Gastro Pathology

Question 1

most common Candida infection of oral cavity

Answer 1

Pseudomembranous (thrush)

Question 2

submucosal nodular fibrous tissue mass formed when chronic irritation results in reactive connective tissue hyperplasia - most often buccal, along the bite line

Answer 2

Fibroma

Question 3

– pedunculated mass in gingiva; dense proliferation of immature vessels similar to granulomas  dense fibrous masses or peripheral ossifying fibroma

Answer 3

Pyogenic granuloma

Question 4

term for lesion of oral cavity w/ uknown etiology, all must be considered pre-cancerous (hyperkeratosis, dysplasia)
risk factors - alcohol & tobacco

Answer 4

Leukoplakia

Question 5

red, eroded region of mucosa with increased rate of malignancy

Answer 5

Erythroplakia

Question 6

most common inflammatory lesion of the salivary glands – block or obstruction of salivary gland duct

Answer 6

Mucocele

Question 7

viral sialadenitis

Answer 7

mumps, parotid gland

Question 8

Bacterial sialadenitis

Answer 8

submandibular glands, Staph aureus & Strep viridans (commonly preceded by sialolithiasis)

Question 9

60% tumors in the parotid gland- contains myxoid, hyaline, chondroid, osseous tissue, over-expresses PLAG1, recur if incompletely excised; slow-growing, mix of epithelial & mesenchymal cells

Answer 9

Pleomorphic adenoma

Question 10

most common primary malignant tumor of the salivary glands; mixture of squamous & mucus cells; aggressive tumors

Answer 10

Mucoepidermoid carcinoma

Question 11

crown of unerupted tooth, result of degeneration of dental follicle (tissue that makes surface enamel); complete removal is curative

Answer 11

dentigerous cysts

Question 12

posterior mandible, locally aggressive w/ a high recurrence rate (multiple can occur in patients w/ nevoid basal cell carcinoma syndrome (Gorlin syndrome)

Answer 12

odotogenic keratocysts

Question 13

inlet patch

Answer 13

most frequent site of ectopic gastric mucosa is in the upper third of esophagus = inlet patch (possible to secrete acid > dysphagia)

Question 14

small patches of ectopic gastric tissue in small bowel or colon may cause ulcers & bleeding

Answer 14

Gastric heterotropia

Question 15

Most common esophageal lacerations
a/w severe vomiting; peristaltic wave a/w vomiting normally causes relaxation of esophagus, but prolonged vomitting can interfere w/ this process; pts present w/ hemetemesis – the tears are superficial and longitudinal

Answer 15

Mallory-Weiss tears

Question 16

transmurual esophageal tears and mediastinitis – catastrophic event

Answer 16

Boerhaave syndrome

Question 17

Barret esophagus, tobacco, obesity, raditation, whites/ M»F; incidence has increased more rapidly than for any other cancer

Answer 17

Esophageal adenocarcinoma

Question 18

a/w alcohol, tobacco, very hot beverages, more common in rural areas, more common in blacks, HPV linked in his risk areas

Answer 18

Squamous Cell Carcinoma of the Esophagus

Question 19

transient mucus inflammatory process that may have varying degree of epigastric pain, N/V

Answer 19

Acute Gastritis

Question 20

most common cause is H pylori, antral gastritis w/ high acid production despite low gastrin levels; urease allows H pylori to generate ammonia from endogenous urea, elevating pH around the organism, toxins like CagA involved in cancer development; deep inflammatory rxn in gastric glands/ induced mucosa-associated lymphatic tissue (MALT) can transform to lymphoma

Answer 20

Chronic Gastritis

Question 21

second most common cause of chronic gastritis,

Answer 21

Autoimmune Gastritis

Question 22

H pylori & NSAIDs; imbalance between mucosal defense and damaging force (same as chronic gastritis); 4x more common in proximal duodenum than the stomach; epigastric burning, worse 1-3 hours after meals, at night, relieved w/ alkali/ food

Answer 22

PUD

Question 23

75% gastric polyps

Answer 23

inflammatory or hyperplastic polyps

Question 24

sporadic in people w/ familial adenomatous polyposis (FAP), no neoplastic potential, increased w/ PPIs due to increased gastrin secretion due to elevated pH

Answer 24

Fundic gland polyps

Question 25

much more common in Japan due to smoked meats, but has dropped by 85% in US due to better food handling; loss of E-cadherin function, key step in the development of diffuse gastric cancer

Answer 25

Gastric Adenocarcinoma

Question 26

Diffuse Gastric Cancer – signet cell; desmoplastic reaction that stiffens the wall of the stomach to form …..

Answer 26

linitis plastica

Question 27

bulky, glandular (mostly decreased in this type) – a/w atrophic gastritis, intestinal metaplasia

Answer 27

Intestinal Gastric Cx

Question 28

small polyploid lesions  desmoplastic  kink / obstruct bowel; can secrete vasoactive substances (most important indicator of prognosis is location)

Answer 28

Carcinoid Cx
Foregut carcinoid tumor – esophagus to duodenum proximal to the ligament of Treitz; gastrinomas a/w PPIs
Midgut carcinoid tumor- jejunum & ilium, tend to be aggressive & multiple
Hindgut – rectal, more likley to produce polypeptide hormones, only occasionally metastasize

Question 29

most common mesenchymal tumor of the abdomen, most occur in the stomach (GOF in c-KIT)

Answer 29

Gastrointestinal stromal tumor (GILT)

Question 30

mildly decreased UDP-glucuronyl transferase, elevated indirect bilirubin

Answer 30

Gilberts

Question 31

Absent UDP-glucuronyl transferase, lethal

Answer 31

Grigler-Najjar syndrome type I

Question 32

conjugated hyperbilirbinemia due to defective liver excretion, black liver

Answer 32

Dubin-Johnson

Question 33

milder defect in excretion/uptake of bilirubin

Answer 33

Rotor’s