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Pathology > GI system- Exam II > Flashcards

GI system- Exam II Flashcards

1
Q

Diseases of the GI tract can be classified as: (5)

A
  1. developmental disorders
  2. inflammatory diseases
  3. functional disorders
  4. circulatory disturbances
  5. neoplastic diseases
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2
Q

Describe the process of digestion (6):

A
  1. ingestion
  2. mastication
  3. deglutition
  4. digestion
  5. absorption
  6. excretion
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3
Q
  • Hiatal hernia
  • Reflux esophagitis
  • Barret esophagus
  • Achalasia
  • Esophageal varices
  • Esophageal cancer

These are all GI diseases

A

esophagus

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4
Q
  • Acute gastritis
  • Chronic gastritis
  • Peptic ulcer disease
  • Stomach cancer

These are all GI diseases involving the:

A

stomach

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5
Q
  • Meckel diverticulum
  • Bowel obstruction
  • Herniation
  • Adhesions
  • Intussusception
  • Volvulus
  • Adenocarcinoma
  • Carcinoid tumor

These are all GI diseases involving the:

A

small intestine

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6
Q
  • Pseudomembranous colitis
  • Diverticulosis
  • Crohn disease
  • Ulcerative colitis
  • Adenomatous polyps
  • Colon cancer

These are all GI diseases involving the:

A

Large intestine

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7
Q

The layers of the GI system include:

A
  1. mucosa
  2. submucosa
  3. muscularis propria
  4. adventitia or serosa
  5. vasculature
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8
Q

The layers of the mucosa of the GI system include:

A
  1. epithelium
  2. lamina propria
  3. muscularis mucosae
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9
Q

The muscularis propria of the GI system can be either:

A

circumferential or longitudinal

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10
Q

Important clinical symptoms and signs relating to the GI system include: (8)

A
  1. dysphagia
  2. vomiting
  3. hematemesis
  4. hematochezia
  5. melena
  6. diarrhea
  7. constipation
  8. odynophagia
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11
Q

Important clinical symptoms relating to the GI system -

difficulty in swallowing:

A

dysphagia

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12
Q

Important clinical symptoms relating to the GI system -

expulsion of stomach contents through the mouth:

A

vomiting

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13
Q

Important clinical symptoms relating to the GI system -

vomiting of fresh, red blood:

A

hematemesis

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14
Q

Important clinical symptoms relating to the GI system -

bright, red blood in stool:

A

hematochezia

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15
Q

Important clinical symptoms relating to the GI system -

black, tarry feces:

A

melena

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16
Q

Important clinical symptoms relating to the GI system -

frequent, loose, watery bowel movements:

A

diarrhea

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17
Q

Important clinical symptoms relating to the GI system -

hard feces that are difficult to eliminate:

A

constipation

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18
Q

Important clinical symptoms relating to the GI system -

painful swallowing:

A

odynophagia

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19
Q

Painful swallowing =

Difficulty in swallowing =

A

odynophagia; dysphagia

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20
Q

A subspecialty of internal medicine involved with diagnosis, treatment, and procedures involving the GI system:

A

gastroenterology

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21
Q

Upper GI endoscopy:

A

esophagogastroduodenoscopy (EGD)

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22
Q

Lower GI endoscopy:

A

colonoscopy

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23
Q

Describe the layers of the esophagus

A
  1. Mucosa (epithelium, lamina propria, muscularis mucosae)
  2. Submucosa
  3. Muscularis
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24
Q

Clinical signs and symptoms of esophageal disease include:

A
  1. dysphagia
  2. odynophagia
  3. heartburn
  4. acid regurgitation into the mouth
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25
Q

A burning behind the sternum related to GERD:

A

Heartburn

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26
Q

Acid regurgitation into the mouth is a sign of:

A

GERD

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27
Q

Dysfunction of ganglion cells of myenteric plexus (Auerbach plexus) that prevents proper relaxation of lower esophageal sphincter- a motility disorder:

A

achalasia

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28
Q

Achalasia can be described as:

A

a functional motor disorder

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29
Q

Achalasia symptoms can include:

A
  1. dysphagia
  2. halitosis
  3. regurgitation
  4. proximal dilation
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30
Q

This image describes what disease?

