Pathoma GI Flashcards
aphatous oral ulcers, genital ulcers, uveitis
Becet’s
Hairy leukoplakia
EBV and immunocompromised state. Not premalignant, because only hyperplastic.
Erythroplakia
Vascular leukoplakia and more suggestive of dysplasia and risk of squamous cell carcinoma of oral cavity.
What is the most common benign cancer of mouth?
pleomorphic adenoma
Warthin tumor
Benign cystic tumor with lymph node tissue (lymphocytes and follicles)
What are the portal caval anastomoses?
1) lower esophagus: L gastric to azygous.
2) rectal venous plexus: superior rectal v (IMA) to inferior rectal and anal veins (internal iliac)
3) Caput: paraumbilical veins and inferior epigastric vein.
Where is the myenteric plexus?
In the muscularis propria?
Layers of gut wall?
Mucosa, submucosa, muscularis propria, serosa
Risk factors for SCC:
alcohol, tobacco, hot tea, Achalasia, plummer-vinson syndrome
Lymph node spread of upper, middle, and lower thirds of esophageal SCC?
upper: cervical nodes.
middle: mediastinal and trancheobronchial nodes
lower: celiac and gastric nodes
Curling ulcer?
Stomach ulcers caused by burns (decreased mucosa blood flow causes mucosa damage)
Cushing ulcer?
Increased vagal stimulation causes increased ACh and parietal cell stimulation
Chronic Autoimmune Gastritis?
Type 4 hypersensitivity reaction against parietal cells. Mostly attacks fundus and body and as a consequence there are Ab against parietal cells or intrinsic factor. Hypochloridia and G-cell hyperplasia.
Where does Chronic H Pylori like to infect?
Antrum of the stomach
What are the 3 consequences of H Pylori Gastritis?
1) ulceration, 2) gastric adenocarcinoma, 3) MALT lymphoma
How should you think about gastric adenocarcinoma?
There are two types; Intestinal and Diffuse.
Acanthosis nigricans
Gastric Adenocarcinoma, Insulin resistance
Leser-Trelat Sign
(seborrheic keratosis)
Gastric Adenocarcinoma
Sister Mary Joseph nodule
Metastasis of intestinal type gastric adenocarcinoma to the supraclavicular lymph node
Krukenberg Tumor
Metastasis of diffuse type gastric adenocarcinoma to the bilateral ovaries
linitis plastica
the desmoplastic response to diffuse type gastric adenocarcinoma
Signet Ring cells
caused by the overproduction of mucous in the diffuse type of gastric adenocarcinoma
HLA DQ2, 8
Celiac disease
Dermatitis Herpetiformis
Celiac disease
What should you think of if a patient with celiac is refractory to diet change?
small bowl carcinoma or t cell lymphoma (EATL)
Tropical Sprue
Sx similar to celiac. Damage is in jejunum and ileum. Causes folic acid deficiency.
Whipple Disease
Caused by tropheryma whippeli which infects MO and builds up in lamina propia of bowl (foamy MO). PAS +. Compresses lacteals so chylomicrons cannot be absorbed into the lymphatics. Fat malapsorption and steatorrhea occur. Involves arthritis, cardiac valves, and CNS.
Carcinoid tumor marker
+ chromogranin
Carcinoid heart syndrome
will see R sided valve fibrosis that causes TR and PS. Don’t left sided because the lung has MAOIs.
5HT and Metastasis to liver–>
Carcinoid syndrome.
SAD PUCKER
Retroperitoneal organs:
Suprarenal, Aorta (and IVC), Duodenum (2-4th parts), Pancreas (except tail), Ureters, Colon (Ascending and descending), Kidneys, Esophagus, Rectum
