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First Aid Gastrointestinal > Pathology 2 > Flashcards

Pathology 2 Flashcards

1
Q

Autosomal Dominant mutation of APC gene on Chromosome 5q. 2-hit hypothesis

A

Familial adenomatous polyposis

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2
Q

Thousands of polyps arise at a young age; pancolonic

A

Familial adenomatous polyposis

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3
Q

FAP + osseous and soft tissue tumors, congenital hypertrophy of retinal pigment epithelium

A

Gardner Syndrome

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4
Q

FAP + malignant CNS tumor

A

Turcot Syndrome

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5
Q

Hereditary nonpolyposis colorectal cancer molecular pathway

A

Autosomal Dominant mutation of DNA mismatch repair genes (microsatellite instability pathway)

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6
Q

Apple Core Lesion

A

Colorectal Cancer

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7
Q

Iron deficiency Anemia in Males

A

Colorectal cancer is of high suspicion

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8
Q

CEA tumor marker

A

Good for monitoring recurrence not screening for colorectal cancer

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9
Q

Molecular Pathway causing Sporadic colorectal cancer

A

APC/beta-catenin (chromosomal instability)

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10
Q

Pathway of CRC pathogenesis

A

normal colon, (loss of APC) colon at risk, (kRAS mutation) adenoma, (loss of p53 of DCC) increases tumorigenesis so carcinoma

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11
Q

Stellate cell

A

causes fibrosis of the liver

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12
Q

Effects of portal HTN

A

esophageal varices (hematoemesis), peptic ulcer, melena, splenomegaly, caput medusa, ascites, gastropathy, anorectal varices

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13
Q

Effects of Liver Cell Failure

A

Hepatic encephalopathy, scleral icterus, fetor hepaticus (musty breath), spider nevi, gynecomastia, jaundice, testicular atrophy, asterixis (hand tremor), bleeds, anemia, ankle edema

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14
Q

Alkaline Phosphatase (ALP)

A

obstructive hepatobilliary disease, HCC, bone disease

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15
Q

ALT > AST

A

Viral hepatitis

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16
Q

AST > ALT

A

Alcohol hepatitis

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17
Q

Amylase

A

Acute Pancreatitis & Mumps

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18
Q

Ceruloplasmin

A

decreased in Wilson Dx

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19
Q

gamma -glutamiyl transpeptidase(GGT)

A

Increased in liver and biliary disease, associated with alcohol

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20
Q

Lipase

A

Acute Pancreatitis (most specific)

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21
Q

Marker of infection, first to increase when HBV resolves, this goes away. If not it is chronic HBV

A

HBsAg

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22
Q

Marker is positive when a patient is infectious and can give HBV to another person

A

HBeAg

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23
Q

Only Ab seen in the window phase of Hep B infection

A

IgM (HBcAb)

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24
Q

Ab in resolved phase of Hep B infection

A

IgG, also seen in chronic HBV

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25
Q

IgG if infection resolves, Sign you won the battle or were immunized to HBV

A

HBsAb

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26
Q

fecal-oral, acq by travelers, Acute hepatitis

A

Hepatitis A

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27
Q

contaminated food, undercooked seafood. PREGNANCY it is associated with fulminant hepatitis

A

Hepatitis E

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28
Q

Birth, Sex, IVDA, primarily acute hepatitis

A

Hepatitis B, Hepatitis C (acute becomes chronic)

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29
Q

Confirms Hepatitis C infection

A

HCV-RNA test

if RNA decreases the patient is recovering, if the patient ihas same RNA levels, it is chronic disease

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30
Q

Dependent on Hep B infection

A

Hepatitis D

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31
Q

HBV+HDV occuring at same time

A

coinfection, less severe

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32
Q

Acquiring HDV with pre-exisiting HepB

A

Superinfection, very severe

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33
Q

VZV or influenza B that has been treated with aspirin

A

Reye Syndrome

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34
Q

Symptoms you’ll see with Reye Syndrome

A

mitochondrial abnormalities, fatty liver, hypoglycemia, vomiting, hepatomegaly, coma

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35
Q

Reversible change with moderate alcohol intake. Macrovascular fatty change that may be reversible with alcohol cessation

A

Hepatic Steatosis

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36
Q

Mallory Bodies

A

Intracytoplasmic eosinophilic inclusions

Alcoholic Hepatitis

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37
Q

“hobnail” appearance

A

Alcoholic Cirrhosis

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38
Q

Sclerosis around central vein (Zone III)

A

Alcoholic cirrhosis

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39
Q

Cellular ballooning and evental necrosis of liver, associated with obesity

A

non-alcoholic fatty liver disease

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40
Q

post-TIPS complication

A

Hepatic encephalopathy

41
Q

Tx for Hepatic Encephalopathy

A

Lactulose (increased NH4+ generation), low-protein diet, and rifaximin (kills intestinal bacteria)

42
Q

Cancer Associated with HepB and C

A

Hepatocellular carcinoma/hepatoma

43
Q

Aflatoxin from Aspergillus

44
Q

Spread of HCC

A

hematogenously

45
Q

Diagnosis of HCC

A

increase AFP, US or contrast CT

46
Q

Liver tumor associated with OCP or anabolic steroid use

A

Hepatic Adenoma

47
Q

Malig. tumor of endothelial origin; associated with exposure to arsenic, vinyl chloride

A

Angiosarcoma

48
Q

Liver infarction secondary to hepatic vein or IVC obstruction

A

Budd-Chiari Syndrome

49
Q

Centrilobular congestion and necrosis from hepatic vein or IVC obstruction

A

Budd-Chiari Syndrome

50
Q

Alpha-1-antitrypsin deficiency

A

Liver: misfolded gene aggregating in hepatocyte ER
cirrhosis with PAS (+) globules in liver
Lung: leads to emphysema due to uninhibited elastase, panacinar emphysema

51
Q

Bilirubin >2.5mg/dL in blood

52
Q

Immature UDP-glucuronosyltransferase at birth

A

unconjugated hyperbilirubinermia, jaundice/kernicterus

physiologic neonatal jaundice

53
Q

Tx of Physiological Neonatal Jaundice

A

Phototherapy, converts unconjugated bilirubin to water-soluble form

54
Q

Increased UCB due to mildly decreased UDP-glucuronosyltransferase conjugation activity.

