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medical board > XV - The Oral Cavity and the GI Tract > Flashcards

XV - The Oral Cavity and the GI Tract Flashcards

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USMLE® Step 1 flashcards
1
Q

Small, painful, rounded superficial erosions of the mouth, covered with a gray-white exudate and having an erythematous rim.

A

Aphthous ulcers (canker sores)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

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2
Q

Extremely common infection caused by herpes simplex virus type 1.

A

Herpetic stomatitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

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3
Q

Test used to identify HSV infection.

A

Tzanck test(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

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4
Q

Glassy, intranuclear acidophilic inclusion bodies. SEE SLIDE 15.1.

A

Herpes simplex virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

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5
Q

Adherent white, curd-like, circumscribed plaque within the oral cavity. The pseudomembrane can be scraped off revealing an underlying granular erythematous inflammatory base.

A

Oral candidiasis /”thrush”(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

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6
Q

An oral lesion seen in patients with HIV. White confluent patches with “hairy” or corrugated surface with marked epithelial thickening.

A

Hairy leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

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7
Q

Hairy leukoplakia is caused by what infectious agent?

A

Epstein-Barr virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

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8
Q

A whitish, well-defined mucosal patch or plaque caused by epidermal thickening or hyperkeratosis, commonly seen in the vermillion border of the lower lip, buccal mucosa, hard and soft palates.

A

Leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

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9
Q

Oral lesion showing a corrugated surface caused by excessive hyperkeratosis. Recurring and spreads insiduously, resulting in a warty-type lesion.

A

Verrucous leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

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10
Q

Red, velvety, granular, circumscribed lesions of the mouth with poorly defined, irregular boundaries. High malignant transformation rate.

A

Erythroplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

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11
Q

Most frequent site of oral cavity carcinomas.

A

Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

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12
Q

Pearly white to gray, circumscribed thickenings of the oral mucosa, which grows in exophytic pattern to produce a visible and palpable nodular, eventually fungating lesions.

A

Oral cavity carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

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13
Q

Most common lesion of the salivary glands resulting from blockage or rupture of a salivary gland duct.

A

Mucocele(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

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14
Q

Inflammation of the salivary glands.

A

Sialadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

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15
Q

Salivary and lacrimal gland inflammatory enlargement presenting as painless lesions, and dry mouth. Can be caused by sarcoidosis, leukemia, and lymphoma.

A

Mikulicz syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

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16
Q

Incomplete relaxation of lower esophageal sphincter in response to swallowing.

A

Achalasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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17
Q

Destruction of the myenteric plexus of the esophagus, duodenum, colon and ureter caused by a flagellate protozoa.

A

Chagas disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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18
Q

Causative agent for Chagas disease.

A

Trypanosoma cruzi(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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19
Q

Adult with progressive dysphagia to solids and eventually to all foods, caused by a narrowing of the lower esophagus, usually as a result of chronic inflammatory disease.

A

Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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20
Q

A congenital defect which causes the esophagus to end in a blind-ended pouch.

A

Esophageal atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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21
Q

Most common type of esophageal atresia.

A

Esophageal atresia with distal tracheoesophageal fistula(Type C)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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22
Q

Thin membranes of normal esophageal tissue consisting of mucosa and submucosa that can partially obstruct the esophagus.

A

Esophageal web(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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23
Q

Congenital esophageal webs commonly appear in which segment of the esophagus?

A

Middle and inferior third of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

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24
Q

A diverticulum of the mucosa of the pharynx just above the cricopharyngeal muscle.

A

Zenker’s diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

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25
Q

A triangular area in the pharyngeal wall where a Zenker’s diverticulum may develop.

A

Killian’s triangle(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

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26
Q

Protrusion of the stomach above the diaphragm, creating a bell-shaped dilation, bounded below by the diaphragmatic narrowing.

A

Sliding hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

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27
Q

Hernia wherein a portion of the stomach, usually along the greater curvature, enters the thorax through the widened space between the muscular crura.

A

Paraesophgeal (rolling) hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

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28
Q

Longitudinal tears along the gastroesophageal junction seen in chronic alcoholics after a bout of retching or vomiting.

A

Mallory-Weiss tears(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

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29
Q

Tortuous dilated veins lying within the submucosa of the distal esophagus and proximal stomach due to increased portal pressure, usually due to cirrhosis. May cause massive hemorrhage if ruptured.

A

Esophageal varices(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587

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30
Q

Presence of eosinophils in the epithelial layer, basal zone hyperplasia and elongation of lamina propria papillae are histologic findings in this condition.

A

Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588

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31
Q

Defined as the replacement of the normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells. A complication of long-standing GERD. SEE SLIDE 15.2.

A

Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

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32
Q

Esophageal lesion at risk of developing adenocarcinoma:Reflux esophagitis or Barrett esophagus?

A

Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 589

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33
Q

Squamous cell carcinoma of the esophagus commonly occur at which segment of the esophagus?

A

Proximal 2/3 of the esophagusAdenocarcinoma- distal 1/3(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

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34
Q

Most common symptoms of esophageal cancer.

A

Dysphagia and odynophagia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

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35
Q

Mucin-producing glandular tumors of the distal esophagus showing intestinal-type features. SEE SLIDE 15.3.

A

Adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

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36
Q

Presence of chronic inflammatory changes in the mucosa of the stomach eventually leading to mucosal atrophy and epithelial metaplasia.

