GI System Pathology 1 Flashcards
What happens when salicylates are given during viral illness?
Reye’s syndrome
What are the most common potential complications of Reye’s syndrome?
Liver damage
Encephalopathy
Which age group is most affected with hepatitis A virus (hav)?
Children
How is HAV transmitted?
Fecal-oral route. HEV is also transmitted through this route.
Which immunoglobulin rises early in the hav infection?
IgM. IgM is the first type of Ig to be made at a new infection.
What is the incubation period for hav?
3-4 weeks
What symptoms are common in early hepatitis A?
Fever
Jaundice
Nausea
What are some of the other signs of hav infection?
Dark-colored urine,
Clay colored stools,
Elevation of serum liver enzymes
What are the three known methods of contracting hbv?
Blood
Perinatally
Sexual contact
What is the incubation period for hbv?
10-12 days
What symptoms commonly occur in hbv infection?
Fever
Fatigue
Nausea
Jaundice with hepatomegaly
Arthralgia
Arthritis
What serum antigen of hbv tends to rise 1-6 weeks before clinical symptoms?
HBsAg (surface antigen)
What serum antigen of hbv occurs during active infection?
HBeAg (e antigen)
What serum antibody against hbv appears weeks after recovery?
Anti-HBsAb (anti-surface antibody)
What serum antibody against hbv appears at onset of clinical symptoms or suggests current or past infection?
Anti-HBcAb (anti-core antibody)
What serum antibody against hbv suggests low risk of infectivity and shows a good chance of avoiding chronic liver disease?
Anti-HBcAb (anti-e antibody)
Why does hbv have a potential carrier state?
Viral dna is integrated in the chromosome of the host cell
What segment of the public has a high rate of hepatitis C virus (hcv) infection?
IV drug users, transfusion or blood product recipients prior to 1992
The delta particle is associated with what disease?
Hepatitis D
What is the transmission route for each type of viral hepatitis?
Hepatitis A (hav) - fecal-oral route
Hepatitis B (hbv) - sexual and parenteral routes
Hepatitis C (hcv) - parenteral route
Hepatitis D (hdv) - sexual and parenteral routes
Hepatitis E (hev) - fecal-oral route
Which type of hepatitis occurs concurrently with another hepatitis infection?
Hepatitis D requires concurrent infection with hepatitis B
Which types of hepatitis may progress to chronic hepatitis?
Hepatitis B
Hepatitis C
What is the most common cause of transfusion-mediated hepatitis?
Hepatitis C
Alcoholic hepatitis involves what changes in the liver?
Infiltration by neutrophils
Focal liver cell necrosis
Presence of Mallory bodies
Fatty changes in the liver
Fibrosis leading to central venous obstruction
What bacteria causes severe gastroenteritis and can be caught from shellfish?
Yersinia enterocolitica
Vibrio parahemolyticus
Salmonella typhi
What organisms can exist chronically in the gall bladder?
Salmonella typhi, Giardia lamblia
What organism, having many animal reservoirs produces endotoxin and is a common cause of food poisoning in the USA?
Salmonella enteritidis
What causes bacillary dysentery?
Shigella dysenteriae
Compare Salmonella and Staphylococcus food poisoning in terms of incubation and explain why?
Staphyloccoccus: 4-8 h because it produces exotoxin
Salmonella: 10-28 h because the cells have to die and start producing exotoxin
Rice water stool is associated with infection by what organism?
Vibrio cholerae
What organism causes infectious jaundice?
Leptospira interrogans
What organism contracted from raw milk causes bloody diarrhea and can mimic appendicitis?
Campylobacter jejuni
What organism is implicated in causing peptic ulcers?
Helicobacter pylori
What type of inflammation of the gums may occur in patients with compromised immune systems?
Acute necrotizing ulcerative gingivitis (trench mouth)
Chronic gingivitis may lead to what condition?
Periodontitis
Candidal stomatitis is also known by what other names?
Thrush
Oral candidiasis
Moniliasis
What are Koplik’s spots?
Lesions that appear on the oral mucosa early in measles
What causes most inflammation of the esophagus?
Gastric acid reflux
What causes Barrett’s esophagus?
Long-standing reflux esophagitis causes gastric metaplasia of the lower esophagus, creating susceptibility to peptic ulceration, esophageal stricture, and adenocarcinoma. Some argue that Barrett’s is a completely different phenotype of GERD not related to long-standing disease.
What are predisposing factors to esophageal cancer?
Nitrosamines from smoked meats
Alcoholism
Smoking
Esophagitis
What are the two types of chronic gastritis?
