Pathoma Flashcards
What is a Zenker Diverticulum?
Outpouching of pharyngeal mucosa through an acquired defect in the muscular wall
Arises from the upper esophageal sphincter at junction of esophagus an pharynx
How can a Zenker’s Diverticulum present?
Dysphagia, obstruction, and halitosis
What is Mallory-Weiss syndrome?
Longitudinal laceration of mucosa at the GE junction
What are some causes of MW syndrome?
Severe vomiting
Usually alcoholism or bulemia
What are esophageal varicies?
Dilated submucosal veins in the lower esophagus, usually related to portal HTN. Can result in painless hematemesis.
What is achalasia?
Disordered esophageal motility with inability to relax LES.
How can achalasia present in clinic?
Dysphagia for solid and liquid
Bird beak sign on barium swallow
What can be a cause of achalasia?
Damage ganglion cells of the myenteric plexus
What are some later complications of GERD?
Ulceration with stricture and Barrett esophagus
What is Barrett esophagus?
Metaplasia of the stratified squamous epithelium to nonciliated columnar epithelium (intestinal metaplasia)
What is the most common area of the esophagus to be affected by adenocarcinoma?
Lower one third of the esophagus
What is gastroschisis?
Congenital malformation of the anterior abdominal wall leading to exposure of the abdominal contents - no amnion sac
What is omphalocele?
Persistent herniation of bowel into umbilical cord - due to failure of herniated intestines to return to body cavity during development. Covered by peritoneum and amnion of the umbilical cord
What is pyloric stenosis?
Congenital hypertrophy of pyloric smooth muscle
How will pyloric stenosis present in clinic?
Classically presents two weeks after birth as porjectile non bilious vomiting
What are the two causes of acute gastritis?
Acid damage to the mucosa of the stomach (decreased mucosal protection or increased acid)
What are a few risk factors for acute gastritis?
NSAIDs (PGE2 inhibitors)
Heavy alcohol consumption
Increased vagal stimulation - leading to increased acid production
What are the two causes of chronic gastritis?
Auto-immune gastritis or H. pylori infection
What is auto-immune gastritis?
Autoimmune destruction of gastric parietal cell located in the body of the stomach. Usually an auto-antibody to parietal cells or intrinsic factor
What are the clinical features of auto-immune gastritis?
Atrophy of mucosa and intestinal metaplasia
Possible gastrin levels
Increased risk of gastric adenocarcinoma
What are the characteristics of chronic H pylori?
Most common
Increased ureases and proteases along with inflammation of weaken mucosal defenses - antrum is most common site
What are the clinical characteristics of chronic H pylori?
MALT lymphoma, gastric adenocarcinoma, ulceration
Presents with epigastric abdominal pain