A

Chronic gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

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37
Q

Most important etiologic association with chronic gastritis. A non-invasive, non-spore forming S-shaped gram negative rod.

A

Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

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38
Q

Gastritis resulting from production of autoantibodies to the gastric gland parietal cells, leading to gland destruction and mucosal atrophy with loss of acid and intrinsic factor.

A

Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

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39
Q

Refers to the replacement of gastric epithelium with columnar and goblet cells of intestinal variety.

A

Intestinal metaplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

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40
Q

A acute mucosal inflammatory process of the stomach, marked by mucosal edema and inflammatory infiltrate of neutrophils and chronic inflammatory cells. Regenerative replication of cells in the gastric pit is prominent.

A

Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

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41
Q

One of the major causes of hematemesis, especially in alcoholics.

A

Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

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42
Q

A breach in the mucosa that extends through the muscularis mucosae into the submucosa or deeper.

A

Ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

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43
Q

Breach in the epithelium of the gastrointestinal mucosa only.

A

Erosions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

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44
Q

Chronic, solitary lesions that occur in any portion of the GIT exposed to the aggressive action of acidic peptic juices.

A

Peptic ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 594

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45
Q

Major cause of peptic ulcer disease in patients without H. pylori disease.

A

NSAID use(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 595

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46
Q

Histologic layers in a chronic, nonperforated, open ulcer.

A

From luminal surface:NecrosisInflammationGranulation tissueScar(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

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47
Q

Chief complication of peptic ulcer.

A

Bleeding(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

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48
Q

Increases risk of developing gastric adenocarcinoma:Acute gastritis vs. peptic ulcer disease?

A

Acute gastritisPUD is NOT a premalignant lesion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

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49
Q

Acute gastric ulceration which occurs in the presence of extensive burns.

A

Curling ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

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50
Q

Acute gastric ulceration which occurs in the presence of injury to the CNS.

A

Cushing ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

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51
Q

Composed of hyperplastic gastric mucosal epithelium and an inflamed edematous stroma. A mass lesion arising from the mucosa.

A

Gastric polyp(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597

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52
Q

Most common site of gastric carcinoma within the stomach.

A

Pylorus and antrum (50-60%), along the lesser curvatureCardia (25%)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598

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53
Q

What are the two most important factors in the genesis of colonic diverticula?

A

Focal weakness in the colonic wall and increased intraluminal pressure(TOPNOTCH)

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54
Q

Morphologic feature of gastric carcinomas with greatest impact on prognosis.

A

Depth of invasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

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55
Q

Gastric carcinoma confined to the mucosa and submucosa, regardless of the presence or absence of perigastric LN metastasis.

A

Early gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

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56
Q

Gastric carcinoma which has extended below the submucosa into the muscular wall.

A

Advanced gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

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57
Q

Three macroscopic growth patterns of gastric carcinoma.

A

Exophytic - protrusion of mass into lumenFlat or depressed - no obvious tumor mass within the mucosaExcavated - a shallow or deeply eroded crater(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

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58
Q

Rigid and thickened stomach, secondary to extensive malignant infiltration.

A

Linitis plastica(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

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59
Q

Histologic classification of gastric carcinoma composed of malignant cells forming neoplastic intestinal glands resembling colonic adenocarcinoma. Associated with H. pylori induced chronic gastritis. SEE SLIDE 15.4.

A

Intestinal variant gastric adenocarcinoma (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 570

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60
Q

Histologic classification of gastric carcinoma composed of gastric-type mucous cells that do not form glands but permeate the mucosa and wall as “signet-ring” cells in an infiltrative growth pattern. Often evoke a desmoplastic reaction that may cause leather bottle appearance (linitis plastica). SEE SLIDE 15.5.

A

Diffuse variant gastric adenocarcinoma (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 570

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61
Q

A malignancy in the ovary that metastasized from a gastric adenocarcinoma.

A

Krukenberg tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

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62
Q

Complete failure of development of the intestinal lumen.

A

Atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

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63
Q

Narrowing of the intestinal lumen with incomplete obstruction.

A

Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

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64
Q

Most common intestinal anomaly which results from the failure of involution of the omphalomesenteric duct, leaving a persistent blind-ended tubular protrusion as long as 5-6cm.

A

Meckel diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

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65
Q

A congenital defect of the periumbillical abdominal musculature that creates a membranous sac, into which intestines herniate.

A

Omphalocoele. SEE SLIDE 15.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

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66
Q

Extrusion of the intestines caused by lack of formation of a portion of the abdominal wall.

A

Gastroschisis. SEE SLIDE 15.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

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67
Q

Condition that prevents the intestines from assuming their normal intra-abdominal positions.

A

Malrotation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

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68
Q

Critical lesion in the development of Hirschprung disease.

A

Lack of ganglion cells in the muscle wall and submucosa of the affected segment.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

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69
Q

Ischemic lesion of the intestines which extends only up to the muscularis mucosae.

A

Mucosal infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

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70
Q

Ischemic lesion of the intestines involving the mucosa and submucosa, sparing the muscular wall.

A

Mural infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

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71
Q

Ischemic lesion of the intestines involving all of the visceral layers.

A

Transmural infarct(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

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72
Q

Most common cause of transmural infarction of the intestines.

A

Acute occlusion of a major mesenteric artery(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

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73
Q

Development of sudden abdominal pain out of proportion to the physical signs. Sometimes accomplanied by bloody diarrhea. May progress to shock and vascular collapse within hours.

