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Lecom PBL OMS-1 S2 Test 1 > patho: esophagus, stomach, small intestine and colon (case 1, 2, 4) > Flashcards

patho: esophagus, stomach, small intestine and colon (case 1, 2, 4) Flashcards

1
Q

when is the esophagus recognizable in development

A

3rd week of gestation

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2
Q

what describes patients with high amplitude contractions of the distal esophagus that are, in part, due to loss of the normal coordination of inner circular layer and outer longitudinal layer smooth muscle contractions

A

nutcracker esophagus

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3
Q

where is zener diverticulum located

A

immediately above the upper esophageal sphincter

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4
Q

what is mechanical obstruction caused by

A

cancers or strictures

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5
Q

what is benign esophageal stenosis generally caused by

A

fibrous thickening of the submucosa

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6
Q

what is the term for idiopathic ledge-like protrusions of mucosa that may cause obstruction

A

esophageal mucosal webs

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7
Q

if esophageal mucosal webs are accompanied by iron-deficiency anemia, glossitis, and cheilosis it is called ______

A

paterson-brown-kelly or plummer-vinson syndrome

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8
Q

what is the main symptoms with esophageal mucosal webs

A

non progressive dysphagia associated with incompletely chewed food

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9
Q

what triad is achalasia characterized by

A

incomplete LES relaxation, increased LES ton, and peristalsis of the esophagus

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10
Q

what does primary achalasia result from

A

distal esophageal inhibitory neuronal that is, ganglion cell, degeneration

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11
Q

what is the term for longitudinal mucosal tears near the gastroesophageal junction

A

mallory-weiss tears

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12
Q

what is boerhaave syndrome characterized by

A

transmural tearing and rupture of the distal esophagus

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13
Q

what is candidiasis in its most advanced form characterized by

A

adherent, gray-white pseudomembranes composed of densely matted fungal hyphae and inflammatory cells covering the esophageal mucosa

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14
Q

what type of ulcers does HSV typically cause

A

punched-out ulcers

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15
Q

what type of ulcers does CMV typically cause

A

shallower ulcerations and characteristic nuclear and cytoplasmic inclusions within capillary endothelium and stroll cells

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16
Q

what is the most common cause of gastroesophageal reflux

A

transient lower esophageal sphincter relaxation

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17
Q

what are the most common symptoms associated with GERD

A

heartburn, dysphagia, and regurgitation of sour-tasting gastric contents

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18
Q

what is hiatal hernia characterized by

A

separation of the diaphragmatic crura and the protrusion of the stomach into the thorax through the resulting gap

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19
Q

what is the cardinal histological feature of eosinophilic esophagitis

A

large number of intraepithelial eosinophils

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20
Q

what is the second most common cause of varices worldwide

A

hepatic schistomiasis

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21
Q

benign tumors of the esophagus are generally ______

A

mesenchymal

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22
Q

what do most esophageal adenocarcinomas arise from

A

barrett esophagus

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23
Q

where does esophageal adenocarcinoma usually occur

A

in the distal third of the esophagus

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24
Q

what is the majority of esophageal squamous cell carcinomas in europe and the USA linked to

A

the use of alcohol and tobacco

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25
Q

where do half to the squamous cell carcinomas occur

A

in the middle 1/3 of the esophagus

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26
Q

what do early lesions of squamous cell carcinoma present as

A

appear as small. gray-white, plaque-like thickenings

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27
Q

where do squamous cell carcinomas of the upper 1/3 of the esophagus favor

A

cervical lymph nodes

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28
Q

where do squamous cell carcinomas of the middle 1/3 of the esophagus favor

A

mediastinal, paratracheal and tracheobronchial nodes

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29
Q

where do squamous cell carcinomas of the lower 1/3 of the esophagus favor

A

gastric and celiac nodes

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30
Q

what is a stomach lesion with neutrophils present called

A

acute gastritis

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31
Q

what is a stomach lesions where inflammatory cells are rare or absent called

A

gastropathy

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32
Q

what is the pH of the gastric lumen

A

close to 1

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33
Q

how often does complete replacement of the surface foveolar cells occur

A

every 3-7 days

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34
Q

what is the term for concurrent erosion and hemorrhage

A

acute erosive hemorrhagic gastritis

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35
Q

who are stress ulcers most common in

A

individuals with shock, sepsis or severe trauma

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36
Q

what is the term for ulcers occurring in the proximal duodenum and associated with severe burns or trauma

A

curling ulcers

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37
Q

what is the term for gastric, duodenal, and esophageal ulcers arising in persons with intracranial disease (and carry a high incidence of perforation)

A

cushing ulcers

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38
Q

the pathogenesis of stress-related gastric mucosal injury is most often related to ______

A

local ischemia

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39
Q

what is dieulafoy lesions caused by

A

submucosal artery that does not branch properly within the wall of the stomach

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40
Q

where are dieulafoy lesions most commonly found

A

along the lesser curvature, near the gastroesophageal junction

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41
Q

how can GAVE be recognized endoscopically

A

as longitudinal stripes of edematous erythematous mucosa that alternate with less severely injured paler mucosa

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42
Q

what is another name for GAVE

A

watermelon stomach

43
Q

what is the most common cause of chronic gastritis

A

infection with H. pylori

44
Q

where in the stomach is H pylori most often found

A

antrum

45
Q

what does the inflammatory infiltrate with H. pylori usually contain

A

variable numbers of neutrophils within the lamina prpria

46
Q

what is autoimmune gastritis associated with the loss of

A

parietal cells

47
Q

what is considered to be the principle agent of injury in autoimmune gastritis

A

CD4+ T cells directed against parietal cell components

48
Q

what is autoimmune gastritis morphologically characterized by

A

diffuse mucosal damage of the oxyntic (acid-producing) mucosa within the body and fundus

