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GI Week 1 > Nelson Pathology > Flashcards

Nelson Pathology Flashcards

1
Q

Define aphthous ulcers

A

Canker sore!
Common, superficial mucosal ulceration

Arises in relation to stress
Often reoccurs

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2
Q

What is a mucosal fibroma?

A

Reactive proliferation of squamous mucosa and underlying subepithelial fibrous tissue

Typically secondary to chronic irriation

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3
Q

What is pyogenic granuloma?

A

Polypoid red lesion

lobular reactive proliferation of capillaries (eruptive hemangioma)

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4
Q

Pyogenic granulomas are common in what populations?

A

Gingiva in children, young adults, and pregnant women

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5
Q

What is glossitis?

A

Inflammation of the tongue

“red beefy tongue”

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6
Q

What causes the red appearance in glossitis?

A

Atrophy of the papillae of the tongue and thinning of the mucosa

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7
Q

What is geographic tongue?

A

“map like” appearance of tongue

Due to focal loss of the papillae with formation of smooth red patches

Intraepithelial neutrophilic inflammation is present

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8
Q

Describe the appearance of hairy leukoplakia and its clinical significance

A

White patches of “fluffy” hyperkeratosis on the lateral sides of the tongue

May be the first presenting sign of HIV!

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9
Q

How do you distinguish hairy leukoplakia from thrush?

A

Hairy leukoplakia CANNOT be scraped off!!!

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10
Q

Leukoplakia appearance and clinical significance

A

White patch or plaque in the oral cavity that cannot be scarped off and cannot be characterized clinically or pathologically as any other disease

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11
Q

Erythroplakia appearance and clinical significance

A

Red, velvety patch in oral cavity that may be flat or slightly eroded

Typical in adults, associated with tobacco

High incidence of precancerous dysplasia

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12
Q

Actinic cheilits appearance and clinical significance

A

Leukoplakic lesion of lower lip with loss of distinct demarction between the lower lip vermilion border and the skin of the lip

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13
Q

Define squamous papilloma

A

Exophytic papillary proliferation of squamous mucosa with fibrovascular core

*can undergo malignant transformation to in-situ and invasive squamous cell carcinoma

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14
Q

What are the key risk factors for squamous cell carcinoma?

A

Smoking
Drinking
Oncogenic HPV

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15
Q

What is the most common site of metastases for oral cavity and pharyngeal squamous cell carcinoma?

A

Local- cervical neck lymph nodes

Distant- mediastinal lymph nodes

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16
Q

What is often the first presenting sign of squamous cell carcinoma?

A

Enlarged cervical neck lymph node!

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17
Q

Why are inverted sinonasal papillomas more likely to recur than other sinonasal papillomas?

A

Inverted sinonsasal papilloma recurrence is due to its inverted growth pattern

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18
Q

What is Xerostomia? Causes?

A

Dry mouth due to decrease in saliva production

Causes: Sjogren’s Syndrome, radiation therapy, medication side effect

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19
Q

What is sialadenitis? Causes?

A

Inflammation of the salivary glands

Causes include trauma, infection, autoimmmune disease

20
Q

What is a sialolithiasis?

A

Stone in the salivary duct

*can lead to obstruction and secondary bacterial infection

21
Q

Describe a mucocele. What can cause it?

A

Results from blockage or trauma to a minor salivary gland, with leakage of content into surrounding connective tissue stroma

Fluid filled mucosal nodule with inflammation

22
Q

What is LESA? Causes?

A

Autoimmune disease involving salivary glands

50% have Sjogren’s syndrome, can be associated with HIV

23
Q

Describe key clinical features and microscopic appearance of pleomorphic adenoma

A

Benign tumor
Tumor is a mix of epithelial cells with a mesenchymal matrix of myxoid, hayline and chondroid tissue

Painless, discrete masses, well circumscribed that have small extensions/protrusions

24
Q

Describe key clinical features and microscopic appearance of Warthin tumor

A

Benign tumor
Encapsulated- papillary, cystic lesion with a dual layer of bland epithelium

8 times greater risk in smokers

Almost always in parotid gland

25
Q

Describe key clinical features and microscopic appearance of mucoepidermoid carcinoma

A

Mixture of squamous cells, mucus-sereting cells and intermediate cells

Appear encapsulated but infiltrate at the margins microscopically

26
Q

Describe key clinical features and microscopic appearance of adenoid cystic carcinoma

A

Slow growing
Predilection for neural invasion

Common in minor salivary glands
Often spreads after removal

27
Q

Most common benign salivary gland tumor?

A

Pleomorphic Adenoma

28
Q

Most common malignant salivary tumor?

A

Mucoepidermoid Carcinoma

29
Q

Which salivary gland is most often involved by salivary gland neoplasms?

A

Parotid Gland

30
Q

Define esophageal atresia

A

Ending of the esophagus

31
Q

Define esophageal stenosis

A

Can be congenital

Usually due to injury and inflammation from chronic gastroesophageal reflux, irradiation, or caustic injury

32
Q

Define tracheoesophageal fistula

A

Esophagus enters the trachea

33
Q

What is the difference between esophageal mucosal webs and Schatzki rings?

A

Rings are like webs but thicker and circumferential

34
Q

Zenker’s Diverticulum

A

Not a true diverticulum!
Outpouching of mucosa/submucosa through a weakened posterior cricopharyngeus muscle

Located above the upper esophageal sphincter

35
Q

Mallory-Weiss Syndrome

A

Presence of longitudinal mucosal lacerations in the distal esophagus and proximal stomach

Usually associated with severe retching or vomiting

History of heavy alcohol use leading to vomiting in 40-80% of patients

Can cause upper GI bleeding

36
Q

Define hiatal hernia

A

Separation of the diagphragmatic crura and protrusion of the stomach into the thorax through the defect

37
Q

What is the most common type of hiatal hernia?

A

Type 1 = the sliding type

38
Q

What are the 3 most common types of infectious esophagitis that can occur in immunocompromised patients?

A

Candida Esophagitis
Herpes Simplex esophagitis
Cytomegovirus esophagitis

39
Q

Eosinophilic esophagitis: pathogenic mechanism, microscopic appearance, clinical presentation

A

Some type of allergy to food but pathogenesis is not understood

Biopsies show high eosinophilic inflammation with basal epithelial hyperplasia -** absence of acute inflammation

May present with:
food impaction
Dysphagia
GERD symptoms

40
Q

Define Barrett’s esophagus

A

Conversion of normal squamous mucosa of the esophagus to metaplastic columnar epithelium as a result of chronic GERD

41
Q

State the major complication of Barrett’s esophagus

A

Increased risk of esophageal glandular dysplasia and adenocarcinoma

42
Q

Risk factors for esophageal adenocarcinoma

A

Barrets esophagus
Long standing GERD
Increased risk with glandular dysplasia

43
Q

Risk factors for esophageal squamous cell carcinoma

A 
Alcohol 
Tobacco
Esophageal injury
Achalasia
Frequent consumption of hot beverages
44
Q

Most common cause of esophageal squamous papillomas?

A

Strong association with HPV

45
Q

Most common benign mesenchymal tumor of the esophagus?

A

?

GI Week 1 (10 decks)

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