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Gastrointestinal - step > Pathology - mouth to eso > Flashcards

Pathology - mouth to eso Flashcards

1
Q

list the benign salivary tumours

A

pleomorphic adenoma

warthin tumour

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2
Q

where do salivary tumours most often present?

A

parotid gland

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3
Q

female with painless, mobile mass on jaw

A

pleomorphic adenom

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4
Q

histo of pleomorphic adenoma please

A

chondromyxoid stroma and epithelium

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5
Q

when will a pleomorphic adenoma reoccur?

A

if ruptures or not completely excised in surgery

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6
Q

chrondomyxoid stroma and epithelium

A 
pleomorphic adenoma
more common in women
benig
painless mass 
parotid gland
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7
Q

what is the most common malignant salivary gland tumor?

A

mucoepidermoid carcinoma

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8
Q

painless, slow growing mass

usually in minor salivary glands

A

mucoepidermoid carcinoma

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9
Q

histo of a mucoepidermoid carcinoma please

A

mucinous and squamous components.

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10
Q

mucinous and squamous components on a salivary gland biopsy

A

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

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11
Q

what is a warthin tumor?

A

benign cystic tumour with germinal centres

kaka a papillary cystadenoma lymphomatosum

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12
Q

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

A

warthin tumour

males

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13
Q

what causes achalasia?

A

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

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14
Q

describe the manometer reading in achalasia

A

high LES resting pressure

uncoordinated peristalsis

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15
Q

barium swallow with dilated distal esophagus with area of distal stenosis

A

bird beak

achalasia

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16
Q

what does achalasia increase the risk of?

A

esophageal squamous cell carcinoma

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17
Q

what infection can cause achalasia

A

T cruzi
Chagas disease
or a paraneoplastic syndrome.

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18
Q 
nocturnal regurgitation of undigested food
dysphagia of solids and liquids
chest pain and heart burn
frequent hiccups
nocturnal cough from aspiration
difficultly belching
A

achalasia

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19
Q

describe the s and sxs of esophageal disorders please

A 
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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20
Q

CREST syndrome

A 
calcinosis, anticentromere abs
Raynaud phenomenon
esophageal dysphagia - s and l
sclerodactyly
telangiectasia
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21
Q

pneumomediastinum

A

boerhaave syndrome

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22
Q

transmural teat of the esophagus

A

boerhaave syndrome

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23
Q

what causes boerhaave syndrome

A

violent retching

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

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24
Q

which is a surgical emergency, Mallory Weiss or boerhaave?

A

boerhaave

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25
Q 
atopy in a patient
dysphagia
heart burn
strictures
no response to GERD theraphy
A

eosinophilic esophagitis

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26
Q

what causes eosinophilic esophagitis

A

esophageal infiltration into the esophagus due to atopy to food allergen

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27
Q

presentation of eosinohpilic esophagitis

A

dysphagia
heart burn
strictures

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28
Q

what causes esophageal stricutures?

A

lye ingestion
alkali chemical ingestion
acid reflux

29
Q

who cares about esophageal strictures

A

stricture – perforation – squamous cell carcinoma

30
Q

what are esophageal varices

A

dilated submucosal veins in lower 1/3 of esophagus

31
Q

what causes esophageal varices

A

portal hypertension, common in OH (cirrhosis)

may be source of upper git bleed

32
Q

esophagitis causes in non immunocompromised

A

acid reflux

chemical ingestion

33
Q

esophagitis in immunocompromised/AIDs

A

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

34
Q

heart burn

regurgitation on supine

A

GERD

35
Q 
heart burn
indigestion
nocturnal cough
nocturnal asthma
acid damage to enamel
early satiety and full abdomen
bloating and belching
A

GERD

36
Q

adult onset asthma

A

GERD

37
Q

describe the manometry in GERD

A

decreased LES tone < 10 mmHg

38
Q

risk factors for GERD please

A 
smoking
OH
caffeine
fatty food
chocolate
pregnancy
obesity
hiatal hernia
39
Q

what dose GERD progress to?

A

barrets - adeoncarcinoma

40
Q

hematemesis in a bulumic

A

Mallory Weiss tear

also in OHics

41
Q

what is a Mallory Weiss tear

A

mucosal lacerations at gastroesophageal junction due to severe vomiting.

42
Q

intermittent dysphagia to solids
microcytic anaemia
esophageal web
possible glossitis

A

plummer vinson syndrome

DIE: dysphagia, iron deficiency, esophageal web

43
Q

what does plummer vinson syndrome increase the risk of?

A

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

44
Q

describe how the esophagus is affected in scleroderma

A

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

45
Q

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

A

decreased LES pressure and dysmotlilty

acid reflux – stricture, barrets, aspiration

46
Q

what is barrett esophagus?

A

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

47
Q

what causes barrett esophagus?

A

chronic acid reflux/GERD

48
Q

what pathologies is barrett esophagus associated with?

A

esophagitis
esophageal ulcers
increased risk of esophageal adenocarcinoma

49
Q

supraclavicular node

A

adenocarcinoma of stomach
esophageal cancer
cervical cancer
pancreatic cancer

50
Q

progressive dysphagia for solids then liquids

weight loss

A

esophageal cancer

51
Q

what is most common type of esophageal cancer world wide

A

squamous cell carcinoma

52
Q

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

A

adenocarcinoma

53
Q

where does squamous cell carcinoma of esophagous occur

A

upper 2/3

54
Q

where does adenocarcinoma of esophagus occur?

A

lower 1/3

55
Q

risk factor for both adenocarcinoma and squamous cell carcinoma of esophagus

A

cigarette smoking

56
Q

risk factors for squamous cell carcinoma please

A 
achalasia
alcohol
cigarettes
zenker diverticula
esophageal web
familial
hot liquids
57
Q

risk factors fo squamouc cell carcinoma please

A 
bareets
cigarettes
fat
GERD
familial
58
Q

RF for esophageal cancer: achalasia

A

squamous

59
Q

RF for esophageal cancer: alcohol

A

squamous

60
Q

RF for esophageal cancer: barretts

A

adenocarcinoma

61
Q

RF for esophageal cancer: cigarettes

A

squamous

adenocarcinoma

62
Q

RF for esophageal cancer: zenker diverticula

A

squamous

63
Q

RF for esophageal cancer: esophageal web/scleroderma/CREST

A

squamous

64
Q

RF for esophageal cancer: familial

A

squamous

adenocarcinoma

65
Q

RF for esophageal cancer: obesity

A

adenocarcinoma

66
Q

RF for esophageal cancer: GERD

A

adenocarcinoma

67
Q

RF for esophageal cancer: hot liquides

A

squamous

68
Q

list all the risk factors for esophageal cancer

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

Gastrointestinal - step (10 decks)

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