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Gastrointestinal > Pathology > Flashcards

Pathology Flashcards

1
Q

causes of primary and secodnary achalasia

A

primary - idiopathic
secondary - Chaga’s disease

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2
Q

features of Plummer-vinson syndrome

A

triad of dysphagia, iron deficiency and oesophageal webs
associated with increased risk of Squamous cell carcinoma
‘plummer DIES’

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3
Q

pathophyiiology changes in barretts oesophagus

A

metaplasia of nonkeratinised stratified squamous epithelium to intestinal non-cilliated columnar with goblet cells

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4
Q

how does burns cause gastric ulcers

A

‘curling ulcer’
burns -> hypovalaemia -> gastric ischaemia

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5
Q

how can a brain injury cause gastritis

A

‘cushing ulcer’
brain injury -> increased vagal tone -> increased Ach -> increased h production

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6
Q

where does h.pylori target initially

A

anstrum of stomach then spreads to the body of the stomach

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7
Q

what type of ulcer does Zollinger ellison syndrome cause

A

duodenal ulcer

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8
Q

bleeding from an ulcer on the lesser curvature of the stomach would be bleeidng from what artery?

A

left gastric artery

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9
Q

bleeding from an ulcer on the duodenum would be bleeding from what artery?

A

gastroduodenal artery

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10
Q

what landmark defines upper and lower GI bleeding

A

ligament treitz

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11
Q

what stain is used to detect faecal fat?

A

Sudan stain

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12
Q

what HLA antigens are associated with coeliac

A

HLA-DQ2 and HLA-DQ8

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13
Q

what antibodies are associated with coeliac

A

anti-tissue transglutaminase
anti-endomysial
anti-deamidated gliadin peptide

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14
Q

histology of coeliac disease

A

loss of villi
mucosal atrophy
crypt hyperplasia
intraepithelial lymphocytosis

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15
Q

fat soluble vitamins

A

A, D, E, K

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16
Q

features of whipples disease

A

‘PAS the Foamy Whipped cream in a CAN’
PAS positive
Foamy macrophages in intestinal lamina propria
Cardiac sx, Athralgias, Neurological sx

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17
Q

causative organism of whipples disease

A

tropheryma whipplei

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18
Q

microscopic pathology in crohns

A

non-caseating granulomas
lymphoid aggregates

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19
Q

composite of kidney stones in patients with crohn’s

A

calcium oxalate

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20
Q

microsopic pathology in ulcerative colitis

A

crypt abscesses / ulcers
bleeding
no granulomas

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21
Q

treatment for crohns vs uc

A

crohns: prednisolone, azathioprine for induction. inflixamab for remission

UC: 5-ASA, 6 mercaptopurine, inflixamab, colectomy

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22
Q

pathophysiology of meckels diverticulum

A

true diverticulum
persistence of the vitelline duct (omphalomesenteric)
may contain ectopic acid-secreting gastric mucosa and/or pancreatic tissue

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23
Q

diagnostic modality for meckels diverticulum

A

Tc-pertechnetate scan (meckels scan(

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24
Q

features of meckels diverticulum

A

rule of 2’s
2x more common in males
2 inches long
2 feet from the illiocaecal valve
2% of population
commonly presents in first 2 years of life
may have 2 types of epithelium (gastric / pancreatic)

25
Q

what mutation is associated with hirsprungs

A

RET mutation
(RET in rectum)

26
Q

most common location of volvulus in children and adults

A

children - midgut
older age - sigmoid
Midgut = minors
SIgmoid = seniors

27
Q

mutation in Familial denomatous polyposis (FAP)

A

APC gene on chromosome 5

28
Q

features of gardner syndrome

A

FAP + osseous tumours

29
Q

features of turcot syndrome

A

FAP or lynch syndrome + CNS tumours
(turcot = tuban)