A

achalasia

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31
Q

Plummer-Vinson Syndrome may also be referred to as:

A

Paterson-Kelly syndrome

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32
Q

Severe Fe-deficiency anemia seen in Scandinavian, and Northern European women:

A

Plummer-Vinson Syndrome (Paterson-Kelly Syndrome)

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33
Q
  • Mucosal atrophy- atrophic glossitis
  • esophageal webs- dysphagia
  • increased risk for squamous cell carcinoma
  • Severe fe deficiency anemia

These are all symptoms of:

A

Plummer-Vinson Syndrome (Paterson-Kelly Syndrome)

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34
Q

In Plummer-Vinson Syndrome (Paterson-Kelly Syndrome), there is an increased risk for:

A

squamous cell carcinoma

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35
Q

In Plummer-Vinson Syndrome (Paterson-Kelly Syndrome), there is an increased risk for squamous cell carcinoma, especially in what locations? (3)

A
  1. esophagus
  2. oropharynx
  3. posterior oral cavity
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36
Q

What results from portal hypertension that produces venous dilation?

A

esophageal varices

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37
Q

Esophageal varices are caused by:

A

portal hypertension producing venous dilation

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38
Q

What can be seen in the image? What disease does this symptom appear in?

A

Atrophic glossitis (mucosal atrophy); Plummer-Vinson Syndrome (Paterson-Kelly syndrome)

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39
Q
  1. Rupture of esophageal varices lead to ____ & ____
  2. Rupture of varix is associated with ____
  3. Rupture of varix accounts for _____
A
  1. hematemesis & massive upper GI bleed
  2. high mortality
  3. half of the deaths in advanced cirrhosis
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40
Q

These images are all showing:

A

esophageal varices

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41
Q

What accounts for half of deaths in advanced cirrhosis?

A

esophageal varices

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42
Q

Seen in chronic alcoholics, where vigilant retching causes esophageal lacerations and hemorrhage:

A

Mallory-Weiss tears (mallory-weiss syndrome)

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43
Q

These images show:

A

Mallory-Weiss tears (mallory-weiss syndrome)

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44
Q

Widened diaphragmatic hiatus that allows protrusion of the stomach through the diaphragm:

A

hiatal hernia

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45
Q

In a hiatal hernia, the ____ is pulled into the thorax

A

gastroesophageal junction

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46
Q

Gastric metaplasia of lower esophageal mucosa- columnar epithelium replaces stratified squamous epihtelium

A

barretts esophagus

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47
Q

What are the symptoms associated with Barretts esophagus?

A
  1. odoynophagia
  2. ulceration
  3. hemmorhage
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48
Q

Individuals with Barretts esophagus are at an increased risk for:

A

adenocarcinoma

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49
Q

In barretts esophagus, ___ replaces ___

A

columnar epithelium replaces stratified squamous epithelium

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50
Q

What are two types of esophageal cancer?

A
  1. squamous cell carcinoma
  2. adenocarcinoma
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51
Q

In cases of ____ individuals experience dysphagia due to narrowing of lumen or interference with peristalsis

A

esophageal cancer

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52
Q

Esophageal squamous cell carcinoma, occurs more often in ___ , has ___ variation, and has ___ prognosis

A

older adults; geographical variation; poor prognosis

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53
Q

What is the most common type of esophageal cancer world wide? What is the most common esophageal cancer in the U.S?

A

squamous cell carcinoma; adenocarcinoma of the esophagus

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54
Q

Esophageal squamous cell carcinoma is most common in the ____ of the esophagus

A

middle third

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55
Q

What are some risk factors associated with esophageal squamous cell carcinoma?

