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GI > Path: Esophagus & Stomach > Flashcards

Path: Esophagus & Stomach Flashcards

0
Q

What portions of the GI tract feature minor salivary glands?

A

The esophagus only.

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1
Q

What is a key difference between the fetal and mature esophagus?

A

The fetal esophagus is lined by ciliated columnar epithelium, whereas the mature esophagus is line by non-keratinized stratified squamous epithelium.

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2
Q

J: This is a developmental abnormality in the cervical esophagus in which a portion of the surface is comprised of various types of glandular mucosa.

A

What is an inlet patch?

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3
Q

What are some notable developmental structural abnormalities to the esophagus?

A

(1) atresia
(2) tracheoesophageal fistula
(3) duplication cyst

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4
Q

What is in the ddx of esophagitis?

A

(1) reflux
(2) allergy
(3) Crohn’s disease
(4) viral (CMV, herpes)
(5) trauma
(6) radiation
(7) pemphigus
(8) pemphigoid
(9) vasculitis
(10) fungal
(11) graft vs. host disease

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5
Q

How does reflux esophagitis appear on endoscopy?

A

Linear erythema with variable linear ulcers.

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6
Q

How does herpes esophagitis appear microscopically?

A

Punched-out ulcers with multinucleated squamous cells and intranuclear inclusions.

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7
Q

How does candida esophagitis appear on endoscopy?

A

White, cheesy plaques.

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8
Q

How does eosinophilic esophagitis appear on endoscopy?

A

(1) tiny, white papules

2) ringed esophagus (called felinization or trachealization

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9
Q

What are some skin disorders that present as esophagitis?

A

(1) pemphigus
(2) pemphigoid
(3) lichenoid reactions

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10
Q

What is a Schatzki ring?

A

A muscular ring covered by squamous epithelium. It is present in 10% of people and is a common cause of dysphagia.

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11
Q

What effect can scleroderma have on the esophagus?

A

Selective atrophy of the inner circular layer of smooth muscle, resulting in decreased motility and reflux.

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12
Q

What is an extreme consequence for the esophagus that could follow repeated wrenching vomiting?

A

A Mallory-Weiss tear, a tear of the distal esophagus resulting in massive hemorrhage.

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13
Q

What GI organ carries the greatest tumor burden?

A

The colon/rectum.

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14
Q

What is the most common malignant cancer of the esophagus?

A

World: squamous carcinoma
US: adenocarcinoma

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15
Q

What profile is most at risk for esophageal adenocarcinoma?

A

An obese male with a high-fat diet, acid reflux and a characteristic microbiome.

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16
Q

In a patient with Barrett’s esophagus, what could be measured to help determine the risk of cancer?

A

The length of the segment of the esophagus that has undergone metaplasia. (Note: this length is typically static.)

17
Q

What is TNM?

A

A three-pronged system for staging a cancer. T=tumor, N=lymph node, M=metastasis.

18
Q

What is a pertinent distinction between esophageal squamous carcinoma and cervical and anal squamous carcinoma?

A

HPV infection is not a prominent risk factor.

19
Q

What profile is most at risk for esophageal squamous carcinoma?

A

An alcoholic smoker that has achalasia and has ingested moldy foods and lye.

20
Q

What are the 2 noted benign lesions of the esophagus?

A

(1) squamous papilloma

(2) glycogenic acanthosis

21
Q

In what part of the stomach are enterochromaffin-like cells most prevalent?

A

The fundus.

22
Q

What is in the ddx for acute gastritis?

A

(1) alcohol
(2) severe stress
(3) shock
(4) radiation
(5) caustic agents (iron pill)
(6) NSAIDs

23
Q

What tests are available for H. pylori infection?

A

(1) biopsy with thiazine stain
(2) biopsy with CLOtest
(3) blood test for antibody
(4) breath test which is no longer used

1634823

24
Q

What is the hallmark of chronic gastritis?

A

Atrophy of the stomach through the loss of parietal and chief cells in the oxyntic mucosa.

25
Q

What is the typical target in autoimmune gastritis?

A

The H+/K+ ATPase pump on the lumenal surface of parietal cells.

26
Q

Describe how autoimmune gastritis can lead to carcinoids.

A

(1) pH increases.
(2) gastrin secretion increases.
(3) enterochromaffin-like cells proliferate into masses, carcinoids, that can be seen microscopically or on endoscopy.

27
Q

Why can autoimmune gastritis lead to bacterial overgrowth?

A

With decreased acid secretion, bacteria are better able to survive in the gastric lumen. Cancer may follow.

28
Q

What is a hematological consequence of autoimmune gastritis?

A

Pernicious anemia.

29
Q

What are the 2 primary causes of chronic gastritis?

A

(1) H. pylori

(2) autoimmune reaction

30
Q

What are the 2 main varieties of gastric polyps?

A

(1) fundic gland polyp

(2) hyperplastic polyp

31
Q

How do fundic gland polyps form?

A

Dilation of the glands formed by parietal and chief cells. No cell proliferation occurs.

32
Q

How do hyperplastic gastric polyps form?

A

As single or multiple growths of varying size, typically in the antrum, arising from an underlying gastritis.

33
Q

What are the 2 varieties of hypertrophic gastropathies?

A

(1) foveolar

(2) parietal

34
Q

What insult often precedes a gastric maltoma?

A

An H. pylori infection.

35
Q

What is a major worry with maltoma?

A

It could develop into large cell lymphoma.

36
Q

Describe the pathogenesis of intestinal type gastric cancer.

A

(1) repeated injury or chronic gastritis
(2) intestinal metaplasia
(3) dysplasia
(4) adenocarcinoma

37
Q

What is the etiology of signet cell gastric cancer?

A

Two mutations to E-cadherin. Does not arise from chronic gastritis.

38
Q

What profile has a higher risk of intestinal type gastric cancer?

A

An aging male with a diet high in nitroso compounds (processed meats) and low in vegetables and vitamin C.

39
Q

What is a common presentation of gastric cancer?

A

A non-healing ulcer.

40
Q

What other cancer is associated with signet cell gastric cancer?

A

Lobular carcinoma of the breast.

41
Q

From what cells are signet cells derived?

A

Mucin-secreting cells.

GI (39 decks)

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