Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

First Aid- Gastrointestinal > Pathology > Flashcards

Pathology Flashcards

1
Q

What are the three salivary gland tumors?

A

Benign and in the parotid gland

  1. Pleomorphic adenoma
  2. Warthin’s tumor
  3. Mucoepidermoid carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pleomorphic adenoma

A

MC
painless, mobile mass
cartilage and epithelium
recurs frequently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Warthin’s tumor

A

benign cystic tumor

germinal centers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mucoepidermoid carcinoma

A

MC malignant tumor
painful mass
Facial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Achalasia

A

Absence of relaxation of LES d/t loss of Auerbach’s (myenteric plexus)
progressive dyshpagia to solids and liquids
bird’s beak barium swallow
chagas
Scleroderma
SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

GERD

A

heartburn/regurge lying down
nocturnal cough and dyspnea
adult onset asthma
decrease in LES tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Esophageal varices

A

Portal HTN
lower 1/3 esophagus
painless bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Esophagitis

A

Reflux
Chemical ingestion
Infection (candida; white pseudomembrane, HSV-1, CMV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MW syndrome

A

Severe vomiting
laceration at GE jxn
alcoholics and bulemics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

BoerHaave Syndrome

A

Beeeeen heaving syndrome

violent retching–> x ray shows left sided effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Esophageal strictures (narrowing or tightening of the esophagus)

A

lye ingestion

acid reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Plummer Vinson Syndrome

A

TRIAD
dysphagia (esophageal webs)
glossitis
IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BArrett’s esophagus

A

Chronic GERD
metaplastic columnar epithelium w/ goblet cells
esophagitis, esophageal ulcers
Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Esophageal cancer

A

SCC (upper 2/3) or Adenocarcinoma (lower 1/3)
Progressive dysphagia, weight loss

RF: AABCDEFFGH
achalasia
alcohol- squamous
barretts- adeno
cigarettes
diverticula (zenkers)- squamous
esophageal web- squamous
familial
fat- adeno
gerd- adeno
hot liquids- squamous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the malabsorption syndromes?

A 
These Will Cause Devastating Absorption Problems
Tropical Sprue
Whipple's Disease
Celiac sprue
Disaccharide deficiency
Abetalipoproteinemia
Pancreatic Insufficiency

Diarrhea, steatorrhea, weight loss, weakness, vitamin and mineral def.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tropical sprue

A

Responds to antibiotics
like celiac sprue
can affect entire small bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

WHIPPle’s disease

A

FOAMY WHIPPed cream in a CAN

Tropheryma whipllei (gram +)
PAS-pos FOAMy mphages

CAN:
Cardiac sxs
Arthralgias
Neurologic Sxs

older men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Celiac sprue

A

Ab to gluten in wheat
distal duodenum and proximal jejunum
loss of vili

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Disaccharidase deficiency

A

Lactase deficiency> milk intolerance
Normal villi
Osmotic diarrhea

Lactose tolerance def if:
admin of lactose> sxs
glucose rises<20 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Abetalipoproteinemia

A

Decreased apo B > can’t generate cylomicrons > decreased secretion of cholesterol/VLDL into blood> fat accumulates in enterocytes

Early childhood:
malabsorption
neurologic manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pancreatic insufficiency

A

CF, obstructing cancer, chronic pancreatitis

Malabsorption of fat and vit A,D,E, K>

Increased fat in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Celiac Sprue

A

Ab to gluten> steatorrhea
HLA-DQ2, HLADQ8
Northern european descent

Blunted villi, decreased mucosal absorption in jejunum

Screen: serum levels of tissue transglutaminase Ab

Increased risk of malignancy: T cell lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Acute gastritis (erosive)

A

Stress/ALCOHOL/uremia/burns/NSAID (decreased PGE–> decreased protection)>
Disruption of mucosal barrier–> inflammation

BURNed by the CURLING iron–curling ulcer> decreased plasma volume> sloughing of gastric mucosa

