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IPIID > Pat > Flashcards

Pat Flashcards

1
Q

Esophageal atresia

A

—due to a thin, noncanalized cord replacement of a segment of esophagus, causing a mechanical obstruction.

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2
Q

Tracheoesophageal fistula

A

a connection between patent esophagus and trachea.

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3
Q

Achalasia

A

—–incomplete relaxation of LES (lower esophageal sphincter), or increased LES tone.

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4
Q

Pyloric stenosis

A

the pylorus (the muscle between the stomach and the intestines) is thickened.

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5
Q

Hiatal hernia

A

Upper stomach squeezes through histus (an diaphragm opening through which esophagus passes)

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6
Q

Meckel’s diverticulum

A

an outpouching or bulge in the lower part of the small intestine.

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7
Q

Hirschsprung disease

A

congenital aganglionic megacolon caused by absence of ganglion cells, and subsequent loss of peristaltic contractions of the affected colon

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8
Q

Megacolon

A

the dilation of the colon in the absence of a mechanical obstruction.

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9
Q

Intussusception

A

one segment of intestine “telescopes” inside of another, causing an intestinal obstruction (blockage).

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10
Q

Volvulus

A

-twisting or knotting of the gastrointestinal tract, resulting in obstruction.

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11
Q

Reflux esophagitis

A

Clinical condition of reflux esophagitis is called GERD (gastroesophageal reflux disease)

—- > Barrett esophagus is characterized by intestinal metaplasia.

—- > dysplasia and esophageal adenocarcinoma

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12
Q

Acute gastritis

A

a mucosal inflammatory process with the presence of neutrophils.

Clinical manifestation varies from asymptomatic, epigastric pain, to mucosal erosion, ulceration, even hemorrhage.

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13
Q

Chronic gastritis

A

Chronic inflammation of the gastric mucosa.

Complications of Chronic Gastritis = PEPTIC ULCER DISEASE (PUD)
PUD = chronic mucosal ulceration affecting the duodenum or stomach, most often associated with H. pylori infection, NSAIDs, or smoking.

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14
Q

Inflammatory Bowel Disease

A

a chronic condition resulting from inappropriate mucosal immune activation.

Mainly two conditions are categorized as inflammatory bowel disease

Crohn disease
Ulcerative colitis

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15
Q

Esophageal varices:

A

Portal hypertension

—– > dilated submucosal veins in the lower third of the esophagus

—— > painless bleeding

———-> bleed massively when they rupture

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16
Q

Mallory-Weiss tear:

A

retching or vomiting

——–> a linear laceration of the mucosa at the gastro-esophageal junction

——– > Pain, hematemesis

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17
Q

Ischemic Bowel Disease

A

Severe atherosclerosis, hypercoagulable states or embolization of cardiac vegetation

——–> Progressive hypoperfusion may cause mucosal or mural infarctions.

———–> Acute vascular obstruction may lead to chronic, transmural infarction.

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18
Q

Vascular ectasia (Angiodysplasia)

A

chronic vascular obstruction

——– > abnormally dilated blood vessels in colonic mucosa or submucosa

——— > bleeding

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19
Q

Simple hyperemia (Intraepithelial infiltration of neutrophils and Eosinophils)

A

—— > Basal zone hyperplasia

--------- > Barrett esophagus (intestinal metaplasia)

 ------------ > dysplasia

   -------------- > esophageal adenocarcinoma.
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20
Q

Squamous dysplasia

A

———— > esophageal squamous cell carcinoma

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21
Q

Genetic factors, H. pylori infection, et al.

A

——— > Chronic inflammation

————- > gastric adenocarcinoma

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22
Q

Mutation of APC gene (adenomatous polyposis coli)

A

——— > familial adenomatous polyposis

———— > colonic adenocarcinoma

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23
Q

Malabsorptive diarrhea

A

follows generalized failures of nutrient absorption and is associated with steatorrhea and is relieved by fasting

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24
Q

celiac disease (gluten-sensitive enteropathy)

A

——– > loss of villi

——–> malabsorption

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25
Q

tropical spruce (tropical enteropathy)

A

—— > inflammation of your intestines, villous atrophy is uncommon

——– > swelling makes it difficult to absorb nutrients from food

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26
Q

Drug toxic injuries

A

—–>massive hepatic necrosis

———–>Acute liver failure (happens in hours to days, not enough time to allow regeneration and scar formation).

Note: Acute viral infections could cause failure over weeks to a few months, so regeneration and scarring are possible.

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27
Q

Acute liver failure

A

(happens in hours to days, not enough time to allow regeneration and scar formation).

28
Q

Chronic liver failure

A

—->cirrhosis with fibrous bands and some degree of portosystemic vascular shunting around regeneration nodules.

29
Q

Portal Hypertension

A

Prehepatic (e.g. thrombosis of portal vein), intrahepatic (e.g. cirrhosis), and posthepatic (e.g. Right-sided heart failure)

—–> increased resistance to portal blood flow

30
Q

Unconjugated Hyperbilirubinemia

A

Excess production of bilirubin (e. g. Hemolytic anemias); Reduced uptake and impaired conjugation by hepatocytes ( e. g. immaturity of hereditary problems)

31
Q

Cholestasis

A

——–>Accumulation of green-brown plugs of bile pigment in hepatocytes and dilated canaliculi

32
Q

Jaundice and icterus (yellow sclera)

A

—–>Unconjugated Hyperbilirubinemia

33
Q

Conjugated hyperbilirubinemia

A

———–> water-soluble, can be excreted in the urine. Hepatocellular disease, bile duct injury, and biliary obstruction.