A

Ischemic bowel injury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

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74
Q

A weakness or defect in the wall of the peritoneal cavity, which permits protrusion of a pouch-like serosa lined sac of peritoneum.

A

Hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 603

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75
Q

A blind pouch that communicates with the lumen of the gut. Histologically describes as small, flask-like or spherical outpouchings, usually 0.5 to 1 cm diameter.

A

Diverticula(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

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76
Q

Telescoping of a proximal segment of a bowel into the immediately distal segment

A

Intussusception(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604

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77
Q

Refers to twisting of a loop of bowel or other structure about its base of attachment, constricting venous outflow and sometimes the arterial supply.

A

Volvulus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604

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78
Q

Characterized by transmural inflammation of the bowel, associated with noncaseating granulomas and fistula formation. Intestinal walls are rubbery and thick. SEE SLIDE 15.7. (+) skip lesions, creeping fat mesentery

A

Crohn’s disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 613

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79
Q

An ulceroinflammatory disease of the colon which is limited to the mucosa and submucosa. No granulomas, no skip lesions. High risk of carcinoma development. SEE SLIDE 15.8.

A

Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 614

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80
Q

Small, nipple-like, hemispherical, smooth protrusions of the intestinal mucosa. Contains abundant crypts lined by well-differentiated goblet or epithelial cells, giving a SERRATED surface architecture. SEE SLIDE 15.9.

A

Hyperplastic polyps(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 593

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81
Q

Hamartomatous proliferations mainly of lamina propria, enclosing widely spaced, dilated cystic glands. Occur most frequently in children younger than 5 years old. SEE SLIDE 15.10.

A

Juvenile polyps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

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82
Q

Most common type of intestinal adenoma, which are tubular glands with slender stalks and raspberry-like heads composed pf neoplastic epithelium forming branching glands lined by tall, hyperchromatic cells.

A

Tubular adenomas. SEE SLIDE 15.11. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

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83
Q

Larger, more ominous intestinal epithelial polyp. Tends to occur in older persons at the rectum or rectosigmoid. Sessile, velvety and cauliflower-like mass projecting 1-3cm above the surrounding mucosa. Frondlike villiform extensions covered by dysplastic columnar epithelium.

A

Villous adenomas. SEE SLIDE 15.11. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

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84
Q

Composed of broad mix of tubular and villous areas, an intermediate between tubular and villous lesions.

A

Tubulovillous adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

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85
Q

Uncommon autosomal dominant disorder with propensity for malignant transformation. Patients with this disease typically develop 500 to 2500 colonic adenomas that carpet the mucosal surface.

A

Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619

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86
Q

Uncommon hamartomatous polyps associated with melanotic mucosal and cutaneous pigmentation. SEE SLIDE 15.12. Caused by germ-line mutations in LKB1 gene.

A

Peutz-Jeghers syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619

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87
Q

Polypoid, exophytic masses that extend along the wall of capacious cecum and ascending colon. Symptoms of fatigue, weakness and iron deficiency anemia.

A

Right sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623

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88
Q

Annular, encircling lesions, “napkin-ring” constrictions of the bowel and narrowing of the lumen. Symptoms pf occult bleeding, changes in bowel habit or crampy left lower quadrant discomfort.

A

Left-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623

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89
Q

Tumor of the small intestines, showing spindle cells with elongated nuclei with fine chromatin and eosinophilic fibrillar cytoplasm. (+) c-KIT gene mutation. SEE SLIDE 15.13.

A

Gastrointestinal stromal tumors (GIST)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 628

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90
Q

Most common site of carcinoid tumors.

A

Small intestine(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774

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91
Q

Tumors arising from endocrine cells along the GIT. Solid, yellow-tan appearance on transection. Nmay also cause a desmoplastic reaction that may cause kinking of bowel and obstruction. Histology shows islands, trabeculae, strands, or sheets of uniform cells with scant, pink granular cytoplasm, with a stippled nucleus. SEE SLIDE 15.14.

A

Carcinoid tumors(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 571

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92
Q

What is the most common ectopic tissue rests seen in the esophagus?

A

Ectopic Gastric Mucosa seen in the upper third of the esophagus (TOPNOTCH)

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93
Q

What is the most common location of Mallory Weiss Tears?

A

Esophagogastric junction or in the proximal gastric (TOPNOTCH)

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94
Q

Definitive diagnosis of Barret Esophagus is made when what type of cells is seen in the columnar mucosa?

A

Intestinal Goblet Cells(TOPNOTCH)

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95
Q

What type of esophagitis presents with linear ulcerations of the esophageal mucosa with histologic findings of intranuclear and cytoplasmic inclusions?

A

CMV esophagitis. SEE SLIDE 15.15. (TOPNOTCH)

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96
Q

98% of Peptic Ulcers are located in what part of the GIT?

A

First portion of the anterior part of the duodenum(TOPNOTCH)

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97
Q

What is the most common location of gastric ulcer?

A

Lesser curvature (TOPNOTCH)

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98
Q

What is the most common location of gastric carcinoma is?

A

Pylorus and antrum > Cardia > body and fundus(TOPNOTCH)

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99
Q

What is the morphologic feature of gastric carcinoma that has the greatest impact on the clinical outcome?

A

Depth of invasion(TOPNOTCH)

100
Q

What is the most common primary source of gastric metastasis?

