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YR2 - Clinical Pathology > 10. GI // stomach // pancreas > Flashcards

10. GI // stomach // pancreas Flashcards

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1
Q

The majority function of the pancreas is in what?

A

Exocrine function

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2
Q

What special enzyme is a trypsin inhibitor found in the pancreas?

what cells is it found in?

A

SPINK-1

acinar + ductal cells

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3
Q

PRSS1 is what type of inheritance?

SPINK1 is what type of inheritance?

A

PRSS1 ==> Autosomal Dominant

SPINK1 ==> Autosomal Recessive

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4
Q

Amylase in blood is a sign of what?

A

Acute pancreatitis

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5
Q

What type of plug occurs in chronic pancreatitis?

A

Protein plugs

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6
Q

What order is destroyed first in chronic pancreatitis?

A

Exocrine => Endocrine

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7
Q

what is formed in chronic pancreatitis?

A

Fibrous tissue

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8
Q

most common type of pancreatic cancer

A

pancreatic ductal carcinoma

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9
Q

PanIN (pancreatic intraepithelial neoplasia) epi

A

Most common neoplastic precursor to invasive pancreatic cancer

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10
Q

what relatives are affected in a familial pancreatic cancer?

A

2x 1st degree relatives

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11
Q

Pancreatic carcinoma generally affects what part of the pancreas?

A

Head of pancreas

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12
Q

What syndrome is associated with pancreatic carcinoma?

A

Trousseau’s syndrome

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13
Q

What is a desmoplastic response?

A

intense non-neoplastic host reaction

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14
Q

What cells are responsible in desmoplastic response (30

A

Fibroblasts // Lymphocytes // ECM

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15
Q

Pancreatic neuroendocrine tumours originate from what cells?

A

islet cells

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16
Q

What disease has an increased risk of pancreatic neuroendocrine tumour?

A

MEN-1 pituitary adenoma

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17
Q

What is the most common type of neuroendocrine tumour?

A

Insulinoma

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18
Q

What happens to blood sugars in insulinoma?

A

Hypoglycaemia

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19
Q

Majority of acute pancreatitis are caused by what?

A

Gallstones

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20
Q

Peri-umbilical haemorrhage is associated with what sign?

A

Cullen’s sign

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21
Q

calculi are associated with what?

A

Chronic pancreatitis + excess alcohol

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22
Q

What is the most common form of oesophagitis?

A

Reflux oesophagitis

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23
Q

What is defective in reflux oesophagitis?

A

lower oesophageal sphincter

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24
Q

What type of metaplasia is present in Barrett’s oesophagus?