34
Q

Alcoholic liver disease

A

Excessive alcohol drinking

—->steatosis, dysfunction of mitochondria, microtubules and cellular membranes, and oxidative stress

—–>resulting injury

——–> hepatocyte death and inflammation

———-> liver fibrosis and deranged vascular perfusion

35
Q

Nonalcoholic Fatty Liver Disease (NAFLD)

A

Metabolic diseases (e.g. obesity, insulin resistance, hyperlipidemia)

——> steatosis, steatohepatitis, and cirrhosis (similar to alcoholic liver disease)

36
Q

primary achalasia

A

failure of distal esophageal inhibiatory neurons

37
Q

Gastroesophageal reflux disease causes

A

decrease in lower esophageal sphincter tone, increase in abdominal pressure (alcohol and tobacco use, obesity, central nervous system, depressants, pregnancy, hiatal hernia, delayed gastric emptying, and increased gastric volume)

38
Q

secondary achalasia

A

Chagas disease, diabetic autonomic neuropahty, malignancy, amyloidosis, or sarcoidosis

39
Q

GERD symptoms

A

heartburn, dysphagia

40
Q

esophagitis

A

reflux esophagitis with scattered intraepithelial eosinophils

41
Q

morphology of reflux esophatitis

A

simple hyperemia, intraepithelial infiltration of neutrophils and eosinophils, basal zone hyperplasia, elongated lamina propria, papillae

42
Q

Barrett Esophagus causes:

A

GERD… intestinal metaplasia of the squamous esophageal mucosa to columnar type of chronic exposure to gastric secretions. dysplasia - low or high grade based on morphologic criteria. may progress to dysplasia and esophageal adenocarcinoma

43
Q

adenocarcinoma

A

Barrett esophagus and long standing GERD (genetic, epigenetic changes)

44
Q

squamous cell carcinoma

A

smoking, alcohol drinking

45
Q

adenocarcinoma vs. squamous cell carcinoma

A

adenocarcinoma usually occurs distally and often involves the gastric cardia. SCC most frequenly found in the mid-esophagus where it commonly causes strictures

46
Q

Mallory-Weiss laceration

A

longitudinal mucosal lacerations at the gastroesophageal junction or gastric cardia (a split in the inner layer of your esophagus) characterized by upper GI bleeding. … caused by foreceful vomiting, retching, or straining.

47
Q

esophageal varices are associated with

A

alcoholic liver diasease … portal hypertension

48
Q

acute hemorrhagic gastritis

A

acute inflammation, erosion and hemorrage of the gastric mucosa due to a breakdown of the mucosal layer and acid-induced injury… epigastric abdominal pain, gastric hemorrhage, hematemesis, and melana

49
Q

chronic gastritis

A

chronic inflammation of the gastric mucosa eventually leading to atrophy (H. pylori infection)

50
Q

H pylori virulence

A

flagella, urease, adhesions, toxins

51
Q

autoimmune atrophic gastritis

A

antibiodies against parietal cells and intrinsic factor. loss of parietal cells which secrete gastic acid and intrinsifc factor.. b12 deficiency and megaloblastic anemia

52
Q

3 complications of chronic gastritis

A

peptic ulcer disease, mucosal atrophy and intestinal metaplasia, dysplasia

53
Q

gastric stress ulcers

A

NSAIDuse, severe tress, sepsis, shock severe burns or trauma, increased intracranial pressure. (high in ICU patinets) complicaitons = bleeding

54
Q

gastric adenocarcinoma

A

elevated massed with heaped up bordrs, cetnral ulceration. linitis plastic - gastric wall is markedly thickened and rugal folds are partially lost (a leatehr bottle appearancE)

55
Q

ischemic bowel disease

A

severe athelrosclerosis

56
Q

inflammatory bowel disease

A

inappropriate mucosal immune activation

57
Q

IBD pathogenesis

A

genetic factors, abnormal mucosal immune resonses, epithelial defects, changes in microbioome

58
Q

morphology of Crohn disease

A

thickened intestinal wall, transmural edema, inflammation, submucosal fibrosis, hypertorphy of muscularis propria (stricture formation)

59
Q

microscopic morphology of chrohn disease

A

distortion of mucosal architecture, epithelia metaplasia (paneth cell metaplasia), non-caseating granulomas.

60
Q

ulcerative colitis

A

crypt abscess, pseudopyloric metaplasia, disease is limited to the mucosa

61
Q

inflammatory intestinal disease

A

obstruction of the diverticula and stasis of contents leads to inflammation, diverticulitis and peridiverticulitis.

62
Q

(genetic) megacolon

A

congenital: Hirschsprung disease - classic, short segment and ultrashort segment types, total colonic aganglionosis.

63
Q

acquired megacolon

A

idiopathic, neurologic disease, inestinal smooth muscle disease and metabolic disorders.

64
Q

colon non-tumor, non-congenital lesions. (vascular extasia)

A

abnormally dialated blood vessels in colonic mucosa or submucosa (usually right colon). clinically rectal bleeding often in elderly.

65
Q

familial adenomatous polyposis.

A

benign neoplasms of the colonic mucosa that have the potential to progress to colonic adenocarcinoma. molecular defects (APC gene). 100% chance of develloping colon cancer by 40

66
Q

morphology of colonic adenocarcinoma

A

polyploid mass when it involves the right side of the colon and a napking ring lesion when on the left side.

67
Q
A

IPIID (6 decks)

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