Rubin's 19: Gastrointestinal Tract

Question 1

Achalasia is associated with what disease in the tropics?

Answer 1

Chagas disease

Question 2

Another term for scleroderma is:

Answer 2

Progressive systemis sclerosis

Question 3

Dx: Multiple small diverticula in the wall of the esophagus

Answer 3

Intramural pseudodiverticulum

Question 4

Ingestion of strong acids produces what kind of reaction?

Answer 4

Coagulative necrosis in the esophagus –> protective eschar that limits injury and further chemical penetration Dx: chemical esophagitis

Question 5

Ingestion of strong bases/alkalines produces what kind of reaction?

Answer 5

Liquefactive necrosis with saponification of membrane lipids

Question 6

Aflatoxin is a well-known:

Answer 6

hepatotoxin, associated with hepatocellular carcinoma

Question 7

Sliding hiatal hernia is most often associated with:

Answer 7

Reflux esophagitis

Question 8

Esophageal varices are most often seen in the setting of:

Answer 8

Portal HTN seen in lower third of esophagus

Question 9

Dx: “Leather bottle” appearance of thickened stomach; no true tumor seen; Extensive fibrosis in the submucosa and muscularis of the stomach wall; Signet ring cells

Answer 9

Linitis plastica (when the entire stomach is involved) - gastric adenocarcinoma Poor prognosis

Question 10

Dx: Enlarged rugal folds of stomach; Severe loss of plasma proteins including albumin from altered gastric mucosa; in adults - overexpression of TGF-alpha

Answer 10

Menetrier disease aka hyperplastic hypersecretory gastropathy

Question 11

Dx: Tarry stool; Upper GI pain; Firm, submucosal, ulcerated mass in the stomach; Spindle cells in cytoplasm

Answer 11

GIST - Gastrointestinal stromal tumor derived from pacemaker cells of Cajal

Question 12

Give the dx: long-standing ulcerative colitis; jaundice; inflammation and obliterative fibrosis of intrahepatic and extrahepatic bile ducts; Beaded biliary tree on radiography

Answer 12

Primary sclerosing cholangitis