49
Q

where does eosinophilic gastritis typically occur

A

in astral or pyloric region

50
Q

who does lymphocyte gastritis preferentially affect

A

women

51
Q

what is lymphocytic gastritis commonly associated with (disease)

A

celiac disease

52
Q

what does PUD generally develop on the background of

A

chronic gastritis

53
Q

where are peptic ulcers most common

A

proximal duodenum

54
Q

where are gastric peptic ulcers predominantly located

A

along the lesser curvature near the interface of the body and antrum

55
Q

what are heaped-up margins most characteristic of

A

cancers

56
Q

why do most peptic ulcers come to clinical attention

A

due to epigastric burning or aching pain

57
Q

when is the risk of adenobocarcinoma of the stomach highest

A

in autoimmune gastritis

58
Q

what is an exuberant reactive epithelial proliferation associated with entrapment of epithelial-lined cysts

A

gastritis cystica

59
Q

what are hypertrophic gastropathies characterized by

A

giant cerebriform enlargement of the rural folds due to epithelial hyperplasia without inflammation

60
Q

what is menetrier disease associated with

A

excessive secretion of transforming growth factor alpha

61
Q

what is menetrier disease characterized by

A

diffuse hyperplasia of the foveolar epithelium of the body and funds and hypoproteinemia due to protein-losing enteropathy

62
Q

what is zollinger-ellison syndrome caused by

A

gastrin-secreting tumors

63
Q

where are the gastronomas that are responsible for zollinger-ellison syndrome most commonly found

A

small intestine or pancreas

64
Q

where do funds gland polyps occur

A

in the gastric body and funds and are well-circumscribed lesions with a smooth surface

65
Q

where do gastric adenomas most commonly occur

A

antrum

66
Q

what is the most common malignancy of the stomach

A

adenocarcinoma

67
Q

familial gastric cancer is strongly associated with _____

A

germline loss of function mutation in the tumor suppressor gene CDH1

68
Q

what does CDH1 encode for

A

cell adhesion protein E-cadherin

69
Q

what are sporadic intestinal-type gastric cancers strongly associated with mutations that _____

A

mutations that result in increased signaling via want pathway

70
Q

what is another term for the leather bottle appearance

A

linitis plastica

71
Q

what is the mean age of presentation for intestinal-type gastric cancer

A

55 years

72
Q

where do extra nodal lymphomas most commonly arise

A

in the GI tract, particularly the stomach

73
Q

what do MALTomas express (which B markers)

A

CD19 and CD20

74
Q

what are the most common presenting features for MALTomas

A

dyspepsia and epigastric pain

75
Q

where do carcinoids typically appear in the stomach

A

arise within oxyntic mucosa

76
Q

what color are carcinoids generally

A

yellow or tan

77
Q

what do most GISTS have a mutation in

A

receptor for tyrosine kinase KIT

78
Q

how are GISTs composed of thin elongated cells classified as

A

spindle cell type

79
Q

what are GISTs dominated by epithelial-appearing cells termed

A

epithelia type

80
Q

what is the most useful diagnostic marker for GISTs

A

KIT

81
Q

what is the most frequent cause of intestinal obstruction worldwide

A

hernias

82
Q

what is the most common cause of intestinal obstruction in the USA

A

adhesions

83
Q

what is the most common cause of intestinal obstruction in children younger than 2 years of age

A

intussusception

84
Q

when does the initial hypoxic injury stage of response to ischemia occur

A

at the onset of vascular compromise

85
Q

what is the most common site of GI ischemia

A

colon

86
Q

what does acute colonic ischemia typically present with

A

sudden onset of cramping, left lower abdominal pain, a desire to defecate, and passage of blood or bloody diarrhea

87
Q

what is the most common acquired GI emergency in neonates

A

necrotizing enterocolitis

88
Q

what is the term for a lesion characterized by malformed submucosal and mucosal blood vessels

A

angiodysplasia

89
Q

what type of digestion is it when proteins, carbs, and fats are broken down into forms suitable for absorption

A

intraluminal digestion

90
Q

what type of digestion involves the hydrolysis of carbs and peptides by disaccharidases and peptidases in the brush border of the small intestinal mucosa

A

terminal digestion

91
Q

what type of diarrhea is characterized by isotonic stool and persists during fasting

A

secretory diarrhea

92
Q

what type of diarrhea occurs with lactase deficiency

A

osmotic diarrhea

93
Q

what types of diarrhea abate with fasting

A

osmotic and malabsorption

94
Q

what type of diarrhea is due to inflammatory disease and characterized by purulent, bloody stools that continue during fasting

A

exudative diarrhea

95
Q

what organ system does cystic fibrosis primarily effect

A

lungs

96
Q

what parts of the small intestine are exposed to the highest concentration of dietary gluten

A

second portion of the duodenum and proximal jejunum

97
Q

what is the histopathy of celiac disease characterized by

A

increased numbers of intraepithelial CD8+ T cells, crypt hyperplasia, and villous atrophy

98
Q

what is the most common celiac disease-associated cancer

A

enteropathy-associated T-cell lymphoma

99
Q

what is an X_linked disorder characterized by severe persistent diarrhea and autoimmune disease that occurs most often in young children

A

autoimmune enteropathy

100
Q

what is IPEX due to

A

gremlin mutation in the FOXP3 gene

101
Q

what is FOXP3 a transcription factor for

A

expressed on CD4+ regulatory T cells

102
Q

what is abetalipoproteinemia characterized by

A

inability to secrete triglyceride-rich lipoproteins

103
Q

what is abetalipoproteinemia caused by

A

mutation in MTP

Lecom PBL OMS-1 S2 Test 1 (9 decks)

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