30
Q

what is puertz-jeghers syndrome

A

autosomal dominannt syndrome featuring numerous hamartomatous polyps throughout GI tract + hyperpigmented macules on mouth, lips genitals, hand

increased risk of breast and GI cancer

31
Q

mutation associated with lynch syndrome

A

(HNPCC)
autosomal dominant mutation of mismatch repair genes (e.g. MLH1, MSH2) + microsatellite instability

32
Q

cancers associated with lynch syndrome (HNPCC)

A

colon
endometrial
ovarian
skin
(CEO’S)

33
Q

tumour marker for colon cancer

A

CEA

34
Q

feature on barium enema of colon cancer

A

apple core lesion

35
Q

what are the 2 main molecular pathogenesis pathways for colorectal cancer

A
  1. chromosomal instability (FAP and most sporadic - left sided)
  2. microsatellite instability through mutation or mutililation of mismatch repair genes (HNPCC and some sporadic - right sided)
36
Q

how to detect portal hypertension in a patient with ascites

A

serum ascites albumin gradient
(SAAG)
if >1.1 = portal hypertension
if < 1.1 = other causes

37
Q

common causative organisms of spontaneous bacterial peritonitis

A

gram negatives
klebsiella
e.coli

38
Q

neutrophil count diagnostic for SBP

A

neutrophils > 250 cells/mm3

39
Q

what is reyes syndrome

A

childhood hepatic encephalopathy
associated with viral infections that have been treated with aspirin
(aspirin metabolites decrease beta-oxidation by reversible inhibition of mitochondrial enzymes)

40
Q

features of reyes syndrome

A

salicylates arent a REYE of sunSHINEE
Steatosis
hypoglycaemia / hepatomegaly
infection
not awake (coma)
encephalopathy and diffuse cerebral oedema

41
Q

what condition are mallory bodies found in

A

alcoholic hepatitis
(intracytoplastic eosinophillic inclusion of damaged keratin filaments)

42
Q

genetic mutation associated with wilsons disease

A

autosomal recessive mutation in copper transporting ATPase
(ATP7B gene on chromsome 13)

43
Q

genetic mutation associated with haemochromatosis

A

autosomal recessive mutation of HFE gene on chromosome 6

44
Q

what is zolinger-ellison syndrome

A

excessive gastrin secretion from a pancreatic or duodenal tumour
increased gastrin levels, reduced gastric pH
refractory peptic ulcers
may be asociated with MEN 1

45
Q

what condition may be associated with zollinger-ellison syndrome?

A

MEN 1

46
Q

features of eosinophillic oesophagitis on endoscopy

A

rings and linear furrows

47
Q

what can cause a false rise in calprotectin

A

NSAIDS

48
Q

what is the enzyme affected in gilberts syndrome

A

UDP-glucoronosyltransferase

49
Q

what chaemotherapy regimens are used in colon cancer

A

FOLFOX or FOLFIRI

50
Q

what type of bacteria is h.pylori

A

gram negative, oxidase positive, catalse positive, comma shaped rods

51
Q

extra collagen and extracellular matrix deposition in periportal and pericentral zones leading to formation of regenerative nodules

A

liver cirrhosis

52
Q

monocuclear infiltration of liver lobules with hepatocyte necrosis and kupffer cell hyperplasia

A

viral hepatitis

53
Q

macrovesicular fatty change with giant mitochondria, spotty change and fibrosis

A

alcoholic hepatitis

54
Q

dense lymphoid infiltrates of hepatic portal tracts with chronic inflammation and hepatocyte necrosis

A

primary biliary sclerosis

55
Q

triglyceride accumulation with the proliferation of myofibroblasts

A

non-alcoholic fatty liver disease

56
Q

what type of bacteria is c.dff

A

gram positive anaerobic bacilli

57
Q

UC and Crohns - Th1 or Th2 mediated?

A

crohns Th1
UC Th2

58
Q

what electrolyte abnormalities occur in refeeding syndrome

A

low mg, phosphate and k

Gastrointestinal (21 decks)

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