GIT Flashcards
Meckel’s Diverticulum Features
Cause: incomplete involution of vitelline duct
Morphology: all layers of GIT present (can have heterotropic pancreatic or gastric tissue present)
*Rule of 2’s
Meckel Diverticulum Conditions
Hemorrhage and peptic ulcer, SBO, diverticulitis, perforation, fistula
Celiac Sprue
Morphology: villous atrophy (flattening of brush border and increased intraepithelial lymphocytes
Serology: anti-tTG Ab (and anti-gliadin Ab, anti-endomysial Ab)
HLA genotype: HLA DQ2 and DQ8
Tx: reversal of changes after gluten free diet
Meconium Ileus
Infant w/ CF, thick mucus at mid-terminal ileum causing SBO
*endogenous
Gallstone Ileus
Stone >2.5cm lodges in terminal ileum, usually through cholecystoduodenal fistula, causing SBO
*endogenous
Hirschsprung Dz
Cause: absence of ganglion cells in Meissen or Auerbach plexus
Localization: rectum always affected
Morphology: dilatation and hypertrophy of the portion proximal to the aganglionic segment (distal well-appearing part is the aganglionic part)
Achalasia complication (condition)?
Squamous cell ca of esophagus, aspiration pneumonia
Investigation: manometry to check LES pressure
Diffuse Adenocarcinoma of stomach
Familial: E-cadherin mutation
Morphology: signet ring cells, no glands
Course: mets to ovaries as Krukenberg’s tumor
Appearance: linitis plastica (leather bottle)
Intestinal Adenocarcinoma
Risk: H.pylori infection
Course: gastritis w/ intestinal metaplasia, then neoplastic cells forming glands
Macrovesicular Steatosis
Large droplet: single fat vacuole displaces nucleus to periphery
Small droplet: multiple fat vacuoles (ETOH, malnutrition)
Microvesicular Steatosis
Multiple fine vacuoles, nucleus is CENTRAL (acute fatty liver of pregnancy, Reye syndrome, drugs)
Mallory Bodies
Intermediate keratin filaments
Non-specific to ETOH hepatitis
Wilson’s Dz
Etiology: accumulation of Cu2+
Morphology: fatty liver, hepatitis
ROS: basal ganglia w/ Cu and Kayser-Fleischer rings in eyes
Labs: 👇🏽 serum ceruloplasmin
Autoimmune Hepatitis
Type 1: Anti-liver/kidney/microsomal (LKM) Ab, Anti-nuclear Ab (ANA), and Anti-smooth muscle Ab (ASMA)
Labs: high IgG
Primary Biliary Cholangitis
Pathogenesis: Anti-mitochondrial Ab
Morphology: granulomatous destruction of medium sized intrahepatic bile ducts *(florid duct lesion)
Primary Sclerosing Cholangitis
Pathogenesis: P-ANCA
Association: chronic ulcerative colitis
Morphology: inflammation, fibrosis and dilation of intrahepatic and extrahepatic bile ducts
Labs: ERCP
Hemochromatosis
Pathogenesis: HFE gene mutation
ROS: micronodular cirrhosis, bronze DM, bronze skin, cardiomyopathy
Toxic megacolon is a complication of what?
C. difficile (pseudomembranous colitis)
Risk factor for pancreatic ca
Smoking
Mallory-Weiss
Pathogenesis: repeated wrenching causing mucosal tear
ROS: painful hematemesis
Plummer-Vinson Syndrome
ROS: esophageal webs, glossitis, iron deficiency anemia causing koilonychia (thin/brittle concave nails) and splenomegaly
Complications: squamous cell ca of esophagus
Sliding esophageal hernia associated with what?
GERD (Barrett’s esophagus and then eventually adenocarcinoma)
Paraesophageal hernia associated with what?
mechanical obstruction like volvulus, etc.
Nonalcoholic Fatty Liver Disease (NAFLD)
Risk: obese, DM (metabolic syndrome)
Morphology: macrovesicular steatosis
Labs: mild elevation of serum transferases
Florid duct lesion
Lymphocytes and poorly formed granuloma surrounding a bile duct found in primary biliary cholangitis
Pathology: Anti-mitochondrial Ab
Hepatic Adenoma
Risk: oral contraceptives, anabolic steroids
GIST
Pathogenesis: cells of Cajal
Morphology: whorls and bundles of spindle cells
Marker: CD-117