A

Systemic lymphoma(TOPNOTCH)

101
Q

What is the usual organism that cause spontaneous bacterial peritonitis in patients with nephrotic syndrome?

A

E. coli(TOPNOTCH)

102
Q

In bacterial peritonitis, approximately how many hours from the time of initiation before there is loss of the gray, glistening quality of the peritoneal surface and it becomes dull and lusterless?

A

2-4 hours(TOPNOTCH)

103
Q

What is the histologic criterion for the diagnosis of acute appendicitis?

A

Presence of neutrophilic infiltration of the muscularis propria.(TOPNOTCH)

104
Q

What is the most important prognostic indicator of colorectal carcinoma?

A

The extent of the tumor at the time of diagnosis or the stage(TOPNOTCH)

105
Q

These structures represent islands of inflamed regenerating mucosa surrounded by ulceration

A

Inflammatory or pseudopolyps(TOPNOTCH)

106
Q

Most adenomas are seen in what part of the GIT?

A

Ampulla of Vater(TOPNOTCH)

107
Q

Most tubular adenomas are found in what part of the GIT?

A

Colon(TOPNOTCH)

108
Q

Morphology: thin wall composed of flattened or atrophic mucosa, compressed submucosa, and attenuated or totally absent muscularis propria.

A

Colonic diverticula(TOPNOTCH)

109
Q

What is the most common site of angiodysplasia?

A

Cecum(TOPNOTCH)

110
Q

Morphology: these are tortuous dilations of submucosal and mucosal blood vessels

A

Angiodysplasia(TOPNOTCH)

111
Q

What area of the GIT is at greatest risk of ischemic injury?

A

Splenic flexure(TOPNOTCH)

112
Q

Morphology: diffuse active inflammation with crypt abscess and glandular architectural distortion

A

Ulcerative Colitis(TOPNOTCH)

113
Q

What is the earliest lesion seen in Crohn Disease?

A

Focal neutrophilic infiltration into the epithelial layer, particularly overlying mucosal lymphoid aggregates(TOPNOTCH)

114
Q

What is the hallmark of inflammatory bowel disease, both CD and UC?

A

Chronic mucosal damage(TOPNOTCH)

115
Q

Gross morphology: narrowing of lumen, bowel wall thickening, serosal extension of mesenteric fat, and linear ulceration of the mucosal surface

A

Crohn disease(TOPNOTCH)

116
Q

What are the two key pathogenic abnormalities seen in Idiopathic Inflammatory Bowel disease?

A

Strong immune response against normal flora and defects in epithelial barrier function(TOPNOTCH)

117
Q

Gross morphology: intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis and hypertrophy of the muscularis propria

A

Crohn disease(TOPNOTCH)

118
Q

Morphology: Small intestinal mucosa laden with distended macrophages in the lamina propria which are PAS positive and contains numerous bacilli and diastase resistant granules. SEE SLIDE 15.16.

A

Whipple disease(TOPNOTCH)

119
Q

Intestinal lipodystrophy is associated with what disease entity?

A

Whipple disase(TOPNOTCH)

120
Q

Disease associated with GLUTEN intake, often affects second portion of duodenum or proximal jejunum. There is increased lymphocytosis and diffuse severe atrophy and blunting of villi.

A

Celiac disease. SEE SLIDE 15.17. (TOPNOTCH) Robbins Basic Pathology, 9th ed. P 578.

121
Q

Morphology: focal crypt cell necrosis or apoptosis with minimal to absent inflammatory cell response in the lamina propria

A

Acute GVHD(TOPNOTCH)

122
Q

Morphology: Marked blunting of the small intestinal villi with a mixed inflammatory infiltrate resembling the atrophic stage of celiac disease

A

Giardiasis(TOPNOTCH)

123
Q

Morphology: Superficial erosion of the mucosa and an adherent pseudomembrane of fibrin, mucus, and inflammatory debris. SEE SLIDE 15.18.

A

Pseudomembranous colitis(TOPNOTCH)

124
Q

Morphology: Small intestinal mucosa usually exhibits modestly shortened villi and infiltration of the lamina propria by lymphocytes

A

Viral gastroenteritis(TOPNOTCH)

125
Q

What virus affecting the GIT can produce a flat mucosa resembling celiac sprue?

A

Rotavirus(TOPNOTCH)

126
Q

Morphology: Characterized by the absence of ganglion cells and ganglia in the muscle wall and submucosa of the affected segment

A

Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)

127
Q

Stercoral ulcers are seen in what disease entity?

A

Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)

128
Q

The majority of these tumors are positive for c-KIT (CD 117)

A

Gastrointestinal Stromal Tumor(TOPNOTCH)

129
Q

What is the most common site of gastric carcinoma?

A

Pylorus and antrum 50%-60%(TOPNOTCH)

130
Q

What is the most favored site of gastric carcinoma?

A

Lesser curvature of the anthropyloric region(TOPNOTCH)

131
Q

What is the most common type of gastric polyp?

A

Hyperplastic polyp(TOPNOTCH)

132
Q

In gastritis, histologically, what signifies an active inflammation?

A

Presence of neutrophils above the basement membrane.(TOPNOTCH)

133
Q

H. pylori infection in duodenal ulcers is present in about how many percent of patients?

A

Virtually ALL (70% in patients with gastric ulcer(TOPNOTCH)

134
Q

A 10 y/o male presented with recurrent painless rectal bleeding with no other associated symptoms. PE findings were unremarkable. The abdomen was soft, non tender, with no palpable mass. What is the clinical impression?

A

Meckel Diverticulum (TOPNOTCH)

135
Q

Most common site of Meckel Diverticulum

A

Antimesenteric border of ileum (TOPNOTCH)

136
Q

True or False. Meckel diverticulum is a true diverticulum

A

True (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

137
Q

Most common site of acquired diverticula.

A

Sigmoid colon (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

138
Q

The most common true diverticulum

A

Meckel Diverticulum (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

139
Q

A 3 week old male infant presented to the ER due to vomiting. Mother denies bilious or bloody emesis. Mother states he is always hungry and vomits after nearly every bottle. PE reveals firm, ovoid, 2 cm abdominal mass. What is the most likely diagnosis?

A

Pyloric stenosis (TOPNTOCH)

140
Q

Pathology of Pyloric stenosis

A

Hyperplasia of pyloric muscularis propria (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

141
Q

Pyloric is more common in male or female?

A

3-5x more common in male (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

142
Q

A 3-day-old infant presented with emesis and failure to pass meconium for the first 36 hours. PE revealed a moderately distended abdomen. Bowel sound are active. No organs or abdominal masses were palpated. Anus was patent. What is the clinical impression?

A

Hirchsprung’s Disease (TOPNOTCH)

143
Q

Most important diagnostic test in Hirchsprung Disease

A

Rectal biopsy (TOPNOTCH)

144
Q

Histologic findings in Hirchsprung Disease

A

Absence of ganglion cells in the submucosal and myenteric plexuses.(and hypertrophic extrinsic nerve fibers) (TOPNOTCH)

145
Q

Typically presentes with failure to pass mecondium in the immediate postnatal period, followed by obstruction or constipation, often with visible ineffective peristalsis, progressing to abdominal distention and bilious vomiting.

A

Hirchsprung’s Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752

146
Q

Most frequent site of ectopic gastric mucosa

A

Upper third of esophagus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 750

147
Q

Aganglionic segment of the colon presents with distention or contracted appearance?

A

Grossly normal or contracted appearance. Normal proximal colon-dilated. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752

148
Q

Dysphagia, regurgitation of undigested food, aspiration, and halitosis strongly suggest diagnosis of ______.

A

Zenker diverticulum (TOPNOTCH)

149
Q

It is characterized by the triad of incomplete LES relaxation, increased LES tone, and aperistalsis of the esophagus

A

Achalasia(TOPNOTCH) Robbins Basic Pathology, 9th ed., p.753

150
Q

Patient presented with dysphagia for both solid and liquid, difficulty in belching, and chest pain. The esophageal obstruction is most likely caused by?

A

Impaired smooth muscle relaxation of LES (Case of Achalasia) (TOPNOTCH)

151
Q

It is the result of distal esophageal inhibitory neuronal/ganglion cell degeneration.

A

Primary achalasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 753

152
Q

Characterized by transmural tearing and rupture of the distal esophagus. Patients present with severe chest pain, tachypnea and shock.

A

Boerhaave syndrome. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 754

153
Q

Most frequent cause of esophagitis

A

Reflux of gastric contents in the lower esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755

154
Q

Most common cause of gastroesophageal reflux

A

Transient lower esophageal sphincter relaxation. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755

155
Q

Severe form of this condition may have histologic finding of eosinophils recruited into the squamous mucosa followed by neutrophils. Basal zone hyperplasia and elongation of lamina propria papillae of the esophagus may be present.

A

GERD (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 561

156
Q

Barrett esophagus confers an increased risk of what cancer?

A

Esophageal adenocarcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 757

157
Q

A 55 y/o patient with a chronic history of heartburn and acid regurgitation underwent EGD, and revealed patches of red, velvety mucosa with interface of light-brown columnar epithelium with goblet cells. He is at risk for developing___.

A

Esophageal adenocarcinoma. This is a case of Barret esophagus. (TOPNOTCH)

158
Q

Patient presented with odynophagia, dysphagia, progressive weight loss, chest pain and vomiting. A 5 cm mass was noted at the distal 3rd of the esophagus, which ulcerate and invade deeply. The most likely diagnosis is

A

Esophageal adenocarcinoma. It usually occurs in the distal 3rd of esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 758

159
Q

Most common site of volvulus

A

Sigmoid colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778

160
Q

Most common cause of intestinal obstruction in children younger than 2 years of age

A

Intussusception(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778

161
Q

Presents with sudden onset of cramping, left lower abdominal pain, a desire to defecate, and passage of blood or bloody diarrhea.

A

Acute colonic ischemia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780

162
Q

Most common acquired GI emergency of neonates, particularly those who are premature or of low birth weight.

A

Necrotizing enterocolitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780

163
Q

Immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed individual

A

Celiac disease/Celiac sprue/Gluten-sensitive enteropathy(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 782

164
Q

Most sensitive test for Celiac sprue

A

IgA antibodies against tissue transglutaminase(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 783

165
Q

Most common bacterial enteric pathogen; an important cause of traveler’s diarrhea

A

Campylobacter jejuni(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786

166
Q

Watery diarrhea associated with ingestion of improperly cooked chicken, unpasteurized milk or contaminated water. It is an important bacterial cause of food poisoning.

A

Campylobacter enterocolitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786

167
Q

Diagnosis of Campylobacter enterocolitis, stool culture or biopsy?