Fundal (type A) gastritis
Antral (type B) gastritis
What symptoms occur with acute gastritis?
Pain, nausea, vomiting, possible occult blood
What occurs with fundal (type A) gastritis?
Decrease or absence of gastric acid production from failure or destruction of parietal cells
Chronic gastritis is associated with what type of infection?
Helicobacter pylori infection
What causes peptic ulcers?
Imbalance between acid secretion and mucous barrier protection, leading to erosion of stomach or duodenal mucosa
What contributes to duodenal ulcers?
Hypersecretion of gastric acid and pepsin
When does the pain begin with duodenal ulcers?
90 minutes to 3 hours after eating, relieved by food
When does the pain begin with gastric ulcers?
Within 30 minutes after eating, not relieved by food
What problems may occur with hypochlorhydria or achlorhydria?
(1) Difficulty digesting protein
(2) Food sensitivities
(3) Constipation
(4) Gas and bloating
(5) Heartburn
(6) Mineral deficiencies
What is a hiatal hernia?
Part of the stomach slides through the esophageal hiatus of the diaphragm
What is most commonly true of gastric cancer?
(1) It is usually adenocarcinoma
(2) It is more common in Japan (50% of all cancers)
(3) It usually occurs after 50 years of age
What is intussusception?
A proximal segment of bowel telescopes into a distal segment, causing obstruction
What is volvulus?
Twisting of part of the GI tract, often causing obstruction
What causes gastroenteritis?
Ingesting food containing bacteria that:
(1) Contain preformed toxins, i.e., Clostridium botulinum, S. aureus
(2) Form a toxin, i.e., Vibrio cholerae, E.coli, Campylobacter jejuni
(3) Invade intestinal cells, i.e., Salmonella, Shigella, E. coli, Yersinia enterocolitica rotavirus
What is typically found in Crohn’s disease?
Transmural skip lesions and non-caseous granulomas of the terminal ileum or colon
What causes celiac disease?
Hypersensitivity reaction to gliadin causing destruction of mucosal villi of the jejunum
What is found in diverticulosis?
Multiple diverticula in the sigmoid colon without inflammation
What is diverticulitis?
Inflamed diverticula, which may cause perforation, peritonitis, abscesses, and bowel stenosis
What predisposes one to hemorrhoids?
Low-fiber diet. This promotes constipation and thus straining that could induce hemorrhoids.
What are the two types of colitis?
Chronic ulcerative
Microbial
What is typically found in colitis?
Continuous ulcerous and inflamed lesions in the rectum and descending colon causing bloody diarrhea with mucous
What is the most common cause of pseudomembranous colitis?
Overgrowth of Clostridium difficile
Hamartomatous polyps most often occur in what syndrome?
Peutz-Jeghers syndrome
What is the most common form of polyp?
Tubular adenomas, which are small and pedunculated and contain malignant foci
What is believed to be the cause of acute appendicitis?
Obstruction of the lumen by a hard mass of feces, a fecalith, which causes bacterial infection and purulent exudate
What are the symptoms of acute appendicitis?
(1) Anorexia
(2) Nausea
(3) Abdominal pain, most commonly in the right lower quadrant
What is a test used to detect colorectal cancer?
Fecal occult blood screening
Chronic pancreatitis is most commonly associated with what condition?
Alcoholism
What are common symptoms of pancreatic cancer?
Abdominal pain radiating to the back
Anorexia
Weight loss
Migratory thrombophlebitis
Chronic liver failure is most commonly associated with what conditions?
Alcoholic cirrhosis
Chronic viral hepatitis
What enzymes are elevated in acute liver failure?
Serum alanine aminotransferase (alt)
Aspartate aminotransferase (ast)
Lactate dehydrogenase (ldh)
What is a common tumor marker for hepatocellular carcinoma?
Serum alpha-fetoprotein (afp)
What may happen with portal hypertension?
Splenomegaly
Ascites
Hemorrhoids
Esophageal varices
What is formed from the normal or abnormal destruction of red blood cells and can cause pigmentation of the skin?
Bilirubin
Excess bilirubin is associated with what condition?
Jaundice
What causes obstructive jaundice?
Conjugated (direct) bilirubin from obstruction, i.e., gallstones, tumors, and strictures; cirrhosis; hepatitis; drugs; and pregnancy
What is the most dangerous cause of jaundice?
Unconjugated (indirect) bilirubin form hemolysis
Cirrhosis is often associated with which type of cancer?
Hepatocellular carcinoma
What are common signs and symptoms of cholecystitis?
Nausea and vomiting
Fever
Right upper quadrant and epigastric pain
Leukocytosis
