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GI/HEPATOBILIARY > PATHOLOGY > Flashcards

PATHOLOGY Flashcards

1
Q
  1. What are diverticula?
  2. What is the manifestation of diverticulitis?
  3. What is the characteristic histopathologic finding of diverticulosis?
A
  1. outpouchings of the colonic wall
  2. manifests with left lower quadrant abdominal pain and is usually caused by blockage of a diverticulum.
  3. focal areas of weakness in the muscularis propria.
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2
Q
  1. What are the features of Crohn’s disease?
  2. What is the clinical presentation of Crohn’s disease?
A
  1. IBD w/ transmural inflammation of the bowel wall and cobblestone mucosa, with skip lesions occurring anywhere along the digestive tract (mouth to anus).
  2. abdominal pain, fever, weight loss, diarrhea (bloody or nonbloody), fistulas, abscesses, and malabsorption.
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3
Q

Describe the features of hereditary hemochromatosis

A
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4
Q

What is the key histologic finding in coeliac disease?

A

villous blunting of small intestine
crypt hyperplasia
increased amount of lymphocytes

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5
Q

What are the pathogenesis of ascites?

A

cirrhotic leads to portal HTN + hypoalbuminemia
leads to increased hydrostatic pressure + decreased oncotic pressure
leads to increased lymph exudate

reduced aldosterone metabolism leads to activation of RAAS
leads to reduced renal blood flow + increased salt and water retention

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6
Q

What are the three forms of gastroenteritis caused by E. coli?

A

Enterotoxigenic = produces toxins which cause traveller’s diarrhea

Enterohemorrhagic = produces verotoxin destroys platelets and RBCS leading to hemolytic uremic syndrome

Enteroinvasive = causes active intestinal invasion/destruction causing traveller’s dysentery

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7
Q

Left sided colorectal carcinoma usually arises due to the…

A

adenoma-carcinoma sequence

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8
Q

What are the liver enzyme levels associated with alcoholic hepatitis?

A

elevated ALT and AST
ALT will be less than AST, usually 2:1 ratio

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9
Q

Where is the most common site for intestinal obstruction? Why?

A

small intestine due to narrow lumen

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10
Q

What is the most common cause of intestinal obstruction of the small bowel?

A

adhesions due to mechanical constriction of the bowel

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11
Q

What is the difference between ileus and small bowel obstruction?

A

ileus is caused by hypomotility
SBO is caused by mechanical obstruction

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12
Q

What is the key feature of intussusception?

A

when segments of proximal bowel telescopes beneath more distal bowel segments

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13
Q

What is the pathogenesis of variceal bleeds?

A

Submucosal
* vulnerable to trauma
Higher pressure/flow
* bleed briskly
Veins: thin walled (weak)
* can’t do first stage of haemostasis : vasoconstriction
Insufficient platelets (splenomegaly, hypersplenism and deficient hepatic thrombopoeitin)
* Can’t do second stage of haemostais: platelet plug
Insufficient clotting factors (liver synthesis failure/ Vit K)
* Can’t do third stage of haemostasis: fibrin stabilization

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14
Q

What are the three manifestations of alcoholic liver disease?

A
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15
Q

______ syndrome presents with multiple gastric and duodenal ulcers, diarrhea, and epigastric pain.

A

Zollinger-Ellison syndrome presents with multiple gastric and duodenal ulcers, diarrhea, and epigastric pain.

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16
Q

Zollinger-Ellison syndrome is most frequently caused by _____ , a gastrin-secreting tumor that induces parietal cells in the stomach to secrete acid

A

pancreatic cancer

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17
Q

_____ disease is congenital megacolon caused by failure of neural crest cell migration, which leads to the congenital absence of Auerbach and Meissner plexuses

A

Hirschprung

18
Q

Acute right-upper-quadrant pain and jaundice and direct hyperbilirubinemia suggest an _____, most commonly due to _____ .

A

acute obstruction of the common bile duct

gallstones, or choledocholithiasis

19
Q

Wilson disease is due to a dysfunction in the _____ gene that codes for a copper transporter found primarily in the liver and to a lesser degree in the brain and kidney. The lack of transport causes ____ to accumulate within the liver and elsewhere in the body

A

ATP7B on chromosome 13

copper

20
Q

Patients with fatty malabsorption disease are at risk for the formation of _____ kidney stones.

A

calcium oxalate

21
Q

_____ is due to impaired inhibitory innervation within the esophageal myenteric plexus

A

distal esophageal spasm

22
Q

___ is the impaired relaxation of the lower esophageal sphincter

A

achalasi

23
Q

Cirrhosis is characterized pathologically by _____ Progression to fibrosis is mediated by persistent ____ cell activation.

A

regenerative nodules with thick, collagenous septae.

stellate

24
Q

Painless rectal bleeding in a young child may be due to a ______ .

A

Meckel diverticulum

25
Q

What is the mechanism of action of PPI?

A

prazoles
irreversibly inhibits H+/K+ ATPase on parietal cells

26
Q

When does anti-Hep B surface antigen (anti-HBsAg) immunoglobulin appear?

A

after successful HBV vaccination or infection clearance

27
Q

Pernicious anemia is characterized by the loss of what?

A

loss of parietal cell mass
leads to decreased HCl secretion + increased gastric pH

28
Q

How can achalasia be treated?

A

injection of botulinum toxin into LES< causing relaxation by blocking cholinergic transmission

29
Q

What is the pathogenesis of Reye syndrome?

A

Aspirin use in children
mitochondrial toxicity leads to impaired fatty acid metabolism
fat deposits in the liver
leads to hepatic dysfunction and diffuse astrocyte (CNS) swelling

30
Q

What is the mechanism of action of histamine H2 receptor blockers?

A

used for reflux
cimetidine
reversible block of H2 receptors leads to decreased H+ secretion by parietal cells

31
Q

What is the side effects of H2 receptor blockers?

A

inhibits CYP450
antiandrogenic
can cross BBB (CNS symptoms)

32
Q

What is the mechanism of action of misoprostol?

A

analog for PGE1, increases production of mucous + decreases acid production
contraindicated in pregnancy/women of childbearing age

33
Q

What are the two primary areas involved in control of nausea and vomiting?

A

vomiting centre = medulla oblangata
- physical act of vomiting

chemoreceptor trigger zone (CTZ) = area postrema of the brainstem
- lies outside of BBB
- sensitive to circulating substances for emesis

34
Q

What are the peripheral pathways involved in vomiting?

A

GI irritation/distension –> release of serotonin by enterochromaffin cells activates 5-HT3 on vagus nerves to activate vomiting centre

vestibular system –> involves H1 and M1 receptors through CNVIII

35
Q

What are the central pathways involved in vomitnig?

A

drugs + toxins activate CTZ directly = stimulates D2, 50HT3 and NK1 receptors

36
Q

What is the most common type of gastric cancer?

A

gastric adenocarcinoma
lymphoma
GI stromal

37
Q

What are the symptoms of gastric cancer?

A

presents late with weight loss, early satiety, abdominal pain, obstruction

38
Q

What is intussusception>?

A

telescoping of a proximal bowel segment into a distal segment
usually seen in children due to meckel diverticulum

39
Q

Portal hypertension is characterized by:

A

increased pressure in portal venous system

40
Q

What is the pathogenesis of acute pancreatitis?

A

autodigestion of pancreas by pancreatic enzymes (trypsin, etc)

GI/HEPATOBILIARY (3 decks)

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