my own GI path Flashcards
which serotype is oral herpes? and where does it remain dormant?
HSV-1
remains dormant in trigeminal ganglia
Hairy Leukoplakia: pathogenesis, CP, progression?
it is a white, rough (‘hairy’) patch on the SIDES of the tongue, usually seen in AIDS pts.
arises dt EBV-induced squamous cell hyperplasia = not pre-malignant (because no dysplasia)
WHat is highest risk for SqCC of oral mucosa
smoking plus alcohol abuse have a synergistic effect
What is the MC and 2nd MC tumor of the salivary glands?
MC = pleomorphic adenoma 2nd = Warthin tumor
What is the MC malignant tumor of the oral mucosa
mucoepidermoid carcinoma
What is the makeup of pleomorphic adenoma
mixed tumor of chondromyxoid stroma (cartilage) plus epithelium (glands = adeno).
What is the CP of pleomorphic adenoma
mobile, painless circumscribed mass at the angle of the jaw that hasn’t invaded anything
What is the prognosis for plemorphic adenoma
high rate of recurrence dt incomplete resection when small islands of tumor extend through the tumor capsule
What is the other name for a warthin tumor and what does it look like under micro
papillary cystadenoma lymphomatosum:
looks like heterotropic salivary gland inside a LN- cystic glandualr structures within a benign lymphoid tissue
What is a mucoepidermoid tumor made of
mucinous and squamous components
What causes Plummer-vinson syndrome and what does it present with? (4)
Cuased by chronic iron deficiency
CP: esophageal web, Iron deficiency anemia, dysphagia, and glossitis
Zenker diverticulum: true or false? where does it arise, and how does it present? (3)
a false diverticulum arises at junction of eso and pharynx (weak cricopharyngeus m.) CP: 1. halitosis (trapped food) 2. dysphagia 3. obstruction/regurg food
Where do esophageal varices arise
lower 1/3 of esophagus
What is the difference between esophageal varices and Mallory Weiss syndrome CP?
esophageal varices = painless hematemesis
Malloery-Weiss = painful hematemesis
What cuases Mallory Weiss synd (2)
severe retching dt bulimia or alcoholism
What is pathogenesis of Mallory Weiss and what does it increase the risk of?
longitudinal tear at GE jnct dt severe vomiting –> painful hematemesis.
Increases risk of Boerhaave syndrome (air trapped in mediastinum) = emergency
achalasia: pathogenesis
T. Cruzi (Chagas dz) or idiopathic damage to cells in myenteric plexus (auerbach) –> dysregulation of peristalsis and esophageal motility and inability to relax LES.
Achalasia: CP (4)
- Bird;s beak sign on barium swallow
- putrid breath (rotting food)
- high LES pressure on esophageal manometry
- Dysphagia for solids and liquids
Achalasia –> increased risk of?
squamous cell carcinoma
GERD is dt? risk factors include?
dt decreased LES tone
-risk factors: caffeine, EtOH, HIATIAL HERNIA**
what is the exact change seen in Barret’s esophagus
non-keratinized stratified squamous epithelium of esophagus changes to non-ciliated columnar epithelium with goblet cells
what causes Barret’s and what does it increase risk of
caused by GERD and increases risk of adenocarcinoma of esophagus
Gastrochisis: pathogenesis? covered by peritoneum? location in abdomen
- patho: congenital malformation of anterior abdominal wall
- not covered
- to right of umbilicus
Omphalocele: patho? covered by peritoneum?
patho: persistent herniation of abdominal contents into umbilical cord
OmphaloCELE = SEALED by peritoneum
Pyloric stenosis presents how/when*****
- non-bilious projectile vomiting with “olive” mass in abdomen
- presents 2-6 weeks after birth (takes time for stenosis to develop)
What are 3 etiologies of acute gastritis**
- NSAID use–> decreased PGE2–> decreased gastric mucosa protection
- Burn –> hypovolemia –> mucosal ischemia (Curling ulcer)
- **Brain injury –> ^ICP –> ^ vagal stimulation –> ^ACh production –> ^ H+ secretion
2 etiologies of chronic gastritis
- H. pylori infx
2. Autoimmune destruction of parietal cells
Peptic ulcer disease occurs in 2 locations: which is MC? and what is the CP of each with mnemonic?
- Duodenal ulcer = MC
- Gastric ulcer
CP: Gastric ulcer = Greater pain with eating
Duodenal ulcer = Decreased pain with eating
**can think that wherever the ulcer is, that pH predominates