Pathology - mouth to eso Flashcards by Becky Koscik

list the benign salivary tumours

pleomorphic adenoma

warthin tumour

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where do salivary tumours most often present?

parotid gland

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female with painless, mobile mass on jaw

pleomorphic adenom

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histo of pleomorphic adenoma please

chondromyxoid stroma and epithelium

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when will a pleomorphic adenoma reoccur?

if ruptures or not completely excised in surgery

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chrondomyxoid stroma and epithelium

pleomorphic adenoma
more common in women
benig
painless mass 
parotid gland

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what is the most common malignant salivary gland tumor?

mucoepidermoid carcinoma

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painless, slow growing mass

usually in minor salivary glands

mucoepidermoid carcinoma

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histo of a mucoepidermoid carcinoma please

mucinous and squamous components.

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mucinous and squamous components on a salivary gland biopsy

malignant
mucoepidermoid carcinoma
presents as painless, slow growing mas. doesn’t mention anything about mobility (pleomorphic adenoma is mobile)

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what is a warthin tumor?

benign cystic tumour with germinal centres

kaka a papillary cystadenoma lymphomatosum

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who is more like to get a benign cystic tumor with germinal centres

warthin tumour

males

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what causes achalasia?

failure of relaxation of the LES due to loss of myenteric/auerback plexus

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describe the manometer reading in achalasia

high LES resting pressure

uncoordinated peristalsis

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barium swallow with dilated distal esophagus with area of distal stenosis

bird beak

achalasia

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what does achalasia increase the risk of?

esophageal squamous cell carcinoma

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what infection can cause achalasia

T cruzi
Chagas disease
or a paraneoplastic syndrome.

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nocturnal regurgitation of undigested food
dysphagia of solids and liquids
chest pain and heart burn
frequent hiccups
nocturnal cough from aspiration
difficultly belching

achalasia

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describe the s and sxs of esophageal disorders please

heart burn (most common in GERD)
dysphagia of solids only - due to obstruction ie cancer, web, stricture
dysphage of solids and liquids - due to problems with motility ie dermamyositis, myasthenia gravis, stroke,  systemic sclerosis, CREST syndrome and achalsia

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CREST syndrome

calcinosis, anticentromere abs
Raynaud phenomenon
esophageal dysphagia - s and l
sclerodactyly
telangiectasia

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pneumomediastinum

boerhaave syndrome

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transmural teat of the esophagus

boerhaave syndrome

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what causes boerhaave syndrome

violent retching

tis a transmural tear at the distal esophagus -> surgical emergency

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which is a surgical emergency, Mallory Weiss or boerhaave?

boerhaave

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``` atopy in a patient dysphagia heart burn strictures no response to GERD theraphy ```

eosinophilic esophagitis

what causes eosinophilic esophagitis

esophageal infiltration into the esophagus due to atopy to food allergen

presentation of eosinohpilic esophagitis

dysphagia heart burn strictures

what causes esophageal stricutures?

lye ingestion alkali chemical ingestion acid reflux

who cares about esophageal strictures

stricture -- perforation -- squamous cell carcinoma

what are esophageal varices

dilated submucosal veins in lower 1/3 of esophagus

what causes esophageal varices

portal hypertension, common in OH (cirrhosis) | may be source of upper git bleed

esophagitis causes in non immunocompromised

acid reflux | chemical ingestion

esophagitis in immunocompromised/AIDs

candida - pseudomembrane white, yeast with pseudohyphase HSV-1: punched out ulcers, intranuclear inclusions CMV: linear ulcers with intranuclear eosinophilic inclusions

heart burn | regurgitation on supine

GERD

``` heart burn indigestion nocturnal cough nocturnal asthma acid damage to enamel early satiety and full abdomen bloating and belching ```

GERD

adult onset asthma

GERD

describe the manometry in GERD

decreased LES tone < 10 mmHg

risk factors for GERD please

``` smoking OH caffeine fatty food chocolate pregnancy obesity hiatal hernia ```

what dose GERD progress to?

barrets - adeoncarcinoma

hematemesis in a bulumic

Mallory Weiss tear | also in OHics

what is a Mallory Weiss tear

mucosal lacerations at gastroesophageal junction due to severe vomiting.

intermittent dysphagia to solids microcytic anaemia esophageal web possible glossitis

plummer vinson syndrome | DIE: dysphagia, iron deficiency, esophageal web

what does plummer vinson syndrome increase the risk of?

squamous cell carcinoma of esophagus (Strictures, achalasia so far)

describe how the esophagus is affected in scleroderma

esophageal smooth muscle atrophy -- decreased LES pressure and dysmotility -- acid reflux and dysphagia -- stricture, barrets, aspiration

what are consequences of atrophy of the esophageal smooth muscle in scleroderma

decreased LES pressure and dysmotlilty | acid reflux -- stricture, barrets, aspiration

what is barrett esophagus?

glandular metaplasia - replacement of nonkeratinized stratified squamous epithelium with intestinal epithelium ie nonciliated columnar with goblet cells in the distal esophagus

what causes barrett esophagus?

chronic acid reflux/GERD

what pathologies is barrett esophagus associated with?

esophagitis esophageal ulcers increased risk of esophageal adenocarcinoma

supraclavicular node

adenocarcinoma of stomach esophageal cancer cervical cancer pancreatic cancer

progressive dysphagia for solids then liquids | weight loss

esophageal cancer

what is most common type of esophageal cancer world wide

squamous cell carcinoma

what is most common type of esophageal cancer in the USA?

adenocarcinoma

where does squamous cell carcinoma of esophagous occur

upper 2/3

where does adenocarcinoma of esophagus occur?

lower 1/3

risk factor for both adenocarcinoma and squamous cell carcinoma of esophagus

cigarette smoking

risk factors for squamous cell carcinoma please

``` achalasia alcohol cigarettes zenker diverticula esophageal web familial hot liquids ```

risk factors fo squamouc cell carcinoma please

``` bareets cigarettes fat GERD familial ```

RF for esophageal cancer: achalasia

squamous

RF for esophageal cancer: alcohol

squamous

RF for esophageal cancer: barretts

adenocarcinoma

RF for esophageal cancer: cigarettes

squamous | adenocarcinoma

RF for esophageal cancer: zenker diverticula

squamous

RF for esophageal cancer: esophageal web/scleroderma/CREST

squamous

RF for esophageal cancer: familial

squamous | adenocarcinoma

RF for esophageal cancer: obesity

adenocarcinoma

RF for esophageal cancer: GERD

adenocarcinoma

RF for esophageal cancer: hot liquides

squamous

list all the risk factors for esophageal cancer

``` achalasia alcohol barrets cigarettes esophageal web fat familial GERD hot liquids ```