Always CUSHion the brain> increased vagal stim> increased Ach> increased H prod.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Chronic gastritis: (nonerosive)

TYPE A and TYPE B

A

ABBA

Pernicious ANEMIA affects the gastric BODY (autoimmune destruction of parietal cells)

H. pyoria BACTERIUM affects the ANTRUM *MALT lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Menetrier’s disease

A 
Gastric hypertrophy (rugae) and parietal cell atrophy, increased mucus cells
protein loss

Precancerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Stomach cancer

A

Adenocarcinoma
Agressive local spread
node/liver metastases
Acanthosis nigricans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Intestinal Stomach cancer

A

Lesser curvature–> ulcer w/ RAISED MARGINS

H. Pylori, somked foods, chronic gastritis, achlorhydria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diffuse Stomach cancer

A

Signet ring cells

Thick and leathery stomach wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Virchow’s node

A

metasteses from stomach to left supraclavicular node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Krukenberg’s tumor

A

bilateral metastases to ovaries
abundant mucus
signet ring cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Sister Mary Joseph’s nodule

A

Subcutaneous periumbilical metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

GASTRIC ulcer

A 
Pain GREATER w/ meals> weight loss
H. Pylori in 70%
decreased mucosal protection against gastric acid
NSAIDS
Increased risk of carcinoma
older pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

DUODENAL ulcer

A 
pain DECREASES w/ meals> weight gain
h. pylori in 100%
decreased mucosal protection, increased acid secretion (ZE syndrome)
beign
Hypertrophy of Brunner's glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Ulcer complications

A
  1. Hemorrhage: lesser curvature of stomach> left gastric artery, ulcer on the posterior wall of the duodenum> bleeding from gastrodudenal artery
  2. Perforation: duodenal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Chrons Disease

A

For CHRONS think of a FAT GRANny and an old CRONE SKIPping down a COBBLESTONE road away from the WRECK (rectal sparing)

Intestinal bacteria
diarrhea may or may not be bloody
Creeping fat
noncaseating GRANulomas and lymphoid aggregates
SKIP lesions
COBBLESTONE mucosa
WRECKtal sparing

*STRINGSIGN lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Tx for Chrons

A 
corticosteroids
azathioprine
MTX
infliximab
adalimumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Ulcerative colitis

A

Autoimmune
Colon inflammation
“Lead pipe appearance” (loss of haustra)
Bloody diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How do you treat ulcerative colitis?

A

ASA preparations
6-mercaptopurine
infliximab
colectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Irritable bowel syndrome

A

Recurrent abdominal pain:
improves w/ defectation
change in stool frequency
change in stool appearance

Middle aged women
chronic sxs: diarrhea, constipation, alternating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Appendicities

A 
Obstruction by fecalith (adults)
lymphoid hyperplasia (children)

Diffuse periumbilical pain migrates to McBurney’s point

Nausea, fever, perforates–> peritonitis

Tx. appendectomy

Diff: diverticulitis (elderly), ectopic pregnancy (bhcg to rule otu)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

True diverticulum

A

3 gut wall layers outpouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

False diverticulum

A

mucosa and submucosa outpouch

occurs when vasa recta perforate the muscularis externa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Diverticulosis

A

Increased luminal pressure and weak colonic wall

hematochezia, asymptomatic

Tx- low fiber diets

sigmoid colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Diverticulitis

A

Inflammation of diverticula> LLQ pain, fever, leukocytosis
“left sided appendicitis”

Stool occult blood +/- hemotochezia

Tx: antibiotics

45
Q

Zenker’s Diverticulum

A

False diverticulum
herniation of mucosal tissue at Killian’s triangle between THYROPHARYNGEAL and CRICOPHARYNGEAL parts of the inferior pharyngeal constrictor

Halitosis (trapped food), dysphagia, obstruction

46
Q

Meckel’s Diverticulum

A

FIVE 2s:
2 inches long
2 feet from the ileocecal valve
2% of pop
First 2 years of life (MC congenital anomaly of GI tract)
2 types of epithelia (gastric/pancreatic)

