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Flashcards in 10. GI Pathoma Deck (47):
1

Tracheo-Esophageal Fistula

most common type?

Connection between Trach and the esophagus

-esophageal atresia w/ distal esophagus connecting to trach

-can cause polyhydramnios (cant swallow anything)

2

Plummer-Vinson syndrome

Esophageal webbing

Iron deficiency anemia

Beefy red tongue (atrophic glossitis)

3

Zenker Diverticulum

where does it outpouch?

how does it present-

Outpouching of the pharyngeal mucosa through a defect in the wall 

-Killian Triangle

-halitosis, dysphagia

4

Mallory-Weiss syndrome

whos the main to get this

Lacerations at the gastroesophageal junction due to Severe vomiting

painful hematemesis (bloody vomit)

-alcoholics and bullemics

5

Boerhaave syndrome

Transmural, distal esophageal rupture due to violent retching

6

Achalasia

what causes this

Absence of relaxation of the LES (lower esophageal sphincter)

-loss of Myenteric (Auerbach) plexus

 

7

GERD

what anatomy fuck up can cause this?

reflux of acid from the stomach due to Decr. LES tone 

-sliding hiatal hernia  

8

Gastroschisis

abdominal contents coming thru abdominal folds

(Not covered by peritoneum)

9

Omphalocele

Herniation of abdominal contents

Covered by peritoneum (silver cap)

10

Pyloric Stenosis

when does it happen/ what does the mass look like/ how is the vomit?

Hypertrophy of the pyloric smooth muscle

-doesnt present at birth. usually in 2-6 weeks.

-olive shaped mass

-non billious vomiting

11

Barrett esophagus

whats it caused by?

Metaplasia of 

nonkeratinized stratified squamos cells -> 

nonciliated columnar /goblet cells

-chronic GERD

-increased risk of esophageal adenocarcinoma

 

12

What are the two types of Esophageal cancers?

where are they/how do you get them?

Squamos Cell - upper 2/3. alc, hot liquids, strictures, smoking, achalasia (more common world wide

Adenocarcinoma - lower 1/3. chronic GERD, Barrett, obesity (common in America)

13

Acute gastritis

Main causes/ common among who?

 

 

-Too much acid/ too little mucosa protection

-alcoholics or NSAID users

14

Chronic Gastritis 

Increase risk of gastric cnacer

-H. Pylori (MALToma)/ Autoimmune (antibodies to parietal cells and intr

15

What are parietal cells?

What receptors are on it?

where are they located?

Secretes acid in the stomach

Ach, Gastrin, Histamine receptors

-body and the fundus

16

where is gastrin produced?

G cells (in the antrum and duodenum)

17

Peptic Ulcer Dz

Duodenal ulcer

what other things can cause it?

where is perforation most common?

what can happen with posterior ulcers

-Pain Decreases with meals (when you eat, the duodenum secretes protective coat (Brunners glands) cuz it knows food/acid is bout to come in)

-decr. mucsoal protection/incr. gastric acid (h. pylori)

-Zollinger-Ellison syndrome (Gastrinoma)

-anterior wall of stomach

-rupture of Gastroduodenal artery/ acute pancreatits

18

Peptic Ulcer Dz

Gastric Ulcers

whats a main cause?

where is the rupture? what would bleed.

 

pain becomes Greater with meals (stomach knows food is coming down so it secretes more acid)

-NSAIDS

-lesser curvature of stomach (bleeding from Left gastric artery)

 

19

Gastric Cancer (Adenocarcinoma)

Intestinal Vs Diffues type

what do they look like/where are they found/risk factors

-how does gastric carcinoma present (the rare signs)

malignant proliferation of surface epithelial cells in the stomach

Intestinal: irregular ulcer with f'd up margins. lesser curvature. rf: H.pylori, nitrosamines (smoked food), gastritis, Blood type A 

Diffuse: Signet ring cells (mucin filled cells with periph nuclei) that infiltrate gastric wall. Stomach wall grossly thickens 

-Acanthosis Nigrans (skin thickening in axilla) / Leser-Trelat (morgan freemans all over their skin- sub keratosis)

20

What are the three mets of stomach cancer?

Virchow node: left supraclavicular node 

Kruckenberg tumor: bilateral met to ovaries (mucin & signet ring cells)

Sister mary Joseph: Subcutaneous periumbilical met

21

What is duodenal atresia associated with?

what are some clinical features

Downsyndrome

-polyhydramnios, distension of the stomach "Double bubble" on xray, billious vomiting

22

Meckel Diverticulum

what causes it?

True diverticulum - outpouching of ALL THREE layers off of the intestine near the ileocecal valve

-failure of Vitelline duct 

23

Volvulus

where do they happen in elderly/young

Twisting of bowel around its mesentary

results in obstruction of bowel and infarction of arteries

elderly: Sigmoid colon

Young: Cecum

24

intussusception

most common location?

clinical finding?

telescoping of the bowel

-ileocecal junction

-currant jelly stool

25

Acute mesenteric ischemia/infarction

whats the most often occlusion

clinical presentaiton

Blockage of intestinal blood flow

-SMA (superior mesenteric Arterty)

Pain out of Proportion

26

Lactose Intolerance 

decreased function of the lactase enzyme along the brushboarder  

27

Celiac Dz

what does having this cause?

what skin condition does it cause?

lab findings?

biopsy?

where in the gi is affected

Autoimmune damage to small bowel villi due to Gluten/Gliadin (protein found in wheat)

-malabsorption and steatorrhea.

-dermatitis herpetiformis (deposition of IgA in papilla)

IgA antibodies to endomysium, tTg, gliadin

Flattening Villi / Crypt hyperplasia

-Duodenum

 

28

Tropical Sprue

similar to celiac dz /tropics

responds to antibiotics 

29

Whipple Dz

what section of Gi is involved

what does this lead to?

infection w Tropheryma whipplei

foamy macrophages (they eat the t. whipp)

CAN

Cardio probs, Arthralgas, Neuro probs

Lamina propria

-fat malabsorption/ steatorrhea

 

30

Carcinoid tumor

most common site?

what does it usually secrete?

symptoms once met to liver?

malignant prolif of neuroendocrine cells

positive for chromogranin

-small bowel 

-Serotonin

bronchospasm, diarrhea, flushing of the skin

31

Irritable Bowel Syndrome

who mainly gets it?

Reccurent/Rlapsing abdominal pain 

32

Inflammatory Bowel Dz

Ulcerative collitis

location? diarrhea?

key hallmarks? 

complication? p-anca?

what protects against UC?

Mucosal and submucosal inflam only

-Colon (duh) **Starts at rectum and works it way up 

(continuous) Bloody poop

-Crypt abscesses (filled with neutrophils)  / LEAD PIPE / Psuedopolyps

-Toxic megacolon or Rupture 

-Positive P-ANCA

-Smoking

 

 

33

Inflammatory Bowel Dz

Chrons DZ

location? type of poop?

hallmarks?

whats it look like on imaging

Full thickness(Transmural) of inflam. 

anywhere from mout to the anus (Skip lesion)

non bloody poop

-noncaseaating granulomas/lymphoid aggs/cobblestoning of mucosa/creeping fat

-String sign

34

Hirschsprung Dz

clinical presention

how do you diagnose it?

what causes it?

Defective relaxation of colon characterized by lack of ganglion cells/enteric nervous plexuses (Auerbach and Meissner)

-failure to pass meconium w/in 48 hrs / massive dilation megacolon

-rectal suction biopsy

-Failure of neural crest migration

35

Angiodysplasia

Acquired malformation. Tortuous dilation of vessels

36

Ischemic Colitis

where does it most often occur/ why?

Splenic Flexure & atherosclerosis of SMA

37

Colonic Polyps 

(Hyperplastic type)

what do they look like?

benignt, usually in the left colon (rectosigmoid)

saw tooth appearance on microscopy

38

Colonic polyps

(adenomatous type)

what mutations cause this?

Neoplastic prolif of glands. pre-malignant

-mutations in APC and KRAS

 

39

Familial Adenomatous polyposis (FAP)

whats the genetic description. what mutation

how do you treat it

Autosomal Dominant

-mutation of the APC gene (chromosome 5)

-colonectomy

40

Gardner syndrome

FAP (familial adenomatous polyposis) + osteomas, fibromatosis (proliferation of fibroblasts)

41

Turcot Syndrome

FAP + CNS Tumors (medulloblastoma and glial tumors)

42

Juvenile polyposis syndrome

where?

Autosomal dominant syndrome in kids

consists of hamartomatous polyps in the 

colon, stomach, small bowel

43

Peutz-jaghers syndrome

what clinical signs would you see?

Autosomal dominant featuring shit ton of hamartomas throughout entire GI tract.

Hyperpigmented mouth, lips, hand, genetaila

increased risk of GI cancers

 

44

Hereditary Non Polyposis Colorectal Carcinoma (HNPCC) / (Lynch syndrome)

which other cancers do it lead to?

Inherited mutation in the DNA mismatch repair genes

-microsatellite instability

-colorectal, endometrial, ovarian

45

what does left-sided colon cancer look like?

Napkin ring lesion

pencil thin poop

46

what does right sided colon cancer look like?

Iron deficiency anemia

47

Whats CEA serum marker used for 

Recurrent cancers