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GI Nelson > Oral and esophageal (1.7) > Flashcards

Oral and esophageal (1.7) Flashcards

1
Q

What conditions often have canker sores (aphthous ulcers)?

A

Celiac disease

Inflammatory Bowel Disease

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2
Q

What is a fibroma (irritation fibroma)?

A

A fibroma is a proliferation of squamous mucosa and underlying subepithelial fibrous tissue d/t a chronic irritation

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3
Q

What is a pyogenic granuloma?

A

A pyogenic granuloma is a polypoid red lesion

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4
Q

What are pyogenic granulomas composed of?

A

Pyogenic granulomas are lobular reactive proliferations of capillaries…eruptive hemangioma

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5
Q

Who is most likely to develop a pyogenic granuloma?

A

Children, young adults, and pregnant women

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6
Q

Where are pyogenic granulomas most likely to occur?

A

Pyogenic granulomas occur in the gingiva

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7
Q

What causes the beefy-red appearance of glossitis?

A

Certain deficiency states like vitamin B12… secondary to atrophy of the papillae and thinning of the mucosa

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8
Q

A patient has glossitis, iron deficiency anemia, and esophageal dysphagia associated with esophageal webs: what is the name of the syndrome?

A

Plummer-Vinson syndrome

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9
Q

Why is benign migratory glossitis often referred to as geographic tongue?

A

Because the of the map-like appearance of the tongue

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10
Q

Is geographic tongue bad?

A

Geographic tongue is usually asymptomatic…there can be a mild burning sensation

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11
Q

What causes geographic tongue?

A

Mostly unknown…possible genetic component

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12
Q

What is a heterotopic collection of sebaceous glands in the oral cavity?

A

Fordyce’s Granules

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13
Q

What is squamous papilloma?

A

An exophytic papillary proliferation of squamous mucosa with a fibrovascular core

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14
Q

What are associated with squamous papilloma?

A

HPV infection

Trauma/irritation

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15
Q

Hairy leukoplakia:

A

White, fluffy patches on lateral sides of tongue… cannot be scraped off

Secondary to EBV infection in an immunocompromised person

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16
Q

What does leukoplakia…NOT hairy leukoplakia… just leukoplakia, look like?

A

White patch/plaque in oral cavity (not necessarily tongue)

Cannot be scraped off or characterized as anything else

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17
Q

Who gets leukoplakia?

A

Adult tobacco users

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18
Q

What is the concern with leukoplakia?

A

Precancerous squamous dysplasia (5-25%…less than erythroplakia)
Squamous hyperplasia and hyperkeratosis

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19
Q

What does erythroplakia look like?

A

Red, velvety patch…may be flat or slightly rounded

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20
Q

Who gets erythroplakia?

A

Adult tobacco users

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21
Q

What is the concern with erythroplakia?

A

Precancerous dysplasia…more so than with leukoplakia (erythroplakia is red because of blood supply)

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22
Q

What does actinic cheilosis look like?

A

Actinic cheilosis is a leukoplakic lesion of the lower lip that causes a loss of distinct demarcation between lip and skin

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23
Q

What are some histological features of actinic cheilosis?

A

Disordered maturation of the epithelium with cytologic atypia
Increased mitotic activity
Orthokeratosis
Dermal solar changes

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24
Q

What are the common risk factors for oral cavity, oropharyngeal, hypopharyngeal, and laryngeal SCC?

A

Tobacco use
EtOH use
HPV

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25
Q

What is the biggest risk factor for nasopharyngeal SCC?

A

EBV

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26
Q

A patient has oral cavity or pharyngeal SCC, where are the most likely locations for metastases?

A

Cervical neck lymph nodes (typical presenting sign)

Mediastinal lymph nodes, lungs, liver, bone

27
Q

What is xerostomia?

A

Dry mouth due to decreased saliva production

28
Q

What are some possible causes of xerostomia?

A

Sjogren’s syndrome
Previous radiation therapy
Some medications

29
Q

What is sialadenitis? What can be seen?

A

Inflammation of the salivary gland

There is a bulge/nodule/bump/etc

30
Q

What are some possible causes of sialadenitis?

A

Trauma
Bacterial or viral infection (mumps)
Autoimmune disease (Sjogren’s)

31
Q

What is the name of an autoimmune disease against salivary glands that produces a bulge/nodule/bump/etc?

A

Lymphoepithelial sialadenitis (LESA)

32
Q

What is a possible cause of LESA?

A

Sjogren’s

33
Q

What is a mucocele?

A

A mucocele is a fluid filled mucosal nodule caused by a minor salivary gland leaking

34
Q

What are three types of mucocele?

A 
Retention mucocele (caused by obstruction)
Extravastion mucocele (caused by trauma)
Ranula (mucocele of the sublingual gland)
35
Q

What is the most common salivary gland tumor? What gland does it usually occur in?