True diverticulum
persistence of vitelline duct

Dx: pertechnetate study for ectopic uptake

47
Q

Intussusception

A 
Telescoping of 1 bowel segment into distal segment
illeocecal jxn
CURRANT JELLY stools
Children
Abdominal emergency
48
Q

Volvulus

A

Twisting of bowel around mesentery> obstruction and infarction
cecum and sigmoid colon (redundant mesentery)
elderly

49
Q

Hirschsprung’s disease

A

HirschSPRUNG’s is a giant spring that has SPRUNG in the colon

Down syndrome
chronic constipation early in life

Congenital megacolon, lack of enteric nervous plexuses (failure of NCC migration)

dx: renal suction biopsy and tx w/ resection

50
Q

Dudodenal atresia

A

bilious vomiting
proximal stomach distension> double bubble on xray

Failure of recanalization of small bowel

Down syndrome

51
Q

Meconium ileus

A

CF> meconium (earliest stool of an infant) plug obstructs intestine > prevents stool passage at birth

52
Q

Necrotizing enterocolitis

A

Necrosis of intestinal mucosa and perforation

most common in premies

53
Q

Ischemic colitis

A

Decreased intestinal blood flow> ischemia of distal colon and splenic flexure

Pain out of proportion w/ physical findings
Pain after eating> weight loss

Elderly

54
Q

Adhesion

A

Fibrous band of scar tissue
forms after surgery

small bowel obstruction

55
Q

Angiodysplasia

A

tortuous dilation of vessels> hematochezia

Cecum, terminal ileum, ascending colon

older pts

Dx: angiography

56
Q

Colonic polyps

A

Masses that protrude into gut lumen
Most are NON neoplastic
Rectosigmoid

Tubular= small, rounded, benign

Villous= long, finger-like

57
Q

Adenomatous colonic polyp

A

Precancerous> CRC

Increased risk w/ size
Increased epithelial dysplasia

VILLOUS = viLLAINOUS

asymptomatic, lower GI bleed, partial obstruction, secretiory diarrhea

58
Q

Hyperplastic polyp

A

MC non-neoplastic polyp in COLON

59
Q

Juvenile colonic polyp

A

Sporadic lesions in children < 5 yrs of age
Rectum
single- no malignant potential
juvenile polypoisis syndrome- multiple juvenile polyps in GI tract> increased risk for ADENOCARCINOMA

60
Q

Peutz Jeghers

A

Single polyps that are NOT malignant

PJ Syndrome- AD, multiple non malignant hamaratomas through GI tract, hyperpigmented mouth lips, hands, genitalia; increased risk CRC

61
Q

CRC epidemiology

A

3rd MC cancer
3rd most deadly in US
>50 yrs
25% family hx

62
Q

CRC: FAP

A 
AD
APC gene on 5q chromosome, 
2 hit Ho
100% to CRC
thousands of polyps
pancolonic
always involves rectum
63
Q

Gardner’s syndrome

A

FAP + osseous and soft tissue tumors

congenital hypertrophy of retinal pigment epithelium

64
Q

Turcot’s syndrome

A

TURcot=TURban

FAP + malig CNS tumor

65
Q

HNPCC/Lynch syndrome

A

AD
mut of DNA mismatch repair genes
80% to CRC
proximal colon

66
Q

RF for CRC

A

IBD
tobacco
juvenile polyposis synd
PJ syndrome

67
Q

Presentation of CRC

A

rectosigmoid>ascdending>descending

ascending- mass, Fe def anemia, weight loss

descending- infiltrating mass, obstruction, colicky pain, hematochezia

68
Q

Dx CRC

A

Fe def anemia in males and postmenopausal females

screen pts: > 50 w/ colonoscopy or stool occult blood test

Dx: apple core lesion on barium enema x ray

CEA marker- good for monitoring recurrence

69
Q

Order of gene events leading to CRC

A

AK-53

  1. Microsatellite instability pathway (15%)
  2. APC/B catenin (85%)

normal colon> lose APC gene> colon at risk> K-ras mutation> adenoma> loss of p53

70
Q

What is a carcinoid tumor?

