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Path Flashcards

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1
Q

Webs vs Schatzki rings

A

Semi circumferential vs completely

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2
Q

Achalasia etiology and complications

A

Chagas and increased risk of cancer

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3
Q

Mallory Weiss Tears-etiology

A

Heavy ETOH use-less can not relax-and then vomit heavy pressure causes laceration
Linear laceration of esophagus

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4
Q

5 types of non infectious esophagigtis

A

GERD, CD, GVHD, chemical/mechanical

And infectious

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5
Q

Sphagetti and meatball on histo

A

Candida-yeast and hyphe form

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6
Q

Punched out lesions of esophagus and multinucleated cells

A

Herpes esophagitis

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7
Q

Linear ulceration in esophagitis- and characteristic on histo

A

CMV effected cells with owls eye

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8
Q

Eosinophilic infiltration prox vs distal

A

Eosinophilic vs GERD

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9
Q

Replacement of Sq with columnar epi in eso

A

Barrets

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10
Q

Barrets key (3)

A

Intestinal metastasis
Associated with dysplasia
30-40 Risk of adenocarcinoma

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11
Q

Salmon colored distal eso

A

Barrets

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12
Q

Goblet cells in eso

A

Barrets-key

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13
Q

Eso cancers

  • papilloma
  • squamous dysplasia
  • adenocarcinoma
A

HPV
Squamous cell carcinoma-MCC worldwide
MCC US-Barrets (90%)

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14
Q

Gastric mucosa cells (3 layers)

A

Foveolar
Neck-where Stemcells are
Gastric-glands-chief and parietal cells

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15
Q

Congenital Stomach D/o

A

Pyloric stenosis-projectile vomit, Turner/trisomy 18, olive mass

Acute Gastritis-Noninfecitous (NSAD/ETOH/stress) vs infectious (CMV @IC-big cells with cherry red inclusion)
-see foveolar layer erosion of histo

Chornic Gastritis-H pylori vs Autoimmune vs distinctive

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16
Q

H pylori gastritis types

A

Antral-neutropilic infiltrate and associated with PUD (associated with H hylori)

Multifocal atrophic type-gastric adeno carcinoma, BCellLymphoma

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17
Q

H pylori micro

A 
Gm -
S shaped
Fecal oral or salivary
CagA and Vac A are toxins
Produce urease
Infect 60% of world
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18
Q

Silver stain and Giemsa stain

A

Detect H pylori

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19
Q

Intestinal metaplasia

A

See goblet cells in stomach

Progressess to dysplasia

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20
Q

Autoimmune gastritis

A

Destruction of parietal cells and chief cells via auto Ab (can be to specific B12/If/something else)
-no Acid-try to make neuroendocrine cells to overgrow-dysplasia then carcinoma

Associated with megaloblastic anemia (pernicious)-no IF cant absorb b12

Histo-lose glandular compartment-only have foveolar layer and neuroendocrine cell hyperplasia

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21
Q

Chemical gastritis

A

Mucosa trying to fix self (AKA reactive)

NSAID, Bile reflux

Histo-foveolar hyperplasia, decreased mucin, sM in lamina propria

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22
Q

Hypertrophic gastropathy

A

Hyperplasia of foveolar cells

Tons of mucin being created-lose lots of protein-malnutrition

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23
Q

PUD association (1) and 4 layers

A

H pyolri-clean ulcer!

Surface debris
Acute inflammation
Granulation tissue
Fibrosis

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24
Q

4 types of gastric polyps

A

Hyperplastic-local overgrowth of fovoar layer
-Meniteriers-whole diffuse foveolar layer overgrowth-no polyp
Inflammatory fibroid-inflammation
Hamartomous polyp-associated with genetics
-nL components of cells arranged in abnL way
Fundic gland-FAP association

