GIT I Flashcards
CONGENITAL ABNORMALITIES
______, _____, and duplications may occur in any part of the GI tract. when present within the esophagus they are discovered shortly after birth, usually due to regurgitation during feeding
atresia, fistula, and duplications
CONGENITAL ABNORMALITIES
_______, a segment of the esophagus does not develop, leaving only a thin, noncanalized cord and causing mechanical obstruction
atresia
CONGENITAL ABNORMALITIES
________ is an incomplete form of atresia in which the lumen is markedly reduced in caliber as a result of fibrous thickening of the wall
stenosis
CONGENITAL ABNORMALITIES
_______ tissues (developmental rests) are common in the GI tract. The most frequent site of ectopic gastric mucosa is the upper 3rd of the esophagus where it is referred to as an inlet patch.
ectopic tissue
CONGENITAL ABNORMALITIES
__________ is a blind outpouching of the alimentary tract that communicates with the lumen and includes all 3 layers of the bowel wall
true diverticulum
CONGENITAL ABNORMALITIES
_____________ generally presents between the 3rd and 6th weeks of life as new-onset regurgitation, projectile nonbilious vomiting after feeding, and frequent demands of refeeding
congenital hypertrophic pyloric stenosis
CONGENITAL ABNORMALITIES
________ diseases causes functional obstruction of the colon due to failure of ganglion cells to migrate to the wall of the colon resulting from mutation in the receptor tyrosine kinase
Hirschsprung disease
CONGENITAL ABNORMALITIES
Hirschsprung disease
Heterozygous loss-of-function mutations in the receptor tyrosine kinase ______ account for the majority of familial and approximately 15% of sporadic Hirschsprung diseases.
receptor tyrosine kinase RET
CONGENITAL ABNORMALITIES
HIRSCHSPRUNG
diagnosis of Hirschsprung disease requires histologic confirmation that _________ are absent within the affected segment
disease limited to the rectosigmoid is termed _________
proximal extension are termed as ______________
ganglion cells
short-segment Hirschsprung disease
long-segment Hirschsprung disease
ESOPHAGUS
Esophageal obstruction
________- describes functional obstruction of the esophagus by intense, high amplitude, uncoordinated contractions of inner circular, and outer longitudinal smooth muscle
nutcracker esophagus
ESOPHAGUS
Esophageal obstruction
_________- also known as corkscrew esophagus is due to the appearance on barium swallow, is characterized by repetitive simultaneous contractions of the distal esophageal smooth muscle
diffuse esophageal spasm
ESOPHAGUS
Esophageal obstruction
__________ including high resting pressure or incomplete relaxation may be presented as an isolated anomaly or accompany nutcracker esophagus or diffuse esophageal spasm
lower esophageal dysfunction
ESOPHAGUS
Esophageal obstruction
in the upper-esophagus, webs may be accompanied by iron-deficiency anemia, glossitis, and cheilosis, as part of ___________
plummer-vinson syndrome
ESOPHAGUS
_______ is characterized by the triad of incomplete lower esophageal sphincter relaxation, increased lower esophageal sphincter tone, and aperistalsis of the esophagus
achalasia
ESOPHAGUS
_______ achalasia may arise in Chagas disease, in which trypanosoma cruzi infection causes destruction of the myenteric plexus, failure of peristalsis, and esophageal dilation
secondary achalasia
ESOPHAGUS
logitudinal mucosal tears near the gastroesophageal junction called _________ are most often associated with severe retching or vomiting secondary to alcohol intoxication
mallory-weiss tears
ESOPHAGUS
chemical and infectious esophagitis
Symptoms range from self-limited pain, particularly on swallowing called __________, hemorrhage, structure, or perforation in severe cases
less severe chemical injury to the esophageal mucosa can occur when medicinal pills lodge and dissolve in the esophagus, a condition termed ____________
odynophagia
pill-induced esophagitis
ESOPHAGUS
chemical and infectious esophagitis (Morphology)
candidiasis is characterized by adherent, gray white _______ composed of densely matted fungal hyphae, and inflammatory cells covering the esophageal mucosa
pseudomembranes
ESOPHAGUS
chemical and infectious esophagitis (Morphology)
histologic features of esophageal ____________ are similar to those of skin and include basal epithelial cell apoptosis, mucosal atrophy, and submucosal fibrosis without significant acute inflammatory infiltrates
graft vs host disease
ESOPHAGUS
reflux of gastric contents into the lower esophagus is the frequent cause of esophagitis and the most common outpatient GI diagnosis in the US
reflux esophagitis
ESOPHAGUS
reflux esophagitis
transient lower esophageal sphincter relaxation is thought to be a major cause of _________
GERD
ESOPHAGUS
________ is a form of acute eosinophilic dominated esophageal inflammation associated with atopic disease
in addition to GERD like symptoms, patients experience food impaction, dysphagia, and vomiting
eosinophilic esophagitis
ESOPHAGUS
______________ are caused by portal hypertension which is due to impaired blood flow, through the portal venous system and liver
Morphology:
torturous dilated veins within the mucosa and submucosa of the distal esophagus and proximal stomach
Clinical manifestations
Variceal hemorrhage
esophageal varices