A

MC in SI
Neuroendocrine cells
50% of small bowel tumors
appendix, ileum, rectum

Dense core bodies on EM

produces 5HT> carcinoid syndrome:
wheezing, right sided heart murmurs, diarrhea, flushing

tx: resection
octreotide
somatostatin

71
Q

What is cirrhosis

A

alcohol, viral hep, biliary disease, hemochromatosis

diffuse fibrosis and nodular regeneration destroys normal architecture of liver

increased risk for hepatocellular carcinoma

72
Q

What alleviates portal HTN?

A

portosystemic shunts>
esophageal varises
caput medusae

73
Q

esophageal varices, melena, splenomegaly, caput medusae, portal hypertensive gastropathy, hemorrhoids

A

effects of portal HTN

74
Q

coma, scleral icterus, fetor hepaticus, spider nevi, gynecomastia, jaundice, testicular atrophy, liver flap=asterixis, bleeding tendency, anemia, ankle edema

A

liver failure

75
Q

AST and ALT

A 
Viral hepatitis (ALT>AST)
Alcoholic hepatitis (AST>ALT)
76
Q

ALP

A

Obstructive liver disease
bone disease
bile duct disease

77
Q

GGT

A

Increases in various liver and biliary diseases like ALP

NOT in bone disease

78
Q

Amylase

A

Acute pancreatitis

mumps

79
Q

Lipase

A

Acute pancreatitis

80
Q

Ceruloplasmin

A

Decreases in Wilsons disease

81
Q

Reye’s syndrome

A

Rare
Fatal childhood hepatoencephalopathy
assoc. w/ viral infection (VZV and influenza B) that has been treated w/ ASPIRIN

Aspirin metabolites decrease beta oxidation by reversible inhibition of mitochondrial enzyme

82
Q

What children can be treated w/ aspirin?

A

those w/ kawasakis disease

83
Q

Alcoholic liver disease: hepatic steatosis

A

short term change w/ moderate alcohol intake

Macrovesicular fatty change that may be REVERSIBLE if you stop treatking

84
Q

Alcoholic liver disease: alcoholic hepatitis

A

sustained long term alcohol consumption

swollen and necrotic hepatocytes w/ neutrophillic infiltration
Mallory Bodies

make a toAST w/ alcohol (AST > ALT)

85
Q

Alcoholic liver disease: alcoholic cirrhosis

A

final and IRREVERSIBLE

shrunken liver w/ hobnail appearance
sclerosis around central vein

sxs of chronic liver disease (jaundice, hypoalbuminemia)

86
Q

Hepatocellular carcinoma

A

MC primary malignant tumor of the liver in adults (hematogenous dissemination)

Increase in alpha-fetoprotein

Assoc w/ Hep B and C, Wilsons Disease, hemochromatosis, alpha1-antitrypsin def, alcoholic cirrhosis and carcinogens

Find: jaundice, tender hepatomegaly, ascites, polycythemia, hypoglycemia

Can lead to Budd chiari syndrome

87
Q

Cavernous hemangioma

A

benign liver tumor
30-50 yrs
no biopsy b/c of risk of hemorrhage

88
Q

hepatic adenoma

A

benign liver tumor
oral contraceptive, steroid use
regresses spontaneously

89
Q

angiosarcoma

A

exposure to arsenic, polyvinyl chloride>

malignant tumor of endothelial origin

90
Q

Nutmeg liver

A

Back up of blood into the liver

d/t RHF, Budd chiari syndrome

can lead to centrilobluar congestion and necrosis> cardiac cirrhosis

91
Q

Budd chiari syndrome

A

Occlusion of IVC/hepatic veins w/ centrilobular congestion/necrosis>
congestive liver disease