A
  1. alcohol & tobacco
  2. Plummer vinson syndrome
  3. diet
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56
Q

Esophageal adenocarcinoma typically is located in the:

A

lower segment of esophagus

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57
Q

What is a risk factor for esophageal adenocarcinoma?

A

barret esophagus

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58
Q

What esophageal cancer is most common in the u.s?

A

esophageal adenocarcinoma

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59
Q

What are the steps of an esophagus developing esophageal adenocarcinoma?

A
  1. squamous epithelium
  2. esophagitis
  3. barretts esophagus (columnar epithelium)
  4. dysplasia
  5. carcinoma
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60
Q

List the epithelial cells of the stomach:

A
  1. mucous cells
  2. parietal cells
  3. chief cells
  4. endocrine cells
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61
Q

The parietal cells of the stomach are responsible for secreting:

A

HCL and intrinsic factor

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62
Q

The chief cells of the stomach are responsible for secreting:

A

pepsin

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63
Q

The endocrine cells of the stomach (also called ____) are responsible for secreting:

A

G-cells; gastrin

64
Q

Inflammation of the gastric mucosa:

A

gastritis

65
Q

Gastritis that is purely erosive in nature, due to irritant and NSAIDS

A

acute gastritis

66
Q

Gastritis that is either erosive or non-erosive, due to infection or autoimmune process

A

chronic gastritis

67
Q

What are the symptoms of acute erosive gastritis

A
  1. epigastric burning
  2. pain
  3. nausea
  4. vomiting
68
Q

Describe the erosions seen in acute erosive gastritis:

A

shallow erosions

69
Q

What may be the cause of acute erosive gastritis?

A
  1. aspirin
  2. NSAIDs
  3. alcohol
  4. stress
  5. shock
  6. sepsis
70
Q

One of the major causes of hematemesis in alcoholics:

A

acute erosive gastritis

71
Q

Chronic gastritis is referred to as ___ or ___ gastritis

A

infectious or autoimmune

72
Q

The most common form of chronic gastritis is due to:

A

infection by helicobacter pylori

73
Q

Why does autoimmune chronic gastritis occur?

A

autoantibodies to parietal cells (HCL)

74
Q

Helicobacter pylori gastritis can be responsible for causing: (3)

A
  1. peptic ulcer disease
  2. adenocarcinoma
  3. MALT lymphoma
75
Q

H. Pylori is considered a potential:

A

human carcinogen

76
Q

How do we test for H. Pylori?

A
  1. visualize gram-negative S-shaped rods
  2. biopsy and silver stain
  3. urea breath test
  4. antibody test for H. pylori
77
Q

autoimmune gastritis may also be called:

A

atrophic gastritis

78
Q

autoantibodies against gastric parietal cells causing gastric mucosal atrophy:

A

autoimmune (atrophic) gastritis

79
Q

What are some risk factors for autoimmune (atrophic) gastritis

A
  1. no intrinsic factor
  2. low serum vitamin b-12
  3. pernicious anemia
80
Q

deeper than erosions and may extend to muscularis

A

gastric stress ulcers

81
Q

Risk factors for gastric stress ulcers include:

A

ICU patients- shock, trauma, burn, sepsis

82
Q

Most peptic ulcers are generally:

A

solitary lesions

83
Q

Most peptic ulcers occur in the ____

A

duodenum

84
Q

98% of peptic ulcers are located in the:

A

duodenum and stomach

85
Q

sharply-demarcated ulcer with clean, smooth base

A

peptic ulcer

86
Q

Chronic peptic ulcer lesions may exhibit:

A

puckering due to fibrosis

87
Q

describe the clinical course/symptoms of peptic ulcer disease:

A
  1. acute/chronic blood loss
  2. nausea, vomiting, hematemesis, & melena
  3. perforation (major cause of death in PUD)
88
Q

What is the major cause of death in PUD?