ESOPHAGUS
_________ esophagus is a complication of chronic GERD that is characterized by intestinal metaplasia within the esophageal squamous mucosa and is associated with an increased risk of cancer
Barret Esophagus
ESOPHAGUS
____________ is classified as a low-grade or high grade. Atypical mitoses, nuclear hyperchromasia, irregularly clumped chromatin, increased nuclear-to-cytoplasmic ratio, and failure of epithelial cells to mature as they migrate to the esophageal surface are present in both grades
dysplasia
ESOPHAGEAL TUMORS
___________ typically arises in the background of barret esophagus and long standing GERD
adenocarcinoma of the esophagus
ESOPHAGEAL TUMORS
esophageal tumors (Esophageal adenocarcinoma)
chromosomal abnormalities and mutations of tumor suppressor genes _________ and _________ are detected at early stages
TP53 and CDK2A
ESOPHAGEAL TUMORS
Esophageal tumors (esophageal adenocarcinoma)
usually happens in the ___________ of the esophagus and invade the adjacent gastric cardia
distal 3rd
ESOPHAGEAL TUMORS
squamous cell carcinoma begins as an in situ lesion termed ___________ (this histopathology is referred to as intraepithelial neoplasia or carcinoma in situ at sites outside the GI tract e.g. uterine and cervix
squamous dysplasia
STOMACH
Gastropathy and acute gastritis
distruption of protective mechanisms is illustrated by the following examples:
___________ NSAIDs inhibit COX-dependent synthesis of prostaglandins E2 and i2 which contribute to nearly all the above defense mechanisms including: mucus, bicarbonate, phospholipid secretion; mucosal blood flow; and epithelial restitution
institution of cyclooxygenase (COX) by NSAIDS
STOMACH
Gastropathy and acute gastritis
distruption of protective mechanisms is illustrated by the following examples:
______________ by ammonium ions can result in gastric injury in uremic patients and those infected with urease-secreting H. pylori
inhibition of bicarbonate transporters
STOMACH
Gastropathy and acute gastritis
distruption of protective mechanisms is illustrated by the following examples:
___________- have been suggested as factors that explain the increased susceptibility of older adults to gastritis
___________- may account for an increased incidence of acute gastritis at high altitudes
reduced mucin and bicarbonate secretion
decreased oxygen delivery
STOMACH
Stress related mucosal disease
________ are most common in the setting of shock, sepsis, or severe trauma
________ refer to ulcers occuring in the proximal duodenum in the context of severe burns or trauma
________ refers to gastric, duodenal, and esophageal ulcers arsing those with intracranial disease, they have an elevated risk of perforation
stress ulcers
curling ulcers
cushing’s ulcers
STOMACH
Stress related mucosal disease
Non-stress related causes of gastric bleeding include the following two conditions:
1. __________- consists of an abnormal submucosal arteriole that is usually found within the lesser curvature of the stomach near the gastroesophageal junction
- ___________ is responsible for 4% of non-variceal upper GI bleeding
dielafoy lesion
Gastric antral vascular ectasia (GAVE)
STOMACH
Chronic gastritis and its complications
Chronic gastritis is most often caused by _____- infection
H. Pylori
STOMACH
Chronic gastritis and its complications
H. PYLORI
______: allows the bacteria to be motile in viscous mucus
______: which generates ammonia from endogenous urea and thereby elevates local gastric pH and enhances bacterial survival
______: enhances bacterial adherence to surface folveolar cells
______: such as cytotoxic associated gene A (Cag A)
flagella
urease
adhesins
toxins
STOMACH
Chronic gastritis and its complications
Helicobacter pylori gastritis
Lymphoid aggregates some with germinal centers are frequently present and represent induced _________ that has the potential to transform into lymphoma
mucosa-associated lymphoid tissue
STOMACH
__________ gastritis in contrast to H. Pylori associated gastritis, typically spares the antrum and is often associated with marked hypergastrinemia
___________ gastritis is associated with loss of parietal cells which is responsible for secretion of gastric acid and intrinsic factor.
Leads to cobalamin (Vitamin B12) deficiency –> pernicious anemia
autoimmune atrophic gastritis
STOMACH
autoimmune atrophic gastritis
is characterized by diffuse damage to the ______ mucosa within the body and fundus
oxyntic (acid producing)
STOMACH
UNCOMMON FORMS OF GASTRITIS
___________ is characterized by tissue damage associated with dense infiltrates of eosinophils in the mucosa, muscularis, usually in the antral or pyrolic region
eosinophilic gastritis
STOMACH
UNCOMMON FORMS OF GASTRITIS
this disease preferentially affects women and produces nonspecific abdominal symptoms. It is idiopathic but approximately 40% of cases are associated with celiac disease suggesting an immune-mediated pathogenesis.
Lymphocytic Gastritis
STOMACH
UNCOMMON FORMS OF GASTRITIS
the descriptive term _________ is applied to any gastritis that contains granulomas
granulomatous gastritis
STOMACH
___________ refers to chronic mucosal ulceration affecting the duodenum or stomach and is almost always associated with H. Pylori infection, NSAIDs or cigarette smoking
Peptic ulcer disease