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25
Gastric neoplasms (4)
Adenocarcinoma-h pyolri/chornic gastritis, irregular ulcer (not clean like peptic) Lymphoma-h. Pyolri Carcinoid-h. Pylori Sarcoma (GI stromal tumor)
26
Adenocarcinoma (2 types)
Intestinal type-glandular formation-intestinal metabplasia Infiltrative type-very poorly differentiated - SIGNET RING FEATURE-mucin in cells pushes nucleus to side - hereditary diffuse gastric cancer-young women in 30s-E cadherin mutation
27
MALT
Gastric lymphoma Associated with with H pylori See lymphoid follicles in mucosa that destroy gland
28
Gastrointestinal Stromal Tumor
C-kit mutations!!!! | Treated with Tyrosine kinase inhibitor (gleevec)
29
Carcinoid tumor
Hypochlorohydria and hypergastrinmia Associated with pernicious anemia and ZE syndrome Glandular pattern-cookie cutter of glands-multiple
30
Meckel diverticulum
Can see pancreatic and gastric tissue
31
5 types of intestinal obstruction + assocaiations
Intussusception-associated with rotavirus infection in peds Hernias Adhesions Volvulus Hirschbrungs-migration of NC to distal colon-strong associated with Downs
32
Ischemic bowel disease occurs @ | -two types
Watershed areas Mucosal (histo-surface has hemorrhage-deeper is good) to transmural (looks dark red vs nL pink)
33
Celiac disease 4 associations
Gluten insesntivity-intraepitheliual lymphocytes (T cells) Associated with dermatitis herpetiformis Flattened villi (villus blunting) and crypt hyperplasia T cell lymphoma!!!>rarely adenocarcinoma
34
Pseudomembranous colitis
Abx associated C. diff-makes C. Dif toxin which causes destruction (lyses cells) Gross-Yellow plaque in colon Histo-mushroom cloud
35
Whipples disease
Trpheryma whippeli effects macrophages Distended foamy macropahges-bacteria accumulate in macrophages - PAS-D + (shows bacteria)
36
IBD extraintestinal manifestations (3)
Migratory polyarthtis, Skin lesions, and PSC
37
CD vs UC
CD-ileum and colon, skip lesions, strictures, transluiral, non caseating granulomas, fistulas UC-colon only, diffuse, no strictures, limited to mucosa, no granulomas or fistulas
38
Diversion colitis
Make blind segment in bowel after surgery-undergoes inflammatory changes
39
Microscopic colitis
Asssociated with celiac and autoimmune disease Middle aged women with non bloody diarrhea No abnL on colonoscopy @bx-see collagenous collitis (collagen under epithelium) or lymphocytic
40
Polyps in intestine
Inflammatory-solitary rectal ulcer syndrome-see mucosal prolapse-looks like cancer-rectal bleed and mucosal discharge Hamartomatous-mature tissue, Peutz Jeguers-AD-STK11/LKB1 gene-multiple hamartaous polyps-associated with pancreas, breast, lung, etc tumors and muscles growing between glands Juvenile-children<5-if more than three its syndrome-BMPRA1/SMAD4 -gland dialated with inflammatory cells hyperplastic Neoplastic-different types of adenomas
41
Cowdens Syndrome
PTen gene mutation Many hamartanous polyps-many on skin and in GI
42
Cronkite Canada syndrome
Severe diarrhea-high mortality GI hamartamous polyps
43
intestinal adenomas
Tubular Villlous-look like colloid Serrated-hyperplastic and nuclear features of tubular
44
FAP
APC mutation-AD AKA gardners-osteomas, skin tumors, thyroid tumors AKA turcot syndrome (brain tumor) Can be attenuated<100 polyps
45
Lynch
4 genes for DNA repair | -microsatellite instability
46
Adenocarcinoma of colon
``` Many are sporadic 10% with familiarl thing APC/Beta Catenin pathway-APC, KRAS, P53 -associated with tubular adenoma MSI pathway-Lynch-MLH1, MSH2 - associated with serrrated adenoma ```
47
Anal canal
Adenomacarinoma-upper Basaloid-middle SCC-bottom-HPV
48
Appendices tumors
Carcinoid-MCC tumor-most are benign can mets to liver get carcinoid syndrome-salt and pepper chormatin pattern Adenomas, adenomacarcinoma Goblet cell carcinoid-have mucin differentiation and aggro Mucionous lesion-Pseudomyxoma peritoneii-common in appendix/ovary-mucous in entire cavity-mucocele is begning lesion
49
Pediatric liver disease (2)
Neonatal hepatitis-very large hepatocytes with many nuclei Billary atresia-lose segment of billary tree - ductular proliferation in liver-trying to regenerate
50
Acute fatty liver of pregnancy
No steatohepatitis
51
Cholesterol gallstones
Yellow | Native and Mexicans
52
Pigmented stones
Most common world wide Associated with sickle cells or chornic hemolytic anemia
53
3 types of cholescystitis
Acute Aclaclulus-ICU pts Chornic-MCC
54
Porcelain gallbladder
Dystrophic calcification of GB | -can progress to carcinoma
55
RF for extrahepatic carcinoma
Osbtructive Maurice, PSC, liver flukes
56
Acute pancreatitis RF
Obstruction, ETOH, drugs, hyperCa2+ (renal failure pt) Histo-see lots of necrosis
57
Chornic pancreatitis RF Gross Histo