A

Stool culture(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 787

168
Q

Presents with 1 week of diarrhea, fever, and abdominal pain, constitutional symptoms for about 1 month. May also present with waxing and waning diarrhea. Caused by gram-negative, facultative anaerobe.

A

Shigellosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 787

169
Q

Complications of Shigella infection(Triad)

A

Sterile reactive arthritis, urethritis, and conjunctivitis.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 788

170
Q

Infection by a gram-negative bacilli causing diarrhea, common in young children and older adults by ingestion of contaminated food, particularly raw or undercooked meat, poultry, eggs, and milk.

A

Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789

171
Q

Patients with sickle cell disease are particularly susceptible to osteomyelitis caused by:

A

Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789

172
Q

The principal cause of traveler’s diarrhea

A

Enterotoxigenic E. Coli(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 790

173
Q

Mechanism of diarrhea in this infection : adenylate cyclase activation, increase intracellular cAMP, opens CFTR to drive chloride secretion and diarrhea.

A

Cholera(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 785

174
Q

Most common etiologic agent causing pseudomembranous colitis/antibiotic-associated colitis.

A

Clostridium difficile(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 791

175
Q

Most frequent complication of Peptic ulcer disease

A

Bleeding(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768

176
Q

Most frequent etiology of noninfectious chronic gastritis

A

Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768

177
Q

Characterized by irregular enlargement of gastric rugae associated with excessive secretion of TFG-alpha.

A

Menetrier disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 768

178
Q

Syndrome most commonly found in the small intestine or pancreas, caused by gastrin-secreting tumors; most remarkable feature is doubling of oxyntic mucosal thickness

A

Zollinger-Ellison Syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 769

179
Q

Most common site of gastric adenoma in the stomach

A

Antrum(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 770

180
Q

Most common malignancy of the stomach

A

Adenocarcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 771

181
Q

Most common type of cancer the predominates in high-risk areas and develops from flat dysplasia and adenomas

A

Intestinal-type gastric cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 772

182
Q

Most common site of extranodal lymphoma

A

Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773

183
Q

Most common inducer of MALToma in the stomach

A

H. pylori(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773

184
Q

GI Tumor characterized by cutaneous flushing, sweating, bronchospasm, colicky abdominal pain, diarrhea, and right-sided cardiac valvular fibrosis.

A

Carcinoid tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774

185
Q

The most common mesenchymal tumor of the abdomen

A

GI stromal tumor(GIST) tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775

186
Q

The most important prognostic factor for GI Carcinoid tumor

A

Location(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775

187
Q

Most common site of GIST

A

Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777

188
Q

Most frequent cause of intestinal obstruction

A

Hernias(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777

189
Q

Most common sites of ischemic bowel disease

A

Splenic flexure, sigmoid colon, rectum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 784

190
Q

Autosomal recessive disorder presenting with explosive diarrhea with watery, frothy stools, and abdominal distention.

A

Congenital lactase (disaccharidase) deficiency(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 784

191
Q

IBD presenting with thick wall appearance, transmural inflammation, skip lesions, knife-like ulcer, marked fibrosis and serositis

A

Crohn disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., . 797

192
Q

IBD which may presents with thin wall appearance, inflammation limited only to mucosa, marked pseudopolyps, broad-based ulcer, moderate lymphoid reaction, and toxic megacolon (complication)

A

Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 797

193
Q

Most important characteristic of colorectal adenomas that correlates with risk of malignancy.

A

Size of the tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 808

194
Q

An autosomal dominant disorder in which patients develop numerous colorectal adenomas as teenager caused by mutation of APC

A

Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 809

195
Q

Most common syndromic form of colon cancer; colon cancers tend to occur at younger ages

A

HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809

196
Q

Most common location of HNPCC

A

Right colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 809

197
Q

Autosomal dominant disorder characterized by familial clustering of cancers at several sites caused by DNA mismatch repair

A

HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809

198
Q

Location of colorectal cancer presenting with fatigue and weakness due to iron deficiency anemia

A

Right-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623

199
Q

Most common site of metastasis of colorectal adenocarcinoma

A

Liver(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 813

200
Q

Which of the following statements regarding oral plaques is TRUE? (A) leukoplakia has a strong association with tobacco use (B) among the oral leukoplakias, those on the floor of the mouth have the highest rate of transformation to squamous cell carcinoma (C) hairy leukoplakia in AIDS patients have a high risk of malignant transformation (D) erythroplakia is less likely to undergo malignant transformation than leukoplakia

A

leukoplakia has a strong association with tobacco use (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 581-82

201
Q

Which of the following is the most common site of oral cavity carcinoma? (A) lateral orders of the mobile tongue (B) floor of mouth (C) vermilion border of the lateral margins of the lower lip (D) hard palate

A

Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

202
Q

A 28 year old man presents with a 5 year history of a slow growing, painless, preauricular mass. FNAB showed clusters of bland cells admixed with myxoid material. He undergoes parotidectomy, and histopathologic examination of the mass shows bland epithelial cells forming clusters, ducts, and sheets, with surrounding myxoid stroma. SEE SLIDE 15.19. There are also islands of cartilage. His tumor (A) can metastasize (B) is a chondrosarcoma (C) is the commonest tumor of the parotid gland (D) does not undergo malignant transformation

A

is the commonest tumor of the parotid gland (pleomorphic adenoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 584

203
Q

A 55 year old male smoker undergoes parotidectomy for a cystic mass. Histopathology shows cystic spaces lined by abranching, two-tiered layer of epithelial cells, with well developed lymphoid tissue right beneath the lining. SEE SLIDE 15.20. This tumor is thought to arise from (A) respiratory epithelium (B) heterotopic salivary tissue trapped within a lymph node (C) myoepithelial cells (D) macrophages

A

Heterotopic salivary tissue in a lymph node (Warthin tumor) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585.