A

Gilbert Disease

55
Q

Bilirubin increases with fasting and stress

A

Gilbert Disease

56
Q

Absent UDP-glucuronosyltransferase, patients die with in a few years, kernicterus, increase UCB

A

Crigler-Najjar Syndrome type I

57
Q

Treatment of Crigler-Najjar Syndrome Type I

A

Plasmapheresis and phototherapy

if were less severe type II version (just need phenobarbital)

58
Q

Conjugated Hyperbilirubinemia due to defective liver excretion. GROSSLY BLACK LIVER

A

Dubin-Johnson Syndrome

59
Q

Milder case of conjugated hyperbilirubinemia without black liver

A

Rotor Syndrome

60
Q

Problem with bilirubin uptake causes hyperbilirubinemia

A

Gilbert Disease

61
Q

Problem with bilirubin conjugation cause unconjugated bilirubinemia

A

Crigler-Najjar

62
Q

Tx of Wilson Disease

A

Penicillamine or trientine

63
Q

Autosomal recessive inheritance on chr13, mut ATP7B

A

Wilson Disease

64
Q

decreased ceruloplasmin, cirrhosis, corneal deposits, copper accumulation

A

Wilson Disease

65
Q

Basal ganglia degeneration, asterixis, dementia, dyskinesia, dysarthria

A

Wilson Disease

66
Q

Kayser-Fleischer Ring

A

Wilson Disease

67
Q

Bronze Diabetes

A

Hematochromatosis

68
Q

Micronodular cirrhosis, diabetes mellitus, skin pigmentation

A

Hematochromatosis

69
Q

C282Y or H63D mutation on HFE gene

A

Primary hematochromatosis (autosomal recessive)

70
Q

Prussian Blue Stain

71
Q

Tx of hereditary hemochromatosis

A

repeated phlebotomy, deferasirox, deferoxamine

72
Q

Complication of hemochromatosis

A

CHF, testicular atrophy, increase risk of HCC

73
Q

Cause of secondary hemachromatosis

A

chronic transfusion, increased ferritin, increased iron, decrease in TIBC

74
Q

Onion Skin bile duct fibrosis causing beading of intra-and extrahepatic duct

A

Primary Sclerosing Cholangitis

75
Q

Hypergamaglobulinermia (IgM)

A

Primary Sclerosing Cholangitis

76
Q

~40y/o woman with increase serum mitochondrial antibodies, associated with autoimmune conditions

A

Primary biliary cirrhosis

77
Q

lymphocytic infiltrate and granulomas of Biliary

A

Primary Biliary cirrhosis

78
Q

Extrahepatic biliary obstruction

A

Secondary Biliary Cirrhosis

79
Q

Female, Fat, Fertile, Forty

A

Gallstones

80
Q

Black GB stone

A

radiopaque, hemolysis

81
Q

Brown GB stone

A

radiolucent, infection

82
Q

Neurohormonal activation triggering contraction of GB, forcing a stone into the cystic duct

A

Biliary colic

83
Q

Gallstone ileus

A

Gallstone onstructing ileocecal valve, waxing and waning RUG pain

84
Q

Diagnosis for gall stone

A

ultrasound

85
Q

Cholesterol GB stone

A

radiolucent, opaque if calcified, assoc with obesity, Crohn, CF, estrogen, rapid wt loss, Native American

86
Q

Rokitansky-Aschoff sinus formation

A

GB mucosa dives down into smooth muscle of GB wall. Vague RUQ pain

87
Q

(+) Murphy Sign

A

inspiratory arrest on RUQ palpation due to pain (Cholecystitis)

88
Q

Acute of Chronic inflammatio of GB

A

Cholecystitis

89
Q

Calcified GB due to chronic cholecystitis

A

Porcelain GB, high rates of GB carcinoma

90
Q

Autodigestion of pancreas by pancreatic enzymes

A

Acute Pancreatitis

91
Q

Causes of Acute Pancreatitis

A

GET SMASHED
gallstones, ethanol, trauma, steroids, mumps, autoimmune dx, scorpion sting, hypercalcemia, hyperTG (>1000mg/dL), ERCP, Drugs (sulfa)

92
Q

Increased Amylase and Lipase

A

Acute Pancreatitis

93
Q

Calcification of pancreas, caused by alcohol abuse and CF

A

Chronic Pancreatitis

94
Q

CA-19-9 tumor marker

A

Pancreatic adenocarcinoma

95
Q

Trousseau Syndrome

A

migratory thrombophlebitis, redness and tenderness on palpating extremities associated with Pancreatic adenocarcinoma

96
Q

Whipple Procedure

A

remove head and neck of pancreas, duodenum an dGB

helps tx pancreatic adenocarcinoma

97
Q

Risk Factors for Pancreatic Adenocarcinoma

A

Tobacco, Chronic pancreatitis, diabetes, >50y/o, jewish or black

98
Q

OP

First Aid Gastrointestinal (5 decks)

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