Varices and visible abdominal and back veins

Absence of JVD

Assoc: Hypercoagulable state, polycytehmia vera, pregnancy, hepatocellular carcinoma

92
Q

alpha 1 antitrypsin def

A

Misfolded gene product protein aggregates in hepatocellular ER>
cirrhosis w/ PAS positive globules in the liver

Lungs> lack of functioning enzyme> decrease in elastic tissue> panacinar emphysema

93
Q

Jaundice

A

Yellow skin/sclera from elevated bilirubin

direct hepatocellular injury
obstruction to bile flow
hemolysis

94
Q

Physiologic neonatal jaundice

A

At birth
immature UDP-glucuronyl transfearse> unconjugated hyperbilirubinemia> jaundice/kernicterus

tx: phototherapy

95
Q

What are hereditary hyperbilirubinemias?

A

gilbert’s syndrome
crigler najjar syndrome type 1
dubin johnson syndrome

96
Q

gilbert’s syndrome

A

asymptomatic
elevated UNCONJUGATED bilirubin w/out over hemolysis
Bilirubin increases w/ stress/fasting

mild decrease in UDP glucuronyl transferase or decrease in bilirubin uptake

97
Q

crigler najjar syndrome type I

A

Absent UDP glucuronyl trnasferase> UNCONJUGATED bilirubin

early in life, pt die w/in a few years

Jaundice, kerinecterus (bilirubin deposition in the brain), increase in unconjugated bilirubin

tx: plasmapheresis and phototherapy

98
Q

dubin johnson syndrome

A

Defective liver excretion> CONJUGATED hyperbjilirubinemia

grossly black liver

benign

99
Q

Wilsons disease

A

Copper is Hella BAD

COPPER accumulation (liver, brain, cornea, kidneys, joints)
Ceruloplasmin decrease, Cirrhosis, Corneal deposits, Copper accumulation, Carcinoma
Hemolytic anemia
Basal ganglia degeneration
Asterixis
Dementia, Dyskinesia, Dysarthria

Tx. penicillamine

Autosomal recessive

100
Q

Copper is normally excreted into bile by hepatocyte copper transporting ATPase. Gene?

A

ATP7B

101
Q

Hemochromatosis

A

Hemochromatosis Can Cause Deposits

Deposition of hemosiderin–disease of Fe deposition

Triad:
Cirrhosis
Diabetes mellitus and skin pigmentation–> bronze diabetes

results in CHF

tx. phlebotomy, deferasirox deferoxamine

102
Q

Primary hemochromatosis

A

C282Y or H63D mutation on HFE gene

assoc w/ HLA-A3

103
Q

Gallstones

A 
4Fs
Female
Fat
fertile
forty

Charcot’s traid : jaundice, fever, RUQ pain (positive murphy’s sign)

104
Q

cholecystitis

A

inflammation of the gallbladder

gallstones
ischemia
infections (CMV)

Increase alkaline phosphatase if bile duct becomes involved

105
Q

Acute pancreatitis

A

GET SMASHED

Autodigestion of pancreas by pancreatic enzymes

Galstones
Ethanol
Trauma
Steroids
Mups
Autoimmune
Scropion sting
HYpercalcemia
Hypertriglyceridemia
ERCP
Drugs
106
Q

Epigastric abdominal pain radiating to back, anorexia, nausea

elevated amylase, lipase

A

acute pancreatitis

107
Q

Chronic pancreatitis

A

Alcohol abuse

Chronic inflammation, atrophy and calcification of the pancreas> pancreatic insufficiency

steatorrhea, fat vit def, diabetes

amylase and lipase are less elevated

108
Q

Pancreatic adenocarcinoma

A

6 months or less to live b/c usually metastesized at presentation

aggressive from pancreatic ducts, pancreatic head

CA-I9-9 tumor marker

tobacco, chronic pancreatitis, >50, jewish/african american

First Aid- Gastrointestinal (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions