Second Part Of Ex 1 Flashcards
What is portal venous congestion leading to portal HTN?
Esophageal varices
What is the order of primary salivary gland pathologies. ?
- Parotid 2. Sublingual 3. Submandibular. Minor salivary glands
______% of leukoplakia can turn to what?
25, squamous cell carcinoma
Where is cholera most common?
India/Africa
Pseudopolyps are associated with what?
Ulcerative colitis
What kind of hiatal hernia is separate portion of the stomach protrudes, and is prone to strangulation or obstruction ? Q
Non axial ( rolling )
What is tenesmus and what condition is it associated with ?
Sensation of inadequate BM, sigmoid diverticulitis
Esophageal varices is secondary to what?
Cirrhosis
What is twisting a loop of bowel ?
Volvulus
External hemorrhoids =?
Below the anorectal line
If an acquired diverticulum in the Colon becomes infected what can happen?
Perforation leading to hemorrhage
What is excreted via salivary glands?
> 99% h20, IgA, enzymes
What is multiple small shallow ulceration of the stomach/duodenum ?
Acute peptic ulceration
What makes up the majorly of all parotid gland tumors?
Pleomorphic adenoma
When antibiotics disrupt intestinal flora, this allows what to happen?
Clostridium diff to overgrow
If herpes spreads to the brain what is it called? (Life threatening)
Herpesviral encephalitis (usually HSV-1)
Superficial inflammation =?
Mucosal ulcerations
What are symptoms of GERD?
Dysphasia, heartburn, “sour brash”
Where is the most common site of tumors in the small intestine?
Duodenum
What kind of polyp makes up the majorly of gastric polyps.?
Inflammatory and hyper plastic polyps (75%)
How many children die each ear from infectious enterocolitis
12,000 ( 500 infants a day)
What are the 3 top malabsorption problems in the US?
Pancreatic insufficiency, celiac disease, crohn disease
Do smaller or larger glands have higher cancer risk ?
Smaller (but are less common)
Oral cancer is about _____more common among males?
2x
Relapsing “attacks” with grossly bloody and mucoid stool is associated with what?
Ulcerative colitis
What a treatment for sigmoid diverticulitis?
Increase fiber, lifelong dietary modification
What percent of cholera is lethal and in what amount of time?
70% in 24 hours
What is a raised lesion that is firm with irregular boarders, that look whitish-grey or erythematous?
Oral squamous cell carcinoma
What is the most common location for angiodysplasia?
Cecum, but also in ascending colon
Environmental enteropathy is cycles of what?
Mucosal injury, malnutrition, and inflammation
Acute peptic ulceration is a complication of what 3 things?
Severe physiological stress, high NSAIDS, inter-cranial disease.
What constitutes diagnosis of travelers diarrhea?
Three or more unformed loose stools in 24 hours
What are other names for a canker sore ?
Aphthous ulcer, recurrent aphthous stomatitis
What is the actual problem causing barrett esophagus ?
The lower esophageal sphincter doesn’t close all the way.
How common is pyloric stenosis ?
1-400 births
What is lower pharyngeal outpouching superior to the UES?
Zenkers diverticulum
Are peptic ulcers more common in men or women ?
Men !0, woman 4
Genital herpes is called what?
HSV-2
What kind of gastric polyp makes up 15% of them?
Fundic gland
What kind of hiatal hernia is most common and is a “bell shaped” dilation ?
Axial (sliding)
What are risks for squamous cell carcinoma (oral) ?
Alcohol, tobacco, >30, HPV-16
What part of the esophagus is where squamous cell carcinomas would be found?
Middle 1/3
What do you see with the crypts with campylobacter?
Crypt access
What percent of colon cancers are lethal?
40%
Villus flattening is a characteristic of what?
Environmental enteropathy
What is complete rupture at the thoracic esophagus? Hammans sign?
Boerhaaves syndrome
What is esophageal metaplasia at the distal esophagus? Where strat squamous Turing into columnar?
Barrett esophagus
What causes oral candidiasis? (Thrush)
Candida albicans
What is an early sign of appendicitis?
Periumbilical/epigastic discomfort
What is a vascular lesion with tortuous and dilated submucosal and mucosal vessels?
Angiodysplasia
Are most hiatal hernias symptomatic ?
No!
What disease is when chronic gastritis leads to atrophy with antibodies against parietal cells?
Autoimmune gastritis, pernicious anemia
What are complications of barrett esophagus ?
Esophageal adenocarcinoma, ulceration
If someone has lost a lot of weight, has abdominal dissension, borborygmus, flatulence, anorexia?
Malabsorption
What kind of ulcer gets worse after eating?
Gastric
What is when a segment of intestine telescopes into a distal segment?
Intussusception
Who is at risk for barrett esophagus ?
White ppl (30-300) males (4x) 40-60
Campylobacter enterocolitis may initiate what?
Reactive arthritis (HLA-B27)
How do you diagnose adenomas?
Screen, sessile or pedunculated, polyectomy
In what condition do 100% of patients develop colon cancer, most commonly before 30?
Familial adenomatous polyposis
Giardiasis (never fever) = ?
Malabsorption
What kind of mineral deficiency is associated with celiac disease?
Iron
How do you diagnose zenkers diverticulum?
Barium swallow and video fluoroscopy
Eating a highly processed diet increased your risk of colorectal adenocarcinoma ?
30x
What kind of esophagitis is most common after an ulcer and debilitated?
Infectious
What sign is achalasia associated with?
Bird beak sign
Flagellated protozoa is associated with what?
Giardia lamblia
What is the genetic mutation for someone with familial adenomatous polyposis ?
APC gene on chromosome 5
What is the treatment for crohns disease?
Probiotics, and immunosuppressive meds
Chronic and relapsing abdominal pain, bloating, constipation and diarrhea are symptoms of what?
IBS
Colorectal adenocarcinomas most commonly metastasize to where?
Liver
How common is crohns disease?
1:500
What is the cause of the ischemia in ischemic bowel disease?
From hypotension or occlusion, mucosal infarction
What kind of Esophageal lesion is associated with ectopic gastric mucosa, upper 1/3. Asymptomatic.
Ectopia
Parasitic diseases affect how many people?
> 1/2 the worlds pop
What causes viral gastroenteritis in children ?
Rotavirus
What is the most common cause of esophagitis ?
Reflux esophagitis
What is the most common outpatient G.I. Complaint?
GERD
What % of parotid gland tumors are malignant ?
15-30%
What kind of Esophageal lesion is associated with atresia, tracheal fistula, Stenosis, regurgitation?
Mechanical
What is celiac disease?
Immune mediated, reaction to gliadin
IBD is most commonly seen in what type of control?
Females, adolescence, white.
Tumors of the small intestine account for what percent of all G.I. Malignancies ?
1%
Are adenomas age related?
Yes
What kind of parotid gland tumor is more invasive, less mobile and malignant?
Carcinoma Ex Pleomophic adenoma
What is the most common malignancy of the G.I. Tract?
Colorectal adenocarcinoma
What are symptoms of acute ischemic bowel disease?
Sudden/severe abdominal pain, nausea. Vomiting, frank blood in stool
Where do most intestinal obstructions occur?
Small intestine
What is the cause of lynch syndrome?
Inherited mutations in DNA mismatch repair system
What deficiency is associated with colorectal adenocarcinoma ?
Iron deficiency anemia
What is the long term survival rate for someone with squamous cell carcinoma?
<50% long term
What are risks for chronic gastritis ?
Heliobacter pylori infection, old age
Skip lesions are seen in what condition?
Crohns disease
What are symptoms of dermatitis herpetiformis ?
Blister on arms, legs, butt, itchy, seen in 10% of celiac disease patients
What do Crohn’s disease and ulcerative colitis have in common?
IBD, Familial, females, risk of adenocarcinomas
What is a benign smooth muscle tumor of the esophagus ?
Leiomyoma
What parts are injured in viral gastroenteritis?
To superficial cells of the stomach or SI
What are the most common types of tumors of the small intestine?
50% adenocarcinoma, 50% carcinoid tumors
What does ulcerative colitis?
Rectum/distal colon
Canker sores are most common in what kind of people?
Females, over 20, Celiac disase, IBD, Behcet disease
Crohn disease effects what ?
Entire GI tract, Most commonly in the ileum
What mutation is common for oral cancer?
TP53
Oralfacial herpes is called what?
HSV-1
What are treatments for ischemic bowel disease?
Prophylactic antibiotics
What condition is associated with a wall defect that leads to a blind need pouch and there are most commonly multiple ?
Sigmoid diverticulitis
What type of gastritis is transient mucosal inflammation (neutrophils), with possible erosion/ulceration ?
Acute
If the appendix Rutgers there is what?
High morbidity and mortality.
When does zenkers diverticulum develop and what are sympotoms?
After an increase in pharyngeal pressure. Halitosis, dysphasia, regurgitation
What has a high (50%) risk of transitioning to CA has irregular boarder and is a red velvety area?
Erythroplakia
What causes 10-20% initial HSV infections ?
Acute herpetic gingivostomatitis
What kind of Esophageal lesion is secondary to portal hypertension ?
