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Part 1 > GI System Pathology 1 > Flashcards

GI System Pathology 1 Flashcards

1
Q

What happens when salicylates are given during viral illness?

A

Reye’s syndrome

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2
Q

What are the most common potential complications of Reye’s syndrome?

A

Liver damage

Encephalopathy

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3
Q

Which age group is most affected with hepatitis A virus (hav)?

A

Children

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4
Q

How is HAV transmitted?

A

Fecal-oral route. HEV is also transmitted through this route.

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5
Q

Which immunoglobulin rises early in the hav infection?

A

IgM. IgM is the first type of Ig to be made at a new infection.

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6
Q

What is the incubation period for hav?

A

3-4 weeks

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7
Q

What symptoms are common in early hepatitis A?

A

Fever

Jaundice

Nausea

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8
Q

What are some of the other signs of hav infection?

A

Dark-colored urine,

Clay colored stools,

Elevation of serum liver enzymes

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9
Q

What are the three known methods of contracting hbv?

A

Blood

Perinatally

Sexual contact

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10
Q

What is the incubation period for hbv?

A

10-12 days

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11
Q

What symptoms commonly occur in hbv infection?

A

Fever

Fatigue

Nausea

Jaundice with hepatomegaly

Arthralgia

Arthritis

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12
Q

What serum antigen of hbv tends to rise 1-6 weeks before clinical symptoms?

A

HBsAg (surface antigen)

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13
Q

What serum antigen of hbv occurs during active infection?

A

HBeAg (e antigen)

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14
Q

What serum antibody against hbv appears weeks after recovery?

A

Anti-HBsAb (anti-surface antibody)

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15
Q

What serum antibody against hbv appears at onset of clinical symptoms or suggests current or past infection?

A

Anti-HBcAb (anti-core antibody)

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16
Q

What serum antibody against hbv suggests low risk of infectivity and shows a good chance of avoiding chronic liver disease?

A

Anti-HBcAb (anti-e antibody)

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17
Q

Why does hbv have a potential carrier state?

A

Viral dna is integrated in the chromosome of the host cell

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18
Q

What segment of the public has a high rate of hepatitis C virus (hcv) infection?

A

IV drug users, transfusion or blood product recipients prior to 1992

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19
Q

The delta particle is associated with what disease?

A

Hepatitis D

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20
Q

What is the transmission route for each type of viral hepatitis?

A

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

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21
Q

Which type of hepatitis occurs concurrently with another hepatitis infection?

A

Hepatitis D requires concurrent infection with hepatitis B

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22
Q

Which types of hepatitis may progress to chronic hepatitis?

A

Hepatitis B

Hepatitis C

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23
Q

What is the most common cause of transfusion-mediated hepatitis?

A

Hepatitis C

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24
Q

Alcoholic hepatitis involves what changes in the liver?

A

Infiltration by neutrophils

Focal liver cell necrosis

Presence of Mallory bodies

Fatty changes in the liver

Fibrosis leading to central venous obstruction

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25
Q

What bacteria causes severe gastroenteritis and can be caught from shellfish?

A

Yersinia enterocolitica

Vibrio parahemolyticus

Salmonella typhi

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26
Q

What organisms can exist chronically in the gall bladder?

A

Salmonella typhi, Giardia lamblia

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27
Q

What organism, having many animal reservoirs produces endotoxin and is a common cause of food poisoning in the USA?

A

Salmonella enteritidis

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28
Q

What causes bacillary dysentery?

A

Shigella dysenteriae

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29
Q

Compare Salmonella and Staphylococcus food poisoning in terms of incubation and explain why?

A

Staphyloccoccus: 4-8 h because it produces exotoxin

Salmonella: 10-28 h because the cells have to die and start producing exotoxin

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30
Q

Rice water stool is associated with infection by what organism?

A

Vibrio cholerae

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31
Q

What organism causes infectious jaundice?

A

Leptospira interrogans

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32
Q

What organism contracted from raw milk causes bloody diarrhea and can mimic appendicitis?

A

Campylobacter jejuni

33
Q

What organism is implicated in causing peptic ulcers?

A

Helicobacter pylori

34
Q

What type of inflammation of the gums may occur in patients with compromised immune systems?

A

Acute necrotizing ulcerative gingivitis (trench mouth)

35
Q

Chronic gingivitis may lead to what condition?

A

Periodontitis

36
Q

Candidal stomatitis is also known by what other names?

A

Thrush

Oral candidiasis

Moniliasis

37
Q

What are Koplik’s spots?

A

Lesions that appear on the oral mucosa early in measles

38
Q

What causes most inflammation of the esophagus?

A

Gastric acid reflux

39
Q

What causes Barrett’s esophagus?

A

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.

40
Q

What are predisposing factors to esophageal cancer?

A

Nitrosamines from smoked meats

Alcoholism

Smoking

Esophagitis

41
Q

What are the two types of chronic gastritis?