204
Q

A 60 year old chronic alcoholic man suddenly has massive hematemesis and dies. At autopsy, his lower esophagus shows bluish, dilated veins in the submucosa with surrounding erythema. One of the veins is ruptured. Which of the following is expected of his liver? (A) smaller than normal, firm, with nodular external surface (B) markedly enlarged, with multiple hemorrhages on cut section (C) smaller than normal, with a nutmeg appearance on cut section (D) markedly enlarged, with a greasy yellowish cut surface

A

Smaller than normal, firm, with a nodular external surface (cirrhosis) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587

205
Q

A 24 year old female complains of heartburn, usually following spicy or sour meals. She takes antacids, with partial relief. She undergoes endoscopy where her lower esophagus appears diffusely erythematous with some epithelial erosions. A biopsy showed eosinophils in the epithelial layer, with basal zone hyperplasia. This is (A) reflux esophagitis (B) Barrett esophagus (C) esophageal candidiasis (D) squamous cell carcinoma

A

Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588

206
Q

A 33 year old man with a 10 year history of intermittent heartburn undergoes endoscopy, where his lower esophagus appears salmon-pink and velvety. Biopsy of the velvety area shows an epithelium composed of columnar cells with dark basal nuclei, and interspersed goblet cells. Compared to the normal population, this man has a 30- to 100-fold greater risk of developing (A) lymphoma (B) squamous cell carcinoma (C) adenocarcinoma (D) carcinoid

A

Adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

207
Q

Which is the most common site of esophageal squamous cell carcinoma? (A) cervical (B) upper thoracic (C) middle third (D) distal third

A

middle third (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 590

208
Q

What is the most important etiologic association of chronic gastritis? (A) Helicobacter pylori (B) Smoking (C) Alcohol abuse (D) NSAIDS

A

Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

209
Q

The histologic changes in chronic gastritis may predispose to the development of (A) squamous cell carcinoma and adenocarcinoma (B) adenocarcinoma and lymphoma (C) lymphoma and gastrointestinal stromal tumour (D) gastroinstestinal stromal tumor and squamous cell carcinoma

A

adenocarcinoma and lymphoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.592

210
Q

A 34 year old triathlete on chronic NSAIDs consults for chronic epigastric pain. An endoscopy showed a punched out, 2cm diameter ulcer in the duodenum, with perpendicular margins, extending into the submucosa. If a biopsy is performed, arrange the following layers from internal to external: (A) inflammation (B) necrosis (C) scar (D) granulation tissue

A

necrosis, inflammation, granulation tissue, scar (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

211
Q

A 25 year old man who suffered from a scalding burn, 80% of his body surface area, is admitted. In the burn unit, coffee ground material is observed in his NGT. Which of the following describes the type of gastric ulcer expected? (A) multiple,

A

multiple,

212
Q

Which of the following gastric polyps is a true neoplasm? (A) hyperplastic polyp (B) hypoplastic polyp (C) fundic gland polyp (D) adenoma

A

adenoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597-598

213
Q

Which of the following is a known risk factor for the diffuse type of gastric adenocarcinoma? (A) intestinal metaplasia (B) dietary nitrites (C) E-cadherin mutation (D) Her2-neu amplification

A

E cadherin mutation (all other choices are risk factors for intestinal type) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598

214
Q

Why do infants and children with Meckel diverticulum often present with melena? (A) the mucosa of the diverticulum is highly vascular (B) the diverticulum may have functioning gastric mucosa (C) patients with Meckel diverticulum have an increased likelihood of developing adenomas that can bleed (D) Meckel diverticulum is susceptible to Entamoeba histolytica infection

A

the diverticulum may have functioning gastric mucosa (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

215
Q

A 3 month old female with a perinatal history of delayed passage of meconium presents with alternating diarrhea and constipation. Imaging studies show a dilated cecum, ascending and transverse colon. The remaining distal colon is not dilated. Which of the following biopsy findings confirms Hirschprung disease? (A) absence of ganglion cells in the sigmoid (B) presence of ganglion cells in the transverse colon (C) presence of ganglion cells in the cecum (D) presence of ganglion cells in the descending colon

A

absence of ganglion cells in the sigmoid (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

216
Q

A 65 year old diabetic suffers an acute MI and is admitted at the ICU. The next day, he develops severe abdominal pain and melena, and dies a few hours later. Autopsy showed a dark red jejunum and ileum. Examination of one of the mesenteric artery branches shows 95% narrowing by atherosclerosis. Which of the following is the expected histologic finding of the affected bowel? (A) increased mitotic rate in mucosal crypts, decreased maturation of surface epithelial cells, variable neutrophilic infiltration (B) hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (C) tortuous mucosal and submucosal vessels (D) flask like submucosal ulcers filled with necrotic debris

A

hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

217
Q

Which of the following features of intestinal adenomas is the main determinant of risk of harboring an adenocarcinoma? (A) size (B) histologic architecture (C) severity of dysplasia (D) degreee of inflammation

