1/27/15

Question 1

What factors prevent the back leak of H+ ions into the mucosa and strengthen mucosal barrier? What factors encourage the back leak of H+ ions and damage the mucosa?

Answer 1

prevent back leak - mucus, prostaglandins (stimulate mucus production), gastrin (stimulates mucosal growth)
encourage back leak - bile acids, alcohol, NSAIDs and aspirin

Question 2

What type of damage to the right heart is characteristic of carcinoid syndrome?

Answer 2

thickening of the endocardium of the right ventricle, tricuspid stenosis and insufficiency

Question 3

What type of cancer is associated with vinyl chloride exposure? What are the gross characteristics of this type of cancer? Exposure to what other chemical is a risk factor for this type of cancer?

Answer 3

hepatic angiosarcoma which is a multi nodular tumor of blood vessels. Liver parenchyma between nodules is normal.
Exposure to arsenic is also a risk factor for hepatic angiosarcoma

Question 4

What type of cancer is associated with oral contraceptive use and will regress when these drugs are stopped?

Answer 4

hepatic adenoma

Question 5

What enzymes would be elevated in acetaminophen overdose?

Answer 5

AST and ALT but not alkaline phosphatase or lipase

Question 6

What are the presenting signs of pancreatic cancer?

Answer 6

Is often asymptomatic but symptoms include vague abdominal pain that may radiate to the back, obstructive jaundice (scleral icterus, dark urine, elevated total and direct bilirubin, elevated alkaline phosphatase), migratory thrombophlebitis (Trousseau’s syndrome), palpable, contender gallbladder (Courvoisier sign)

Question 7

What area of the bowel is most likely to be affected in Hirschsprung’s disease?

Answer 7

the distal rectum

Question 8

Patients with Plummer-Vinson syndrome are at risk for developing what disease?

Answer 8

squamous cell carcinoma of the esophagus

Question 9

Why can people with renal failure develop acute gastritis?

Answer 9

because uremia is a cause of acute gastritis