A

perforation

89
Q

In peptic ulcer disease, immediate pain =

A

gastric ulcer

90
Q

In peptic ulcer disease, delayed pain =

A

duodenal ulcer

91
Q

Peptic ulcer disease can be described as a ____ disease with decreased ___

A

multifactorial disease; decreased mucosal resistance

92
Q

A common infectious cause of peptic ulcers is:

A

infection with H.pylori

93
Q

What drugs may cause peptic ulcers?

A

Aspirin & NSAIDs

94
Q

Hormonal hyper secretion syndromes leading to peptic ulcers can be described as:

A

neuroendocrine

95
Q

What are two neuroendocrine syndromes associated with peptic ulcers?

A

Cushing syndrome (corticosteroids) & Zollinger-Ellison syndrome (gastrin)

hyper secretion of these hormones

96
Q

What are 5 complications of peptic ulcer disease?

A
  1. minor hemorhage
  2. marhor hemorhage
  3. perforation
  4. stenosis & obstruction
  5. penetration into pancreas
97
Q

condition characterized by gastrin-secreting tumor in pancreas or duodenum (“gastrinoma”)

A

Zollinger-Ellison syndrome

98
Q

Gastrinoma:

A

Zollinger-Ellison syndrome

99
Q

In Zollinger-Ellison syndrome hypergastrinemia causes:

A

hyper secretion of gastric acid

100
Q

Can be described as severe peptic ulcer disease with multiple ulcers in unusual locations:

A

Zollinger-Ellison syndrome

101
Q

gastric adenocarcinoma is seen more often in ___ individuals and has a ___ prognosis

A

older individuals; poor

102
Q

Risk factors for gastric adenocarcinoma include:

A
  1. smoked fish (nitrosamines)
  2. H. Pylori infection
  3. chronic atrophic gastritis
  4. gastric adenomatous polyps
103
Q

gastric adenocarcinoma most often occurs in the:

A

lesser curve of antropyloric region

104
Q

Describe the intestinal type of adenocarcinoma:

A

bulky tumors composed of glandular structures

105
Q

Describe the diffuse type of gastric adenocarcinoma:

A

infiltrative growth of poorly differentiated cells (linitis plastica)

106
Q

Metastatic adenocarcinoma to the ovaries:

A

Krukenburg tumor

107
Q

B/L ovarian metastases is commonly seen in:

A

Krukenberg Tumors

108
Q

Krukenberg tumors are frequently of ____ origin caused by ____ cells

A

gastric origin; mucus producing cells

109
Q

Gastrointestinal tract lymphomas include:

A
  1. non-hodgkin lymphoma
  2. primary lymphomas
  3. secondary lymphomas
110
Q

Is hodgkin lymphoma or non-hodgkin lymphoma associated with gastrointestinal tract lymphoma:

A

NON-hodgkin

111
Q

Primary lymphomas of the gastrointestinal tract:

A

MALT-omas and other NHLs

112
Q

Secondary lymphomas of the gastrointestinal tract involve:

A

extranodal spread

113
Q

Gastric MALT lymphoma: What is the most common site for extranodal lymphomas?

A

stomach

114
Q

B-cell lymphomas of mucosa-associated lymphoid tissue:

A

MALT lymphomas

115
Q

Gastric MALT lymphoma is associated with:

A

H. Pylori infection

116
Q

What can be found in the innermost layer of the small intestine?

A

villi

117
Q

Developmental defect of the ileum- a blind pouch containing all layers:

A

meckel diverticulum

118
Q

Meckel diverticulum may be referred to as:

A

“left-sided appendix”

119
Q

What may produce symptoms similar to appendicitis?

