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Maddy - GI II Exam I - some pharm > Path - Esophagus > Flashcards

Path - Esophagus Flashcards

1
Q

insidious (gradual) onset of dysphagia, odynophagia, or obstruction

A

esophageal squamous cell carcinoma

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2
Q

most common cause of esophagitis

A

GERD

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3
Q

where do most esophageal adenocarcinomas occur

A

distal 1/3 esophagus

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4
Q

loss of coordination of smooth muscle of inner circular layer and outer longitudinal layer

A

nutcracker esophagus

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5
Q

common causes of infectious esophagitis

A
  • Herpes simplex
  • Cytomegalovirus
  • candida/aspergillosis
  • mucormycosis (immunocompromised)
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6
Q

systemic diseases that cause secondary achalasia

A
  • chaga’s dz
  • diabetic autonomic neuropathy
  • lesions of dorsal motor nuclei
  • down’s
  • allgrove syndrome
  • HSV1
  • Sjogren’s
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7
Q

pt presents with dysphagia, pain with swallowing, progressive weight loss, hematemesis, chest pain, and vomiting

A

esophageal adenocarcinoma

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8
Q

histo: patches of red, velvety mucosa extending cephalad from the GE junction

A

barrett esophagus

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9
Q

early mutations in TP53, CDKN2A (p16/INK4a)

A

esophageal adenocarcinoma

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10
Q

SOX2 amplification

A

esophageal squamous cell carcinoma

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11
Q

repetitive, simultaneous contractions of distal esophageal smooth m. causing chest pain when swallowing cold food

A

diffuse esophageal spasm

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12
Q

what can decrease your risk fo esophageal adenocarcinoma

A
  • diet rich in fruits and vegetables

- some serotypes of H. pylori (they cause gastric atrophy leading to reduced acid secretion and reflux)

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13
Q

demographic for esophageal adenocarcinoma

A

caucasian, males (7x more than females)

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14
Q

achalasia due to destruction of esophagus myenteric plexus due to systemic dz

A

secondary achalasia

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15
Q

sx of barrett esophagus

A

heartburn, regurg, dysphagia

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16
Q

compare spread in the lymphatic network between cancers in upper esophagus, middle esophagus, and lower esophagus

A

upper 1/3: cervical LNs

middle 1/3: mediastinal, paratracheal, and tracheobrochial LNs

lower 2/3: gastric and celiac LNs

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17
Q

histo: punched out ulcers w/ viral inclusinos and rim of epithelial cells

A

HSV

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18
Q

salmon colored mucosa

A

barrett esophagus

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19
Q

high amplitude contractions of distal esophagus

A

nutcracker esophagus

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20
Q

greatest concern for barrett esophagus

A

increased risk of esophageal adenocarcinoma

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21
Q

histo: large numbers of intraepithlial eosinophils superficially

A

eosinophilic esophagitis

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22
Q

intestinal metaplasia within the esophageal squamous mucosa

A

barrett esophagus

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23
Q

decreased LES tone and increased abd pressure can cause _____

A

GERD

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24
Q

narrowing of esophageal lumen from fibrous thickening of the submucosa

A

benign esophageal stenosis

25
Q

compare A and B esophageal rings

A

A: present in distal esophagus above GE junction, covered w/ squamous mucosa

B: located at the squamocolumnar junction of lower esophagus, covered w/ gastric cardia mucosa

26
Q

will PPIs help with eosinophilic esophagitis?

A

nope - acid reflux is not a prominent sx

27
Q

demographic for esophageal squamous cell carcinoma

A

pts older than 45, males 4:1, 8x increase in african americans

  • increased incidence in iran, central china, hong kong, brazil, south africa
28
Q

transmural tearing and rupture of distal esophagus leading to mediastinitis, tachypnea, and shock

A

boerhaave syndrome

29
Q

sphincter abnormality in the absence of altered contraction patterns

A

hypertensive lower esophageal sphincter

30
Q

histo: basal epithelial apoptosis with mucosal atrophy and submucosal fibrosis

A

graft vs host disease

31
Q

pts where diet is subconsciously altered to soft food and liquid which attributes to nutritional deficiency and weight loss

A

esophageal squamous cell carcinoma

32
Q

describe venous blood flow from the GI tract

A

venous blood from GI tract –> portal vein in liver –> returns to the heart

33
Q

in situ gray-white plaque in esophagus

A

esophageal squamous cell carcinoma

34
Q

esophagitis associated w/ atopic dermatitis, allergic rhinitis, asthma

A

eosinophilic esophagitis

35
Q

idiopathic ledge-like protrusions of mucosa that may cause obstruction

A

esophageal mucosal webs

36
Q

pathogenesis of esophageal varices

A

portal hypertension –> development of collateral channels at sites where portal and caval systems communicate –> develops congested subepithelial and submucosal venous plexi in distal esophagus and proximal stomach (varices)

37
Q

prognosis of esophageal varices

A
  • 30% w/ variceal hemorrhage due

- >50% who survive first variceal bleed have recurrent hemorrhage within 1 year –> 30% mortality

38
Q

sx of achalasia

A
  • dysphagia
  • difficulty belching
  • chest pain
39
Q

incomplete lower esophageal sphincter relaxation, increased lower esophageal sphincter tone, aperistalsis of esophagus

A

achalasia

40
Q

achalasia due to distal esophageal ganglion cell degeneration

A

primary achalasia

41
Q

normal esophageal stratified squamous epithelium that becomes columnar epithelium

A

barrett esophagus

42
Q

clinical presentation of esophageal varices

A

clinically silent until rupture w/ catastrophic hematemesis

43
Q

risk factors for esophageal squamous cell carcinoma

A
  • alcohol and tobacco synergy
  • esophageal injury
  • achalasia
  • plummer-vinson syndrome
  • scalding hot beverages
  • tylosis
44
Q

stratified squamous epithelium damage leading to dysphagia and pain +/- hemorrhage leading to odynophagia

A

chemical and infectious esophagitis

45
Q

diverticulum immediately above upper esophageal sphincter that develops after age 50

A

Zenker diverticulum

46
Q

mucosal injury due to reflux of gastric juices

A

GERD

47
Q

where do most esophageal squamous cell carcinomas occur

A

middle 3rd of esophagus

48
Q

histo: shallow ulceration with nuclear and cytoplasmic inclusions

A

CMV

49
Q

TP53, E-cadherin, NOTCH1 loss of function

A

esophageal squamous cell carcinoma

50
Q

histo: grey-white psudomembranes of hyphae and inflammatory cells

A

candidiasis

51
Q

metaplastic mucosa alternating b/w smooth, pale, squamous mucosa and light-brown columnar mucosa

A

barrett esophagus

52
Q

risk factors for esophageal adenocarcinoma

A
  • tobacco use

- radiation

53
Q

crunching sound upon auscultation of heart

A

boerhaave syndrome

54
Q

most esophageal adenocarcinomas arise from _____

A

barrett esophagus or obesity related GERD

55
Q

late mutatinos in EGFR, ERBB2, MET, cyclin D1, cyclin E

A

esophageal adenocarcinoma

56
Q

distention of venous vessels in the esophagus

A

esophageal varices

57
Q

circumferential, thick protrusions of mucosa and submucosa in the esophagus

A

esophageal rings (Schatzki rings)

58
Q

budding, irregular shapes, and cellular crowding gland architecture

A

barrett esophagus

59
Q

longitudinal laceration of mucosa near GE junction associated with severe vomiting secondary to alcohol intoxication

A

mallory-weiss tears

Maddy - GI II Exam I - some pharm (23 decks)

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