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Applied Anatomic Pathology > GI > Flashcards

GI Flashcards

1
Q

the celiac trunk supplies which structures

A

stomach
gallbladder
proximal small bowel

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2
Q

the superior mesenteric artery supplies which structures

A

lower duodenum to 2/3rds of transverse colon

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3
Q

the inferior mesenteric artery supplies which structures

A

distal 1/3rd of transverse colon to rectum

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4
Q

what are the two watershed zones of the GI tract

A

splenic flexure and rectosigmoid junction

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5
Q

what is the Z-line

A

squamo-columnar junction in the esophagus (glandular and squamous mucosa)

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6
Q

which condition produces a punched out lesion appearance in the esophagus

A

herpes

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7
Q

which condition produces a velvety, salmon colored mucosa in the esophagus

A

Barrett’s esophagus

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8
Q

where would you find esophageal adenocarcinoma caused by Barrett’s esophagus

A

at or just above the squamocolumnar junction

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9
Q

what should you ink on an esophagus specimen

A

the adventitia because it’s a margin

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10
Q

what is the criteria to differentiate a stomach tumor vs an esophageal tumor

A

epicenter of tumor must be less than or equal to two cm from the EGJ on the stomach side

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11
Q

which sections should you take for an esophageal specimen

A

proximal margin
distal margin
lesion (deepest level of invasion)
lesion to normal
Z-line
Barrett’s if present
lymph nodes if present

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12
Q

what is the most important criteria for staging esophageal cancers

A

depth of invasion

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13
Q

where is peptic ulcer disease most common

A

antrum or EGJ

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14
Q

what is the most common malignant tumor of the stomach

A

carcinoma

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15
Q

signet-ring cell carcinoma causes what

A

linitus plastica (leather bottle appearance)

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16
Q

where should the stomach be opened

A

along greater curvature

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17
Q

which sections should you submit for a stomach

A

proximal margin
distal margin
mass (deepest level of invasion)
mass to normal
ulcers if present
normal
lymph nodes if present

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18
Q

what is the most important criteria for staging stomach carcinoma

A

depth of invasion

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19
Q

tumor involving the serosa of the stomach stages it to a what

A

pT4

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20
Q

what is the most important criteria for staging a stomach GIST

A

containment within stomach

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21
Q

what is a MALT considered

A

extra-nodal non-hodgkin lymphoma

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22
Q

what is the CPT code for a subtotal/total resection of the stomach for something other than a tumor

A

88307

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23
Q

what is the CPT code for a subtotal/total resection of the stomach for a tumor

A

88309

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24
Q

what is a Meckel’s diverticulum

A

blind pouch on anti mesenteric side

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25
Q

where are peptic ulcers most common

A

duodenum

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26
Q

50% of Meckel’s diverticulum have what on cut section

A

ectopic gastric mucosa or pancreatic parenchyma

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27
Q

where is the most common location for bowel ischemia

A

splenic flexure watershed zone

28
Q

what is the most common cause for ischemic bowel

A

arterial thrombus or embolus

29
Q

what sections should you take for an ischemic bowel

A

resection margins
transitional mucosa
vessels with blood clots if present
representative lymph nodes

30
Q

what is the most common location of a carcinoid in the GI tract

A

ileum/appendix

31
Q

majority of adenocarcinoma cases of the GI tract occur where

A

duodenum

32
Q

NET make up ____ % of small bowel tumors

A

50%

33
Q

what is the most important criteria for staging small bowel cancer

A

depth of invasion

34
Q

how many lymph nodes must be submitted for a small bowel case

A

at least 12 but preferably all

35
Q

what are three key elements found in the large intestine but not the small intestine

A

appendices epiploicae
tinea coli
haustra

36
Q

what is Hirschsprung disease

A

absence of ganglion cells and ganglia within muscle wall and submucosa

37
Q

pseudomembranous colitis is caused by what

A

C. difficile infection

38
Q

who, females or males, are most affected by Hirschsprung disease

A

males (4:1)

39
Q

how should you orient Hirschsprung biopsies

A

perpendicular to the rectal wall

40
Q

should you do a lymph node dissection for a diverticulitis case

A

no

41
Q

what is an important anatomic landmark for colon specimens

A

ICV

42
Q

if a lesion is above the anterior serosal reflection, what is the term used

A

radial

43
Q

if the lesion is below the anterior serosal reflection, what is the term used

A

circumferential

44
Q

what is the difference between a high anterior resection and a low anterior resection

A

high: cut above the anterior serosal reflection (no mesorectal tissue)
low: cut below the anterior serosal reflection (mesorectal tissue shows)

45
Q

what is the most common cause of toxic megacolon

A

anti-biotic related pseudomembranous colitis

46
Q

what is a pertinent negative in toxic megacolon cases

A

perforation

47
Q

what is the cause of pseudomembranous colitis

A

C. diff

48
Q

define hematochezia

A

passage of fresh blood through the anus

49
Q

define melena

A

dark stool with particularly digested blood

50
Q

what is important to note for a diverticulosis case

A

presence of exudate and hemorrhage which indicates a perforation

51
Q

what is an important pertinent negative for a diverticulosis case

A

presence or absence of any gross lesions

52
Q

what is a distinctive feature of ulcerative colitis

A

disease occurs towards the distal end of colon

53
Q

what are three distinctive features of Crohn’s disease

A

cobblestone appearance
thickening of the wall
skip lesions

54
Q

which condition, ulcerative colitis or Crohn’s, poses threat of progression on to cancer

A

ulcerative colitis

55
Q

what is the rule of thumb for submitting representative sections in Crohn’s and ulcerative colitis cases

A

one section per 10 cm

56
Q

what is important to note for ruling out cases of familial polyposis

A

number of polyps - must be 100 or more to be considered familial polyposis
if >100, use “innumerable”

57
Q

what is important to submit in a case of familial polyposis

A

large polyps - do not shave off leave them intact

58
Q

how should you open a colon

A

along the anti-mesenteric boarder unless there is a tumor

59
Q

what is the dentate line

A

transition between columnar and squamous epithelium in the anus

60
Q

what is another name for the circumferential radial margin

A

mesorectal margin

61
Q

what is important to note in an anal/rectal specimen

A

whether the resection is complete (grade 3 - bulky), nearly complete (grade 2 - less bulk), or incomplete (grade 1 - visible muscle)

62
Q

what is important to note about the tumor location in regards to anal/rectal specimens

A

how close the tumor is in regards to the margins as well as to the peritoneal reflection and dentate line

63
Q

which staging system is used for anal/rectal malignancies

A

TNM - based on depth of invasion

64
Q

what is the most important factor in staging anal malignancies

A

tumor size

65
Q

which device is used to give proximal and distal donuts of colon resections

A

anvil devise

Applied Anatomic Pathology (17 decks)

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