Path Exam Flashcards
plummer vinson syndrome involves iron deficient anemia, glossitis, and cheilosis (cracking at corners of the mouth) as well as what GI problem
esophageal webs
which esophageal problem can occur secondary to chagas disease (infection by trypanosome cruzi)
achalasia
while alcoholic cirrhosis is most often the cause of portal HTN that leads to esophageal varices in the western world, what can cause this complication elsewhere
schistosomiasis
cancer that results after chronic GERD –> Barrett esophagus –>
adenocarcinoma of the lower 1/3 esophagus
what is mutated in adenocarcinoma of the esophagus
p16 and Rb
what kind of cancer is likely in the upper 2/3 of the esophagus
squamous cell carcinoma
what is this patient at risk for? black man over 45 who uses alcohol, tobacco, hot liquids, achalasia, and from iran or central china or hong kong
squamous cell carcinoma: esophagus
these ulcers are likely to perforate and they occur in patients with intracranial disease which increases vagus firing –> increase acid release in stomach (esophagus, gastric, or duodenal)
cushing ulcer
these ulcers are found in proximal duodenum and are associated with burns and trauma
curling ulcer
most common cause of chronic gastritis
h pylori
this type of gastritis typically spares the antrum and involves excess gastrin production and loss of rugal folds
autoimmune gastritis
whats the major consequence of autoimmune chronic gastritis (and the reason these patients come to see doc)
impaired intrinsic factor production –> no b12 gets absorbed –> pernicious (macrocytic) anemia
foveolar cell hyperplasia that causes protein losing enteropathy (hypoproteinemia) after TGFalpha is overexpressed
menetrier disease
most gastric cancer is adenocarcinoma and germ line mutations in what gene precede many cases
CDH1 (a cadherin- loss of cell adhesion leads to carcinoma)
diffuse gastric tumors often contain ___ cells which are cells with peripheral nucleus that was pushed aside by intracellular mucin vacuoles
signet ring cells
most common place for a lymphoma to metastasize (extra nodal location)
GI tract esp stomach
MALTomas typically have what genetic marker
11:18 translocation (promote B cell survival)
Usually associated with bulky hepatic metastesis, ___ involves ileal tumors which cause cutaneous flushing, bronchospasm, increased bowel motility, right sided cardiac valve thickening
Carcinoid syndrome
Most common GI mesenchymal tumor and where its found
GIST (GI stromal tumor), stomach
GIST has a high association with what condition
Neurofibromatosis type I
GIST arises from what cells
Cells of cajal
Gain of function mutation in cKIT or PDGFRA are associated with what clinical manifestation
GIST
Most common location for volvulus of bowel
Sigmoid colon
Cause of intussusception in children
Spontaneous
Cause of intussusception in adults
Tumor
Common cause for ischemic bowel disease at the splenic flexure (watershed area between SMA and IMA)
Atherosclerosis, AAA, hypercoagulability, embolism, vasculitis, cardiac failure, shock, dehydration, vasoconstrictive drugs
What MHC type is associated with celiac disease
HLA DQ 2 / 8
What kind of T cell is involved in celiac disease damage
CD8 (IL15)
We see flattened villi and elongated crypts in this disease
Celiac
IPEX syndrome is due to germline mutation in the ___ gene and it can lead to autoimmune driven diarrhea (autoimmune enteropathy)
FOXP3
What microorganism causes travelers. Diarrhea
Campylobacter jejuni (gram neg)
Extra intestinal manifestations of travelers diarrhea (campylobacter)
Reactive arthritis, erythema nodosum, guillain barre
Humans are the only reservoir for this bacteria which causes bloody diarrhea after invading the m cells
Shigellosis
Worry. About this infection in people traveling to india, mexico, philipines who present with dysentery followed by bacteremia, fever, abdominal pain
Typhoid fever (salmonella typhii)
This organism prefers. Ileum, appendix, R. Colon (can mimic appendicitis)
Yersinia
Cause of pseudomembranous colitis (after normal flora is eliminated by antibiotics)
C diff
Tropheryma whippelii causes __ to accumulate in small intestine villi lamina propria and lymph nodes in whipple disease
Foamy macrophages
Viral causes of gastroenteritis
Norovirus, rotavirus, adenovirus
Most common parasite to cause pathology in humans: causes microvilli brush border damage and malabsorption
Giardia lamblia
Skip lesions (sharply delineated areas with granular and inflamed serosa and adherent creeping mesenteric fat) are associted with what condition
Crohns disease
Aphthous ulcers are associated with which inflammatory bowel disease
Crohn disease
Extra intestinal manifestations of. Crohns disease and ulcerative collitis include (as if increased risk of colon adenocarccinoma isn’t enough):
Migratory polyarthritis, sacroiliitis, ankylosing spondylitis, uveitis, cholangitis, amyloidosis
Erythema nodosum- crohns only
This inflammatory bowel disease begins. In the rectum and advances retrograde to involve the entire colon
Ulcerative colitis
this abnormality often occurs where vasculature penetrates inner circular layer of muscularis propria at taeniae coli when there is increased intralumenal pressure
sigmoid diverticulitis
this rare autosomal dominant disorder involves hamartomatous (tumor like) polyps, mucocutaneous hperpigmentation, and often loss of function of the gene LKB/STK
peutz-jeghers syndrome
most common tumor of the appendix
benign carcinoid
in a damaged liver, stellate cells (which normally store ____) up regulate ___ genes to produce scar tissue
vitA, PDGFRbeta
what stimulates a stellate cell to begin the process of scar formation
TNF, IL1 (chronic inflammation), kupffer cell cytokines, toxins
histocompatibility complex associated with extra intestinal manifestation of IBD
HLA B 27
dermatologic extraintestinal manifestation of crohns disease
erythema nodosum
dermatologic extraintestinal manifestation of ulcerative collitis
pyodermic gangrenosum
Ground glass hepatocytes (swollen ER) indicates what
Hep B
Lymphoid aggregates or fully formed lymphoid follicles within hepatocytes indicates what
Chronic Hep C
