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Gastrointestinal > Pathology- Esophagus > Flashcards

Pathology- Esophagus Flashcards

1
Q

This is the condition when there is a thin, non-canalized cord that replaces a segment of the esophagus, causing a mechanical obstruction.

A

Atresia

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2
Q

Where does esophageal atresia commonly occur?

A

at or near the tracheal bifurcation

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3
Q

What commonly occurs between the esophagus and trachea in atresia?

A

A fistula develops

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4
Q

What are the problems with a fistula that occurs between the esophagus and trachea?

A

Aspiration, suffocation, pneumonia, and severe fluid imbalances.

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5
Q

This is where the esophageal lumen is markedly reduced in caliber from fiberous thickening of the wall, leading to partial or complete obstruction.

A

stenosis

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6
Q

What are the etiologies of esophageal stenosis?

A

GERD, irraditation, scleroderma, or caustic injury

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7
Q

This is where incomplete formation of the diaphragm allows the guts to herniate into the throacic cavity.

A

Diaphragmatic hernia

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8
Q

This is when closure of the abdominal musculature is incomplete and abdominal viscera herniate into a ventral membranous sac.

A

Omphalocele

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9
Q

THis is when all the layers of the abdominal wall are defective and the guts freely prodtrude outwards.

A

Gastroschisis

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10
Q

What is the name of the malposition of an organ or tissue?

A

Ectopia

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11
Q

What is the name of ectopic gastric tissue in the upper 1/3 of the esophagus?

A

inlet patch

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12
Q

This is a blind outpouching of the GI tract that is lined by mucosa, communicates with the lumen, and includes all 3 layers of the ileum.

A

Meckel diverticulum

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13
Q

What embryological defect causes Meckel Diverticulum?

A

failed involution of the vitelline duct, which connects the lumen to the yolk sac.

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14
Q

What are the 4 components to the Meckel’s rule of 2’s?

A

it occurs in 2% of the population, in 2ft of the ileocecal valve, ~2in long, and symptomatic by age 2.

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15
Q

What are the Sx to Meckel’s diverticulum?

A

Typically asymptomatic, but may have have ectopic gastric or pancreatic mucosa, which may ulcerate and bleed and cause pain, which mimics appendicitis or an intestinal obstruction.

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16
Q

Case: a 2 week old baby presents to the pediatrition for malnutrition. The mother also states that there have been a consistent projectile, nonbilious vomiting. What is a good guess to the cause of this?

A

Pyloric stenosis

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17
Q

What causes congenital pyloric stenosis?

A

hyperplasia of the pyloric muscles, which obstructs the tract

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18
Q

What embryological defect causes Hirschprungs disease?

A

failure of the neural crest cells to migrate to the color during embryogenesis

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19
Q

What causes the megacolon in Hirschprungs since the neural crest cells arent there?

A

the distal intesinal segments lack the submucosal and myenteric plexuses –> no way for colon to contract –> megacolon

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20
Q

What are the Sx to Hirschprungs?

A

obstructive constipation immediately postnatal

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21
Q

This condition is where the outer longitudinal layer of the esophagus contracts before the inner circular layer, causing dysmotility and obstruction.

A

Nutcracker esophagus

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22
Q

This is an abnormal contraction of the esophagus, leading to a functional obstruction.

A

Diffuse esophageal spasm

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23
Q

This is a conditon where diverticuli form immediately above the upper esophageal sphincter, which can accumulate food.

A

Zenker diverticulum

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24
Q

THis is the narrowing of the narrowing of the esophageal lumen caused from fiberous thickening.

A

stenosis

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25
Q

What are the most common causes of esophageal stenosis?

A

Inflammation and scarring from chronic GERD, irraditation, or caustic injury

26
Q

These are semicircumfrential ledge-like protrusions in the upper esophagus.

A

Mucosal webs

27
Q

Which types of patients get esophageal webs?

A

women > 40, those with chronic GERD, graft-vs-host disease, or blistering skin diseases.

28
Q

What Sx might esophageal webs give?