A

Glandular metaplasia

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25
H pylori infects what part of the stomach to cause problems
Antrum
26
Most common type of gastric cancer?
Adenocarcinoma
27
In Coeliac disease, what component is there a reaction to?
Gliadin
28
What do epithelial cells express in Coeliac disease which activates CD8 (Intraepithelial lymphocytes)
IL-15
29
What is the diagnosis test used in Coeliac disease? What does this AB bind to?
IgA Tissue Transglutaminase (TTG)
30
Diverticulosis typically affects what part of the colon?
Sigmoid colon
31
Most common symptom presenting in ulcerative collitis?
Rectal bleeding
32
what is the most common area affected in Crohn's disease?
Ileocolic region
33
What is the most common type of polyp?
Hyperplastic polyp
34
In Peutz-Jeghers syndrome, what chromosome is affected What type of inheritance is it?
STK11 Ch.19 Autosomal dominant
35
DUKES stage is used in what diagnosis criteria
Adenocarcinoma of Colon
36
Von Meyenberg complex is a proliferation of what type of cells? What are formed/
Bile duct cells ====> White nodules form
37
cholangiocarcinoma is what?
Malignant tumour of bile duct cells
38
What is the main cause of cholangiocarcinoma (parasite)
Liver fluke => Clonorchis sinesis
39
tumours of the liver are typically secondary and derive from what 4 areas/
lung breast colon pancreas
40
Pancreatic NENs can metastasise to bone (T/f)
t
41
what is the normal epithelium lining of the oesophagus
stratified squamous layer
42
formation of multiple colorectal polyps
FAP Familial Adenomatous Polyposis
43
What happens to intravascular fluids in physical trauma?
Intravascular fluid loss
44
What happens to extravascular fluids in physical trauma?
Extravascular volume increase
45
Shock post trauma occurs how many hours post onset
2-4
46
Catabolic state post trauma occurs when? What happens to glycolysis // lipolysis / proteolysis?
24-48hr Increase
47
What are 2 key components responsible for activating the catabolic state // anabolic state
IL-1 // TNF-A
48
How does adrenaline affect glycolysis
adrenaline = Increase Glycolysis => increase glucose
49
Glutamine + Omega -3FA does what?
Reduce inflammatory cytokine IL-1 // TNF-a
50
Why do patients die of pneumonia post trauma
Structural weakness => poor cough + retention of secretions
51
What is produced as a biproduct of anaerobic metabolism that leads to hypoxia
Pyruvate ==> Lactate
52
Protein // calorie undernutrition (starvation) is a type of what malnutrition?
Primary malnutrition
53
appetite // absorption and utilisation inadequate are all type of what malnutrition
Secondary malnutrition
54
What happens to phosphates during refeeding syndrome
hypophosphataemia => low phosphates after a starved state
55
meconium ileus can occurs in babies with what type of disease
CFTR => CF
56
Creon delayed release capsules can be given to patients with what? What does it contain (3)
CF Lipases // proteases // amylases
57
Thiamine is a ..... for transketolase // PDH //a-KGDH
Co-factor
58
Wernicke-Korsakoff is what type of def?
B1 def
59
RBC are broken down where? what does it release
Spleen Bilirubin
60
Where does conjugation of bilirubin occur? What is it conjugated with?
Liver Glycine // taurine
61
What can bacteria do in the intestine to the bilirubin thats conjugated? What is it absorbed as
Unconjugate it => Reabsorbed back into system Absorbed as urobilinoigen
62
Jaundice is first seen where?
Sclera
63
Pre-hepatic causes of jaundice (2) that lead to too much bilirubin (unconjugated) **included 1 syndrome
Haemolytic anaemia // Gilbert's syndrome
64
Bile duct obstruction is a form of what type of jaundice?
Post hepatic obstructive jaundice
65
High ALK phosphatase would be indicative of what type of jaundice
Obstructive
66
High ALT // AST would be indicative of what type of jaundice
Damage to hepatocytes
67
What are the 3 stages of cirrhosis
Portal fibrosis --> Bridging fibrosis -> Cirrhosis
68
Which type of viral hepatitis does not cause chronic hepatitis
Hep A
69
Haemochromatosis is a failure of what? What does it lead to
Failure of iron absorption Excess iron stored in wrong places
70
What 2 genes are responsible for haemochromatosis?
HFE + C282Y
71
Wilsons disease => What transporter is affected
Copper deposited in wrong areas due to too little copper transporter Caeruloplasmin
72
Kayser-Fleischer rings are found in the eyes in what disease
Wilson's disease
73
What happens to urine // liver copper levels in Wilson's disease
High Copper => Urine + liver Low Copper => Serum
74
Penicillamine is a treatment for what disease
Wilson's => Copper
75
PiZZ is the most common type of what?
Alpha 1 anti-trypsin deficiency
76
Alpha 1 anti-trypsin is a type of what
Anti-protease
77
Primary Biliary cholangitis (PBC) BT results (2)
Anti-mitochondrial AB + Raised ALP PBC => Inc. ALP
78
Primary sclerosing Cholangitis (PSC) BT results (1) What disease is it associated with
High ALK ulcerative colitis PSC => Inc. ALK
79
The ELF score is used in what?
Fibrosis marker
80
2 inherited disorders of conjugation that would lead to increased unconjugated bilirubin
Gilberts // Crigler-Najjar
81
2 inherited disorders of unconjugation that would lead to increased conjugated bilirubin
Dubin-Johnson // Rotor
82
AST // ALT elevated + normal ALP
Hepatitis
83
AST // ALT normal + High ALP
Obstructive Jaundice
84
In chronic pancreatitis, what is there loss of (2)
Islet cells + acinar tissue
85
Is ALT used in bilary tract damage?
No Only used for damage to hepatocytes => hepatitis
86
where does UC affect? What about crohn's
UC => Large bowel only Crohn's => Mouth -> anus
87
presence of granulomas that are non-caseating epithelioid cell aggregates with Langhans’ giant cells.
Crohn's
88
Crypt abscesses and goblet cell depletion are common in ->
Ulcerative collitis
89
p-ANCA negative
Crohn's
90
p-ANCA positive
UC
91
what happens to albumin levels in trauma
reduced => Hypoalbuminaemia

YR2 - Clinical Pathology (10 decks)

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