A

mocked diverticulum

120
Q

causes of bowel obstruction include: (4)

A
  1. herniation
  2. adhesions
  3. intussusception
  4. volvulus
121
Q

Herniation is caused by:

A

weakness in peritoneum

122
Q

Locations of hernias include: (4)

A
  1. inguinal
  2. femoral
  3. umbilicus
  4. incisional
123
Q

Fibrotic bridges of peritoneum:

A

intestinal adhesions

124
Q

Intestinal adhesions may:

A

trap and kink bowel segments

125
Q

Adhesions are usually a sequelae of:

A

prior surgery or infection

126
Q

When the small intestine invaginates into itself, and becomes necrotic unless everted:

A

intussusception

127
Q

When small intestine invaginates into itself, it will become ____ unless ___

A

necrotic; everted

128
Q

Rotation of a loop of intestine about its own mesenteric root

A

volvulus

129
Q

Where are volvulus most commonly occur?

A

small intestine and sigmoid colon

130
Q

Volvulus leads to:

A

necrosis

131
Q

adenocarcinoma of the small intestine is:

A

rare

132
Q

A low-grade malignancy of neuroendocrine cells, appearing as mucosal nodules:

A

carcinoid tumor

133
Q

A carcinoid tumor is a low-grade malignancy of ____ cells, appearing as ____

A

neuroendocrine cells; mucosal nodules

134
Q

A carcinoid tumor may occur throughout the GI tract but are most common in the:

A

appendix

135
Q

A carcinoid tumor may produce hormones such as:

A

serotonin

136
Q

Caused by a serotonin producing carcinoid tumor that is asymptotic until metastasis to the liver:

A

carcinoid syndrome

137
Q

Carcinoid syndrome is caused by a ____ producing carcinoid tumor that is:

A

serotonin; asymptomatic until metastasis to the liver

138
Q

In carcinoid syndrome, what happens to the serotonin that is no longer metabolized by the liver?

A

causes cramping, diarrhea, flushing and bronchospasm

139
Q

Name the characteristic feature of the large intestine:

A

Crypts

140
Q

Name the characteristic feature of the small intestine:

A

villi

141
Q

The large intestine may be referred to as the:

A

colon

142
Q

What plexi are in the enteric nervous system?

A

myenteric (Auerbach) and submucosal (messier)

143
Q

The colon is colonized by:

A

non-pathogenic strains of bacteria

144
Q

Hirschsprung disease may also be referred as:

A

congenital megacolon

145
Q

Developmental defect of enteric nervous system- angangliosis of terminal colon (myenteric plexus):

A

Hirschsprugn disease- congenital megacolon

146
Q

consists of out-pouching of mucosa and submucosa through muscular layer of colon:

A

diverticulosis

147
Q

Diverticulosis is associated with:

A

a low bulk diet & straining during defecation

148
Q

If diverticulosis becomes inflamed it transitions to:

A

diverticulitis

149
Q

neoplastic polyps of the intestine may also be called:

A

adenomatous polyps or adenomas

150
Q

What are the two categories of intestinal polyps?

A
  1. neoplastic polyps
  2. non-neoplastic polyps
151
Q

What are the two types of neoplastic polyps in the intestine?

A
  1. tubular adenoma
  2. villous adenoma
152
Q

What are two types of non-neoplastic polyps in the intestine?

A
  1. hyperplastic polyp (most common)
  2. hamartomatous poly (Peutz-Jeghers syndrome)
153
Q

Non-neoplastic hyperplasia of the epithelium; most common:

A

hyperplastic polyp

154
Q

A hyperplastic polyp is considered:

A

NOT pre-malignant

155
Q
  • large, pedunculate polyp, consisting of all layers of the mucosa
  • may be associated with Peutz-Heghers syndrome
  • risk for intussusception
  • no malignant change
A

hamartomatous polyp

156
Q
  • autosomal dominant condition
  • pigmented macula’s of oral mucosa and peri oral skin
  • hamartomatous polyps of bowel

-incrased risk for adenocarcinoma outside GI tract (pancreas, breast, lung, ovary, uterus)

A

Peutz-Jegher Syndrome

Pathology (24 decks)

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