A

Pleomorphic adenoma is the most common salivary gland tumor

Pleomorphic adenoma is most likely to occur in the parotid gland

36
Q

What is the microscopic appearance of pleomorphic adenoma?

A

Mix of proliferating appearance

Mesenchymal matrix of myxoid, hyaline, and chondroid tissue

37
Q

What are some gross features of pleomorphic adenoma?

A

Usually a discreet, painless mass that seems well circumscribed (but isn’t…still rarely becomes a carcinoma)

38
Q

What is the second most common salivary gland tumor? What gland does it usually form in?

A

Warthin tumor

The parotid gland

39
Q

What is the microscopic appearance of Warthin tumor?

A

Papillary, cystic lesion (dual layer of bland, neoplastic, eosinophilic epithelium

Associated with reactive lymphoid stroma

Well encapsulated

40
Q

What is warthin tumor associated with?

A

Warthin tumor is associated with reactive lymphoid stroma

Smokers

41
Q

What is the most common MALIGNANT salivary gland tumor (in adults AND kids)?

A

Mucoepidermoid carcinoma

42
Q

What are some microscopic features of mucoepidermoid carcinoma?

A

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

Appear encapsulated, but aren’t…infiltrate at margins

43
Q

What is the most common malignant tumor of the MINOR salivary glands?

A

Adenoid cystic carcinoma

44
Q

What are some features of adenoid cystic carcinoma?

A

It is slow growing

Its 5-year survival rate starts at 70% and then gets cut in half every five years

45
Q

What are esophageal mucosal webs?

A

Protrusions of mucosa –> possible obstruction

Usually in upper esophagus

46
Q

What are some differences between esophageal mucosal webs and Schatzki rings (esophageal rings)?

A

Schatzki rings are thicker and circumferential, may contain muscularis propria, occur in the lower esophagus

47
Q

What is Zenker’s diverticulum?

A

An outpouching of mucosa and submucosa through a weakened posterior cricopharyngeus muscle (above the UES)

48
Q

Is Zenker’s diverticulum a true diverticulum?

A

No…can become large enough to accumulate food and cause problems

49
Q

What is Mallory-Weiss syndrome?

A

Longitudinal mucosal lacerations in the distal esophagus/proximal stomach

50
Q

What causes Mallory-Weiss syndrome?

A

Chronically drinking until you throw up

51
Q

What is a hiatal hernia? What is the most common type?

A

The stomach protrudes into the thorax through a separation of diaphragmatic crura

Sliding type (type 1)…herniation of the gastric cardia

52
Q

What is a type 2 hiatal hernia?

A

Paresophageal type…herniation of the gastric fundus

53
Q

A person is immunocompromised, what are the three most likely causes of infectious esophagitis?

A

Candida esophagitis
Herpes simplex esophagitis
CMV esophagitis

54
Q

What is the proposed pathology to eosinophilic esophagitis?

A

Food allergies…eosinophilic–>think allergies

55
Q

Besides eosinophilic inflammation, what else is seen with eosinophilic esophagitis?

A

Basal epithelial hyperplasia

No acute inflammation

56
Q

What are the signs and symptoms of eosinophilic esophagitis in adults/teenagers?

A

Food impaction
Persistent dysphagia
Unresponsive GERD

57
Q

What are the signs and symptoms of eosinophilic esophagitis in children?

A 
Feeding disorders
Vomiting
Abdominal pain
Dysphagia
Food impaction
58
Q

What change occurs with chronic GERD that is defined as Barrett’s esophagus?

A

Transition from normal squamous mucosa to metaplastic columnar epithelium

59
Q

What is needed to be seen to diagnose Barrett’s esophagus? What tests need to be done?

A

Columnar metaplasia AND intestinal metaplasia

Biopsy (histologic evidence) and endoscopy

60
Q

What are some concerns with Barrett’s esophagus?

A

Esophageal glandular dysplasia

Adenocarcinoma (less than half of the patients)

61
Q

What is the primary risk factor for adenocarcinoma?

A

Barrett’s esophagus…although only half of the people with Barrett’s esophagus develop adenocarcinoma, 95% of the people who develop adenocarcinoma have Barrett’s esophagus

62
Q

What are the risk factors for esophageal SCC?

A 
EtOH
Tobacco
Caustic esophageal injury
Achalasia
Tylosis (genetic disorder...also see thickening of palms and soles)
Plummer-Vinson syndrome
Frequent hot beverages
Possibly HPV
63
Q

What is the most common cause of esophageal squamous papilloma?

A

HPV

64
Q

What is the most common benign mesenchymal tumor of the esophagus?

A

Leiomyoma

GI Nelson (11 decks)

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