A

dysphagia

29
Q

These are completely circumfrential webs that are present in the lower esophagus.

A

Esophageal/schatzki rings

30
Q

What comprises the histological anatomy of A rings?

A

squamous mucosa

31
Q

What comprises the histological anatomy of B rings?

A

gastric cardia-like mucosa

32
Q

This is the increased tone of the LES due to impaired smooth muscle relaxation.

A

Achalasia

33
Q

This NT usually relaxes the LES prior to food entry to the stomach

A

NO

34
Q

What is the pathological mechanism to achalasia?

A

from the failure of distal esophageal inhibitory neurons and/or degenerative changes in neural innervation.

35
Q

These are longitudinal tears of the esophagus near the gastroesophageal junction.

A

Mallory-weiss tears

36
Q

What causes mallory-weiss tears?

A

Failure of relaxation of the gastroesophageal muscles.

37
Q

What types of patients usually get infectious esophagitis from HSV, CMV, or fungal organisms?

A

Immunosuppressed

38
Q

These organisms show up with gray-white pseudomembranes with hyphae and inflammatory cells on the mucosa.

A

Fungal infections (candidiasis, mucormycosis and aspergillosis)

39
Q

These organisms show up as punched-out ulcers with nuclear viral inclusions of histo exam.

A

Herpes

40
Q

These organisms show up as shallow ulcerations with nuclear and cytoplasmic inclusions.

A

CMV

41
Q

This is when there is chronic exposure of the stomach acid to the esophagus, causing esophagitis.

A

GERD

42
Q

What is the cause of GERD?

A

Mainly when the LES tone is reduces or increased abdominal pressure

43
Q

What are the morphological features of a esophagus in GERD?

A

Hyperemia, sometimes basal zone hyperplasia

44
Q

What are the Sx of GERD?

A

Dysphagia, heartburn, sour-tasting regurgitation of stomach crap.

45
Q

This condition is when there are large numbers of intreepithelial superficial eosinophils, typically from an allergic reaction.

A

Eosinophilic esophagitis.

46
Q

This condition is when there is intesinal metaplasia in the esophageal squamous mucosa, typically in pts with chronic GERD.

A

Barrett esophagus

47
Q

Barrett esophagus has an increased risk of what type of cancer?

A

Esophageal adenocarcinoma

48
Q

What are the morphological features of Barrett esophagus?

A

several patches of red, velverty mucosa, extending upwards from the esophageal jxn, alternating between smooth squamous mucosa and columnar gastric mucosa

49
Q

What type of cells from histological examination is clear evidence for Barrett esophagus?

A

Goblet cells

50
Q

This is the formation of caval varicosities because of portal hypertension.

A

Esophageal varicis

51
Q

What is the most common cause of esophageal varices?

A

liver cirrhosis

52
Q

Where does adenocarcinomas typically occur in the esophagus?

A

distal 1/3 of the esophagus

53
Q

What are the Sx to adenocarcinomas?

A

difficulty swallowing, progressive weight loss, hematemesis, chest pain, or vomiting

54
Q

What is the 5-year survival for patients with adenocarcinomas that have metastasized?

A

<25%

55
Q

What is the 5-year survival for patients with adenocarcinomas that have stayed in the mucosa?

A

~80%

56
Q

Who is at a greater risk of squamous cell carcinomas of the esophagus?

A

those that use alcohol and tobacco, poverty, or chemical or radiation trauma, or HPV

57
Q

Where does squamous cell carcinomas occur?

A

middle 1/3 of the esophagus

think squamous in the squamous-only region of the esophagus

58
Q

What does a squamous cell carcinoma look like on endoscopy?

A

Small, gray-white, plaque-looking thickening that grows and obstructs the lumen

59
Q

What are the Sx of squamous cell carcinomas?

A

dysphagia, odynophagia, and obstruction

60
Q

What is the 5-year survival of squamous cell carcinomas when they remain superficial?

A

75%

61
Q

What is the 5-year survival of squamous cell carcinomas when they metastasize?

A

9%

Gastrointestinal (14 decks)

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