Esophageal varices
Are there granulomas or skip lesions seen in Ulcerative colitis?
No
Is there inflammation associated with IBS?
NO
What are some treatments for canker sores?
NSAIDS, B12 (cobalamin)
What is the defect that causes hirschsprung disease?
Neural crest cell migration
What is treatment for IBS?
Fiber, decrease carbs
What does herpes virus lay dormant?
Trigeminal ganglion
What condition is a hemangioma on gingiva, caused by hormonal factors and or irritation that grows rapidly ?
Pyogenic granuloma
What % of he us have appendicitis?
7%
What is the most common acute abdominal condition ?
Quite appendicitis
What is the location of hemorrhoids ?
Anal and perianal vessels
Where are common locations for peptic ulcer?
Prox duodenum (4x), gastric Antrim
Co-morbidity impairs esophageal functioning. Inflammation near Auerbach plexus is what?
Secondary achalasia
What do you see with e coli crypt architecture
Normal
What is the Most common esophageal cancer worldwide?
Squamous cell carcinoma
Are colorectal adenocarcinomas asymptomatic early?
Yes
What makes up 90% of all stomach cancers?
Gastric adenocarcinoma
What is a raised white patch that cant be scraped off?
Leukoplakia
With malabsorption what is defective?
Fats,carbs, proteins, vit A D E K, mineral, electrolytes
What percent of herpes simplex virus is asymptomatic?
80%
What percent of people over 70 have xerostomia?
20%
What is the most common type of oral cancer?
Squamous cell carcinoma
What are shared feathers between duodenal and gastric ulcers?
Eating influences pain, relieved by vomiting or alkaline substance, worse at night
What’s is another name for sigmoid diverticulitis ?
Colonic diverticulosis
What are 2 treatments for achalasia
Botulinum toxin, pneumatic dilation
What percent of sublingual or minor salivary gland tumors are malignant?
50-90%
How common is Ulcerative colitis?
1 per 5,000
What causes viral gastroenteritis in adults?
Norovirus
What is the most common cause of bacterial sialadenitis?
Staph aureus
What kind of esophageal laceration is a longitudinal tear from forceful vomiting?
Mallory weiss tear
90% of all cirrhosis cases have what?
Esophageal varices
What type of esophagitis is acute, self limiting, and due to tobacco, alcohol, pill induce?
Chemical
If you have perianal citing with bright red bloody (frank) stool, most are self limiting which is what?
Hemorrhoids
What are risks for gastric adenocarcinoma ??
H pylori, japan(20x)
What are symptoms of chronic ischemic bowel disease??
Episodic bloody diarrhea, mimics IBD
What is a blocked or rupture of a duct, found on the lower lip in the young and old?
Mucocele (mucous cyst, Ranula)
Who is most commonly effected by tropical sprue?
Children 2-3 years old
What condition is an hereditary cancer syndrome?
Lynch syndrome
What is the most common tumor of the appendix?
Carcinoid, (rarely adenocarcinoma )
Hamartomas = what?
Mature cells
Are adenomas considered malignant until proven otherwise?
Yes
Is fibrosis seen in crohns or ulcerative colitis ?
Crohns
What are dietary risk factors for an adenocarcinoma ?
Low veggie fiber, high amounts of carbs, high animal fat, decreased antioxidants.
What kind of achalasia is most common?
Primary
In HPV (16) associated squamous cell carcinoma where are the most common sites?
Base of tongue, tonsillar crypts
Who is at risk for celiac disease ?
White people, 30-60
What condition is associated with barrett esophagus ?
GERD
What is associated with projectile vomiting and the fluid is not bile stained. ?
Pyloric stenosis
What makes up 20% of lower intestinal bleeds?
Angiodysplasia
What is a nodular mass, following chronic irritation also has
Hyperplasia and fibrosis and is most common along the bite line?
Fibroma
What is a solitary punched out lesion in the stomach ?
Peptic ulcer disease
Where does U.C. Always being ?
Rectum
What are the most common (3) locations of Crohn’s disease ?
Terminal ileum, ileocecal valve
Who is at risk forr a squamous cell carcinoma in the esophagus ?
45^, males, African americans
If caught early what’s the 5 ear survival rate for gastric adenocarcinoma ?
90%
What causes cholera ?
Vinbro cholera (gram -)
Is crohns disease or ulcerative colitis malabsorptive ?
Crohns
What kind of pain is assocaited with peptic ulcers and when?
Gnawing, burning, boring, at night 1-3 hours after eating
When celiac disase manifests on the skin what is it called?
Dermatitis herpetiformis
What is inflammation of the gastric mucosa ?