A

size (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

218
Q

Which of the following is most likely affected by Familial Adenomatous Polyposis? (A) 44 year old female with 150-160 tubular adenomas in the colon (B) 65 year old male with 20-30 tubulovillous adenomas in the colon (C) 54 year old female with 120-130 hyperplastic polyps in the colon (D) 13 year old male with 30-40 hamartomatous polyps in the colon

A

44 year old female with 150-160 tubular adenomas in the colon (minimum of 100 colonic adenomas) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619

219
Q

Carcinoids in which of the following location is least likely to have metastasized at the time of diagnosis? (A) appendix (B) ileum (C) stomach (D) colon

A

Appendix (also, rectum) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.626

220
Q

Four features liked to H. pylori virulence

A

1) Flagella; 2) Urease (raises pH around bacterium); 3) Adhesins; 4) Toxins (involved in ulcer or cancer development) (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.566

221
Q

Which part of the stomach do you biopsy for evaluation of H. pylori gastritis?

A

Antrum (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

222
Q

INCREASED or DECREASED: Gastrin in H. pylori infection

A

Decreased (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

223
Q

INCREASED or DECREASED: Gastrin in autoimmune gastritis

A

Increased (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

224
Q

Characterized by diffuse damage of oxyntic mucosa within BODY and FUNDUS. In contrast with H. pylori gastritis, the inflammatory reaction is DEEP and centered on gastric glands. There is parietal and chief cell loss.

A

Autoimmune gastritis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

225
Q

Round to oval, sharply punched-out defect, with a smooth and clean base with rich granulation tissue.

A

Classic peptic ulcer(TOPNOTCH)Robbins Basic Pathology, 9th Ed p.568

226
Q

Antibodies typically present in autoimmune gastritis

A

Anti-parietal cell and anti-intrinsic factor antibodies. (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.569

227
Q

Two infectious agents linked to development of gastric cancer

A

H. pylori and EBV (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.570

228
Q

Related mutation to GIST

A

Tyrosine kinase c-KIT (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.572

229
Q

During embryogenesis, failure of ______ to migrate from cecum to recum causes Hirchsprung disease.

A

Neural crest cells (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.574

230
Q

Mutation associated with Hirschsprung disease

A

Tyrosine kinase RET loss of function mutation (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.574

231
Q

Can present as atrophy or sloughing of surface epithelium with hyperproliferative crypts. Inflammation initially absent, but neutrophils can be recruited within hours of reperfusion. Bacterial superinfection of the lesion may also lead to pseudomembrane formation that resembles C.diff colitis.

A

Acute intestinal ischemia (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.575

232
Q

OSMOTIC or SECRETORY diarrhea: Cholera

A

Secretory (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.582

233
Q

CROHN DISEASE or ULCERATIVE COLITIS: Skip lesion and can occur anywhere in the GI tract

A

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

234
Q

CROHN DISEASE or ULCERATIVE COLITIS: Thin bowel wall appearance with broad-based ulcers, with normal parts looking like pseudopolyps. At risk to develop toxic megacolon.

A

Ulcerative Colitis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

235
Q

CROHN DISEASE or ULCERATIVE COLITIS: At risk to develop fistulas, malabsorption, and recurrence after surgery

A

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

236
Q

CROHN DISEASE or ULCERATIVE COLITIS: Transmural inflammation with deep, knife-like ulcers with crypt abscesses. Leads to cobblestone appearance.

A

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

237
Q

CROHN DISEASE or ULCERATIVE COLITIS: Presence of NONCASEATING GRANULOMAS in 35%

A

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

238
Q

CROHN DISEASE or ULCERATIVE COLITIS: Risk for colon cancer

A

Both, especially if with colonic involvement in CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

239
Q

Common site of involvement in Crohn disease

A

Terminal ileum, ileocecal valve, cecal area (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.589

240
Q

CROHN DISEASE or ULCERATIVE COLITIS: Metaplastic changes, such as psudopyloric metaplasia (gastric antral-appearing glands) and Paneth cell metaplasia (in the left colon where Paneth cells are normally absent)

A

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.590

241
Q

CROHN DISEASE or ULCERATIVE COLITIS: Typically just involves the colon but can involve the distal ileum (backwash ileitis)

A

Ulcerative Colitis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

242
Q

SYNDROME: Hamaromatous polyp + Facial angifibroma + renal angiomyolipoma + cortical tubers

A

Tuberous sclerosis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.593

243
Q

SYNDROME: Hamaromatous polyp + Nail atrophy + Hair loss + Cachexia + Anemia + Abnormal skin pigmentation

A

Cronkhite-Canada Syndrome (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.593

244
Q

How does one differentiate a hyperplastic polyp (no malignant potential) to a sessile serrated adenoma?

A

Both serrated, but hyperplastic polyps occur more on the left colon. Sessile serrated often on the right. Also, sessile serrated is fully serrated including the crypt base, with crypt dilation and lateral growth. (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.594

245
Q

Initial mutation in the classic adenoma-carcinoma sequence which acounts for 80% of sporadic colon tumors

A

APC tumor suppressor gene inactivation (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597

246
Q

Typical appearance of proximal colon adenocarcinoma

A

Polypod, exophytic (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597

247
Q

Typical appearance of distal colon adenocarcinoma

A

Annular that produce napkin ring constrictions and cause obstruction (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597

medical board (24 decks)

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