodic epigastric pain

complications=> hemorrhage, perforation

20
Q

Which PUD may become malignant?

A

esophageal and stomach (rare)

duodenal ulcers are NOT malignant

21
Q

PUD may be associated with stress ulcers. name the causative factor and name of ulcer

A

burns => Curling ulcer

CNS trauma=> cushing ulcers

22
Q

Define pyloric stenosis

A

congenital hypertrophy of pyloric muscle

23
Q

How will pyloric stenosis present?

A

1st born boy;
projectile vomit 3-4wks after birth;
palpable “olive” mass in epigastric region

24
Q

Tx for pyloric stenosis?

A

surgical

25
Q

Vermiform appendicitis has different presentations in adults and children based on the obstruction. Name them

A

adults=> fecalith

children => hyperplasia of lymphatic tissue

26
Q

Where does appendicitis pain present? why?

A

stimulate visceral pain fibers on LESSER SPLANCHNIC nerves;

colicky pain referred over umbilical region

27
Q

Define acute hemorrhagic pancreatitis and what is it associated with?

A

diffuse necrosis of pancreas by release of activated enzymes;
alcoholism and biliary tract disease

28
Q

Symptoms of acute hemorrhagic pancreatitis

A

sudden onset of acute, continuous, intense abdominal pain that may radiate to back;
N/V and fever that may result in shock

29
Q

Labs w/ acute hemorrhagic pancreatitis

A

high amylase, high lipase (after 3-4 days);

leukocytosis

30
Q

How does acute hemorrhagic pancreatitis present grossly?

A

gray areas of enzymatic destruction, white areas of fat necrosis, red areas of hemorrhage

31
Q

Define chronic pancreatitis

A

remitting and relapsing episodes of mild pancreatitis => progressive pancreatic damage

32
Q

How will chronic pancreatitis typically present?

A

X-rays will have calcifications in pancreas

33
Q

What may chronic pancreatitis result in?

A

pseudocyst formation, diabetes, steatorrhea

34
Q

define pseudocysts

A

possible sequelae of pancreatitis or trauma

35
Q

How do pseudocysts affect the environment it gross in?

A

size => up 10cm diameter w/ fibrous capsule;

no epithelial lining or direct communication w/ ducts

36
Q

risk factors for exocrine pancreatic carcinoma

A

smoking, high fat diet, chemical exposure

37
Q

Where does pancreatic carcinoma typically present? what are the results?

A

head of pancreas => compression of bile duct and main pancreatic duct => OBSTRUCTIVE JAUNDICE

38
Q

Why does pancreatic carcinoma have a poor Px?

A

A-Sx until late

39
Q

How will pancreatic carcinoma present?

A

weight loss, abdominal pain may radiate to back;

jaundice, weakness, anorexia

40
Q

What syndrome is associated w/ pancreatic carcinoma? and what is it?

A

Trousseau syndrome => migratory thrombophlebitis

41
Q

Define cystic fibrosis

A

AR defective Cl- channel of the CFTR gene on chromosome 7

42
Q

How is the Dx of CF typically made?

A

secretion of very thick mucus and HIGH NA AND CL- LEVELS IN SWEAT

43
Q

15% of CF patients present how?

A

meconium ileus w/in 1st year w/ STEATORRHEA, PULM INFECTIONS; OBSTRUCTIVE PULM disease

44
Q

What is the survival age typically w/ CF? How does mortality typically occur?

A

mean age is 20 => typically pseudomonas aeruginosa pulm infection

Kaplan: GI system (11 decks)

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