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gi and nutrition > Pathoma > Flashcards

Pathoma Flashcards

1
Q

What is a Zenker Diverticulum?

A

Outpouching of pharyngeal mucosa through an acquired defect in the muscular wall
Arises from the upper esophageal sphincter at junction of esophagus an pharynx

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2
Q

How can a Zenker’s Diverticulum present?

A

Dysphagia, obstruction, and halitosis

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3
Q

What is Mallory-Weiss syndrome?

A

Longitudinal laceration of mucosa at the GE junction

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4
Q

What are some causes of MW syndrome?

A

Severe vomiting

Usually alcoholism or bulemia

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5
Q

What are esophageal varicies?

A

Dilated submucosal veins in the lower esophagus, usually related to portal HTN. Can result in painless hematemesis.

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6
Q

What is achalasia?

A

Disordered esophageal motility with inability to relax LES.

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7
Q

How can achalasia present in clinic?

A

Dysphagia for solid and liquid

Bird beak sign on barium swallow

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8
Q

What can be a cause of achalasia?

A

Damage ganglion cells of the myenteric plexus

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9
Q

What are some later complications of GERD?

A

Ulceration with stricture and Barrett esophagus

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10
Q

What is Barrett esophagus?

A

Metaplasia of the stratified squamous epithelium to nonciliated columnar epithelium (intestinal metaplasia)

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11
Q

What is the most common area of the esophagus to be affected by adenocarcinoma?

A

Lower one third of the esophagus

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12
Q

What is gastroschisis?

A

Congenital malformation of the anterior abdominal wall leading to exposure of the abdominal contents - no amnion sac

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13
Q

What is omphalocele?

A

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

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14
Q

What is pyloric stenosis?

A

Congenital hypertrophy of pyloric smooth muscle

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15
Q

How will pyloric stenosis present in clinic?

A

Classically presents two weeks after birth as porjectile non bilious vomiting

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16
Q

What are the two causes of acute gastritis?

A

Acid damage to the mucosa of the stomach (decreased mucosal protection or increased acid)

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17
Q

What are a few risk factors for acute gastritis?

A

NSAIDs (PGE2 inhibitors)
Heavy alcohol consumption
Increased vagal stimulation - leading to increased acid production

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18
Q

What are the two causes of chronic gastritis?

A

Auto-immune gastritis or H. pylori infection

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19
Q

What is auto-immune gastritis?

A

Autoimmune destruction of gastric parietal cell located in the body of the stomach. Usually an auto-antibody to parietal cells or intrinsic factor

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20
Q

What are the clinical features of auto-immune gastritis?

A

Atrophy of mucosa and intestinal metaplasia
Possible gastrin levels
Increased risk of gastric adenocarcinoma

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21
Q

What are the characteristics of chronic H pylori?

A

Most common

Increased ureases and proteases along with inflammation of weaken mucosal defenses - antrum is most common site

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22
Q

What are the clinical characteristics of chronic H pylori?

A

MALT lymphoma, gastric adenocarcinoma, ulceration

Presents with epigastric abdominal pain

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23
Q

What are the characteristics of peptic ulcer disease?

A

Solitary mucosal ulcer most often involving the proximal duodenum - most always due to H pylori

24
Q

How will a peptic ulcer present in clinic?

A

Presents with epigastric pain that improves with meals

25
Q

What is the characteristic finding of endoscopic evaluation in peptic ulcer?

A

Shows ulcer with hypertrophy of Brunner glands

26
Q

What is duodenal atresia?

A

Congenital failure of duodenum to canalize associated with Down syndrome

27
Q

What are the clinical features of duodenal atresia?

A

Polyhydramnios, distension of stomach, bilious vomiting

28
Q

What is Meckel Diverticulum?

A

Outpouching of all three layers of the bowel wall

Failure of the vitelline duct to involute

29
Q

Why does lactose intolerance present with diarrhea?

A

Undigested lactose is osmotically active

30
Q

What is the associated genetic component with Celiac Disease?

A

HLA-DQ2 and DQ8

31
Q

What is the most pathogenic component of Celiac?

A

Gliadin

32
Q

What is the key skin finding associated with Celiac?

A

Dematitis herpetiformis - IgA deposition at the tips of dermal papillae

33
Q

What will a duodenal biopsy find in Celiac?

A

Flattened Villi, hyperplasia of crypts and increased intraepithelial lymphocytes

34
Q

What as a carcinoid tumor of the GI tract?

A

Malignant proliferation of neuroendocrine cells

35
Q

What is the common secretion of a carcinoid tumor?

A

Serotonin is secreted and will be metabolized by the liver and secreted as 5-HIAA in the urine

36
Q

What is Hirschsprung disease?

A

Defective relaxation and peristalsis of rectum and distal sigmoid colon - associated with down syndrome

37
Q

What is the cause of Hirschsprung disease?

A

Congenital failure of ganglion cells - neural crest cells

38
Q

What are the clinical features of Hirschsprung disease?

A

Failure to pass meconium and rectal suction biopsy reveals lack of ganglion cells

39
Q

What is diverticula?

A

Outpouchings of the large intestine which can become infected

40
Q

What is the pathway that colonic polyps can transform into carcinoma?

A

APC mut - KRAS - and p53

41
Q

What is Familial Adenomatous Polyposis?

A

Inherited APC mutation which leads to high probability of colon cancer

42
Q

What is annular pancreas?

A

Developmental malformation of the pancreas where is forms a ring around the duodenum

43
Q

What is acute pancreatitis?

A

Inflammation and hemorrhage of the pancreas. Auto-digestion of the pancreatic parenchyma. Can result in liquefactive necrosis due to lipase and amylase activation

44
Q

What is the most common cause of acute pancreatitis?

A

Alcohol and gallstones

45
Q

What is chronic pancreatitis?

A

Fibrosis of pancreatic parenchyma

46
Q

What are the clinical features of chronic pancreatitis?

A

Epigastric abdominal pain that radiates to back
Pancreatic insufficiency - results in malabsorption of fat
Amylase and lipase are not good markers

47
Q

How will pancreatic carcinoma present in clinic?

A

Epigastric abdominal pain and weight loss
Obstructive jaundice with pale stools
Secondary diabetes mellitus

48
Q

What is ascending cholangitis?

A

Bacterial infection of the bile ducts that is usually due to ascending infection with gram negative infection

49
Q

What conjugates bilirubin in the liver?

A

Uridine glucuronyl transferase

50
Q

What is the serologic marker of acute infection for HepB?

A

Postive HBsAG and IgM antibody directed at HBcAB

51
Q

What are the serologic markers of resolved Hep B infection?

A

IgG to both core and surface antigen

52
Q

What are the serologic markers of chronic HepB infection?

A

Presence of HBsAG for more than 6 months

IgG to core, but non to surface

53
Q

What are the serologic markers for a person who was immunized for HepB?

A

IgG to surface antigen and nothing else

54
Q

Primary hemochromatosis is due to what genetic cause?

A

HFE gene

55
Q

What biliary disease is related to UC? What is the serologic marker?

A

Primary sclerosing cholangitis positive p-anca

56
Q

What is primary sclerosing cholangitis?

A

Inflammation and fibrosis of intrahepatic bile ducts

57
Q

What is Primary biliary cirrhosis?

A

Autoimmune granulomatous destruction of intrahepatic bile ducts AMA - positive

gi and nutrition (57 decks)

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