A

Fundal (type A) gastritis

Antral (type B) gastritis

42
Q

What symptoms occur with acute gastritis?

A

Pain, nausea, vomiting, possible occult blood

43
Q

What occurs with fundal (type A) gastritis?

A

Decrease or absence of gastric acid production from failure or destruction of parietal cells

44
Q

Chronic gastritis is associated with what type of infection?

A

Helicobacter pylori infection

45
Q

What causes peptic ulcers?

A

Imbalance between acid secretion and mucous barrier protection, leading to erosion of stomach or duodenal mucosa

46
Q

What contributes to duodenal ulcers?

A

Hypersecretion of gastric acid and pepsin

47
Q

When does the pain begin with duodenal ulcers?

A

90 minutes to 3 hours after eating, relieved by food

48
Q

When does the pain begin with gastric ulcers?

A

Within 30 minutes after eating, not relieved by food

49
Q

What problems may occur with hypochlorhydria or achlorhydria?

A

(1) Difficulty digesting protein

(2) Food sensitivities

(3) Constipation

(4) Gas and bloating

(5) Heartburn

(6) Mineral deficiencies

50
Q

What is a hiatal hernia?

A

Part of the stomach slides through the esophageal hiatus of the diaphragm

51
Q

What is most commonly true of gastric cancer?

A

(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

52
Q

What is intussusception?

A

A proximal segment of bowel telescopes into a distal segment, causing obstruction

53
Q

What is volvulus?

A

Twisting of part of the GI tract, often causing obstruction

54
Q

What causes gastroenteritis?

A

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

55
Q

What is typically found in Crohn’s disease?

A

Transmural skip lesions and non-caseous granulomas of the terminal ileum or colon

56
Q

What causes celiac disease?

A

Hypersensitivity reaction to gliadin causing destruction of mucosal villi of the jejunum

57
Q

What is found in diverticulosis?

A

Multiple diverticula in the sigmoid colon without inflammation

58
Q

What is diverticulitis?

A

Inflamed diverticula, which may cause perforation, peritonitis, abscesses, and bowel stenosis

59
Q

What predisposes one to hemorrhoids?

A

Low-fiber diet. This promotes constipation and thus straining that could induce hemorrhoids.

60
Q

What are the two types of colitis?

A

Chronic ulcerative

Microbial

61
Q

What is typically found in colitis?

A

Continuous ulcerous and inflamed lesions in the rectum and descending colon causing bloody diarrhea with mucous

62
Q

What is the most common cause of pseudomembranous colitis?

A

Overgrowth of Clostridium difficile

63
Q

Hamartomatous polyps most often occur in what syndrome?

A

Peutz-Jeghers syndrome

64
Q

What is the most common form of polyp?

A

Tubular adenomas, which are small and pedunculated and contain malignant foci

65
Q

What is believed to be the cause of acute appendicitis?

A

Obstruction of the lumen by a hard mass of feces, a fecalith, which causes bacterial infection and purulent exudate

66
Q

What are the symptoms of acute appendicitis?

A

(1) Anorexia

(2) Nausea

(3) Abdominal pain, most commonly in the right lower quadrant

67
Q

What is a test used to detect colorectal cancer?

A

Fecal occult blood screening

68
Q

Chronic pancreatitis is most commonly associated with what condition?

A

Alcoholism

69
Q

What are common symptoms of pancreatic cancer?

A

Abdominal pain radiating to the back

Anorexia

Weight loss

Migratory thrombophlebitis

70
Q

Chronic liver failure is most commonly associated with what conditions?

A

Alcoholic cirrhosis

Chronic viral hepatitis

71
Q

What enzymes are elevated in acute liver failure?

A

Serum alanine aminotransferase (alt)

Aspartate aminotransferase (ast)

Lactate dehydrogenase (ldh)

72
Q

What is a common tumor marker for hepatocellular carcinoma?

A

Serum alpha-fetoprotein (afp)

73
Q

What may happen with portal hypertension?

A

Splenomegaly

Ascites

Hemorrhoids

Esophageal varices

74
Q

What is formed from the normal or abnormal destruction of red blood cells and can cause pigmentation of the skin?

A

Bilirubin

75
Q

Excess bilirubin is associated with what condition?

A

Jaundice

76
Q

What causes obstructive jaundice?

A

Conjugated (direct) bilirubin from obstruction, i.e., gallstones, tumors, and strictures; cirrhosis; hepatitis; drugs; and pregnancy

77
Q

What is the most dangerous cause of jaundice?

A

Unconjugated (indirect) bilirubin form hemolysis

78
Q

Cirrhosis is often associated with which type of cancer?

A

Hepatocellular carcinoma

79
Q

What are common signs and symptoms of cholecystitis?

A

Nausea and vomiting

Fever

Right upper quadrant and epigastric pain

Leukocytosis

Part 1 (73 decks)

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