PATH CH 17 Flashcards
zenker diverticulum occurs
immediately above upper esophageal sphincter
traction diverticulum occurs
at esophageal mid- point
epiphernic diverticulum occurs
immediately above lower esophageal sphincter
Esophageal A rings
squamous epithelium above the gastroesophageal junction
Esophageal B rings
gastric cardia- type mucosa @ squamocolumnar junction
Achalasia triad
- incomplete relaxation of lower esophageal sphincter
- increased LES tone
- esophageal aperistalsis
Primary achalsia
failure of distal esophageal neurons to induce LES relaxation during swallowing
What disease can cause secondary achalasia
Chagas disease
longitudinal lacerations at gastroesophageal junction– associated with excessive vomitting
Mallory-Weiss tears
What virus causes punched out ulcers?
Herpes
What virus causes shallow ulceration
CMW
Barrett esophagus
complication of chronic GERD
change from squamous to columnar
esophageal varices – high portal hypertension induces collateral bypass channels between what circulations?
portal and caval
– congested veins in subepithelial and submucosal veins
What are the early changes that llead to adenocarcinoma from barretts esophagus?
chromosomal and p53 abnormalities
amplication and mutations of what genes occur in adenocarcinoma?
amplification: c-ERB-B2, cyclin D and E
mutation in Rb and p16/INK4a cyclin-dependent kinase inhibitor
What is the most common benign esophageal tumor?
leiomyomas
Why are NSAIDs harmful to the gastric mucosa?
- reduce bicarb production
2. interfers with PG action (inhibit acid production, promote mucin secretion, increase vascular perfusion)
ulcers induced by shock, sepsis, or severe trauma
stress ulcer
ulcers that occur in proximal duodenum, associated with burns or trauma
curling ulcers
gastric duodenal and esophageal ulcers in pt with intracranial disease
cushing ulcers
In gastric mucosal injuries, what is the single most important determinate of outcome?
the ability to correct the underlying condition
form of gastritis that spares the antrum, associated with hypergasterinemia
autoimmune gastritis
Intraluminal digestion
emulsification and initial ez breakdown
terminal digestion
hydrolysis with enterocyte brush border
What categories of diarrhea persists with fasting?
Secretory and Exudative
what categories of diarrhea abates with fasting?
osmotic and malabsorptive
What diarrhea is due to inflammatory disease?
exudative
what type of diarrhea is isotonic with plasma?
secretory
Mutation in microsomal triglyceride transfer protein causes what disorder?
abetalipoproteinemia
Autoimmune enteropathy is caused by
IPEX: mutations in FOXP3 gene