Gastritis
What kind of gastritis is less severe but prolonged?
Chronic
What relieves peptic ulcers?
Alkaline substance
What arteries are associated with ischemic bowl disease? (Ischemic colitis)
Superior and inferior mesenteric arteries, and celiac artery
What are characteristics of hemorrhoid?
Thin walled varices, swollen and tortuous
What is responsible for 50% of esophageal cancers in the us?
Adenocarcinoma
What causes celiac disease?
B and T cells damage S.I. Causing villous atrophy
What is the most common form of viral Sialadenitis?
Mumps virus infection (pediatrics = self limiting. Adults, pancreatitis and orchitis)
How does one diagnose lactose intolerance?
Breath hydrogen test
What is a major risk for adenomas and how much higher is the risk?
Family history, 4x increased risk
Q
What is secondary to injury to esophageal mucosa?
Esophagitis
What syndrome is associated with salivary gland problems?
Sjogren syndrome
Canker sores effect what percent of the population ???
40
Where is the problem with lactose intolerance ?
S.I. Brush border
What condition is associated with grey/white pseudomembranes that can be scraped off?
Oral candidiasis
What are symptoms of sigmoid diverticulitis ?
Cramping, LLQ pain
What is lost in celiac Disease?
Villi
What is characterized by dry mouth, due to decreased saliva production?
Xerostomia
What is known as a pregnancy tumor?
Pyogenic granuloma
The ______the size of a adenoma the_______chance of cancer.
Larger, higher
What is it called when inflammation leads to fibrosis that creates adherent intestinal segments?
Adhesions
What are signs of an acute appendicitis ?
Anorexia, nausea, vomiting
The cholera toxin opens what?
CFTR which = a massive chloride ion secretion
What is a major risk of esophageal varices?
Hemorrhage. 50% of first time bleeds are lethal
What is the triad for achalasia?
Incomplete LES relaxation, increased LES tone, esophageal aperistalsis
Internal hemorrhoids =?
Above the anorectal line
What is another name for environmental enteropathy ?
Tropical sprue
What are late symptoms of appendicitis ?
RLQ tenderness to deep/constant pain
What is the most common bacterial enteric pathogen in the US?
Campylobacter jejuni
How many people in the us over have have adenomas?
Half
What is a main symptom of acute peptic ulceration ?
Coffee ground mematemesis
Transmural inflammation with fissures and Melena is associated with what?
Crohn disease
What things are aspirated with toxic Megacolon?
Polyarthritis, sacoiliitis, AS, eye irritation
Where is the most common site of mets for oral squamous cell carcinoma?
Cervical lymph nodes
What is the most common cancer associated with Lynch syndrome?
Endometrial
Is chronic gastric mucosa symptomatic ?
No
What kind of pain is associated with Crohn’s disease?
RLQ pain
How does malabsorption manifest itself?
Chronic diarrhea
What causes travelers diarrhea ?
Fecal oral contamination
What are 3 organisms that cause acute self limited colitis ?
Campylobacter, shigella, E. coli, salmonella
What are risks for pseudomembranous colitis?
Hospitalization
What is congenital outpouching of the small intestine called ?
Meckel diverticulum
What kind of ulcer gets better after eating?
Duodenal
What is another name for hirschsprung disease?
Congenital aganglionic megacolon
What is the most common vascular disorder of G.I. Tract ?
Hemorrhoids
What is the loss of inhibitory innervation to the LES?
Primary achalasia
What are carries are salmonella?
Snakes, lizards, gecko, salamanders q
Thrush is seen in what percent of newborns?
40
What disease is associated with lack of neurologic ganglia in the rectum that may involve the sigmoid colon?
Hirschsprung disease
What is the most common cause of appendicitis ?
Obstruction (50-80%)
What type of esophageal lesion is associated with achalasia, aperistalsis?
Functional
What percent of submandibular gland tumors are malignant ?
40%
What is the main cause of travelers diarrhea?
Enterotoxigenic E. Coli
What organisms is associated with parasitic disease?
Ascaris lumnricoides
How does one diagnose familial adenomatous polyposis ?
100 or more adenomas most commonly 500-2,500
What are treatments for pseudomembranous colitis ?
Vancomycin or metronidazole
What is a shallow painful ulceration in the oral mucosa and or pharynx usually less than 5mm?
Canker sore
What is inhibitory for U.C.?
Smoking
Does location of herpes indicate type ?
No
At what age are most people diagnosed with colorectal adenocarcinoma ?
50-70
What are risk factors for pyloric stenosis ?
White, male, turner syndrome
What is it called when the stomach protrudes into the thorax, via a wider esophageal hiatus?
Hiatal hernia