ETOH, gallstones, cystic fibrosis, autoimmune PRSS1 trypinsogen gene mutation-hereditary Loss normal texture of pancreas and get fibrosis Acinus are gone-just see fibrotic tissue-islets stay (endocrine cells) stay longest-eventually become pseudocyst (no epithelial lining)
58
Pancreatic tumors
Ductal adenocarcinoma-high grade-PERINEURAL INVASION Cystic-low grade -serous-has glycogen in clear cells -Mucinous-Female, ovarian type stroma around cyst -Intraductal papillary mucinous tumor-boarderline to mucinous Solid pseudopapillary tumors-young female-papillary without vascular core-cells die and leave a space-resulting in papillary like structure Acinar tumor-high lipase and mets early-Neuroendocrine Pancreaticoblastoma-peds
59
Hairy Leukoplakia
Associated with HIV
60
Cancer in oral cavity
Squamous cell carcinoma
61
Sinonasal papilloma Nasopharyngeal carcinoma
Grows inward Associated with HVP6 and 11 Associated with EBV
62
Salivary gland tumors
Pleomorphic (epi and myo components or even bone) Warthin tumor-papillary tumor with cystic changes and lots of lymphoid tissue
63
Primary vs secondary iron overload
Primary-HFE gene-see iron in hepatocytes Secondary-hemolysis-see iron in Kuppfer cells (macrophages)
64
Limiting plate
Hepatocytes surrounding portal tract | -determine active hepatitis if limiting plate disruption
65
Canal of hering
Half hepatocytes-produce bile Half cholangiocytes.... Stem cell part of liver-prox billary tree
66
PKD (2 general types then 2 then 3)
AR-Caroli's disease-dilatation of small bile ducts in liver - -Choledochodal cyst of bilary tree - -congenital hepatic fibrosis-noncirrhotic portal hypertension PKD1 and PKD2-bile duct hamartoma All related to billary tree
67
General categories of hepatitis (4)
Viral Drug Autoimmune Steatohepatitis-ETOH or nonETOH
68
ETOH liver disease-3 stages
Micro or macro steatosis Then goes to ETOH hepatitis-inflammation and fibrosis Then cirrhosis
69
ETOH hepatitis histo findings (3)
Neutrophils Hepatocyte ballooning (and non ETOH too) Mallory bodies (and non ETOH too)-but much more in ETOH -degernated cytokeratin
70
NALFD-steps
Obesity and DM Steatosis-nL transaminiases, slow sinulsoidal fibrosis (around central vein) Then see steatohepatitis-ballooning (accumulation of water), Mallory bodies, more rapid fibrosis NASH-non alcoholic steatohepatitis
71
Where does fibrosis occur in fatty liver disease and what stain
Along along sinusoids starting form central vein Tricrhome stain
72
Which is only DNA virus that is hepatotropic
B-which gives it mechanism for chornicity
73
Viral hepatitis that is no (4)98
EBV, CMV, herpes Children-adenovirus
74
Fulminant hepatitis is caused most likely by (2)
HBV then HBA
75
How do people get chornic infection of hep B
Usually cleared But perinatally is not
76
HBV carrier state histo
Ground glass hepatocytes-accumulation of HepB surface Ag
77
HEP C uniqueness for RNA virus And prevention And associations
Can establish chornic infection No vaccine Liver cancer and B cell lymphoma
78
Criggler Najjar
Incompatible with life
79
Gilbert syndrome
Totally benign jaundice that occurs at stress
80
Dublin Johnson syndrome
No effect-but liver is black
81
PBC - epi - test - histo - hits where - leads to?
F>M-50yo Antimitochonrdrial Ab (AMA) Florid duct lesion on histo-looks granulomatous Hits small and medium bile ducts Eventually cirrhosis
82
PSC - epi - association - histo
Male to female-45yo UC Periductular fibrosis-looks like if it is strangling bile duct ---ONION SKINNING
83
Hereditary hemochormatiis - gene - stain
HFE gene-position 282 on chormasome 6-Cystine to Tyrosine Prussiian blue stain
84
Wilson's disease - gene - disease problem
ATP7B on chormasome 13-defect in Cu secretion into bile Get hepatic failure and eye and psychosis
85
Alpha 1 antitrypsin def - allele - effects on organs - stain
Homozyous Z allele Second most common protein in blood Protects lung-emphysema Can not be secreted-makes polymer in hepatocytes-liver disease PAS +-for polymers
86
Liver cell adenomas - epi - RF - complications (2)
F>M, child bearing age OC use and anabolic steroids Benign but can go to HCC, risk of bleeding
87
Focal nodular hyperplasia - RF - histo - complications
Anabolic steroid use Lots of fibrotic tissue-central scar Bengn
88
Hepatocellular carcinoma - RF - complciation - fibrolamellar carcinoma
Chornic liver disease Tendency to invade BV-mets Related to genetics-specific kind of HCC-young pts, no RFs-histo-tumor cells floating In sea of fibrosis
89
Hepatoblastoma mutation
Beta catenin
90
Where does cholangiocaricnoma mets to
Liver and lungs
91
Most common ori]gins of mets disease to liver And where does it mets to
Breast, lung, melanoma (esp eye) Goes to colon and breast

GI M2 (2 decks)

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