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GI > Pathology of Esophagus and Stomach > Flashcards

Pathology of Esophagus and Stomach Flashcards

1
Q

What is the triad associated with Plummer-Vinson Syndrome?

A

Iron deficiency anemia
Atrophic glossitis
Esophageal webs

*Postmenopausal women, increased risk of esophageal squamous cell carcinoma.

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2
Q

What is a Schatski ring?

A

Similar to a web but thicker and circumferential

A ring is above the GE junction
B ring is at the GE junction

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3
Q

What causes esophageal stenosis?

A

Inflammation and scarring from things like chronic GERD, irradiation, scleroderma or caustic injury

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4
Q

What are the three characteristics of achalasia?

A
  1. Incomplete LES relaxation
  2. Increased LES tone
  3. Aperistalsis of esophagus
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5
Q

What are some complications associated with Achalasia?

A
  1. Squamous cell carcinoma
  2. Candida esophagitis
  3. Diverticula
  4. Aspiration pneumonia
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6
Q

What are some causes of pseudoachalasia?

A

Nerve damage from:

  1. Tyrpanosoma cruzi
  2. Metastatic tumor
  3. Amyloidosis
  4. Sarcoidosis
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7
Q

What are some possible complications of a hiatal hernia?

A

Ulceration
Bleeding
Perforation
Strangulation (paraesophagus)

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8
Q

What is a Zenker diverticulum?

A

Outputting just above the UES
Can be caused by motor dysfunction, increased stress on wall or GERD
Some symptoms include dysphagia, regurgitation, mass in neck or aspiration of contents

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9
Q

Where does a traction diverticula occur?

A

Near the midpoint of the esophagus
From scarring of mediastinal lymphadenitis or same as Zenkers
Generally asymptomatic

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10
Q

Where does a Epiphrenic diverticulum occur?

A

Just above the LES
Caused by dyscoordination of peristalsis or LES relaxation
Symptoms include massive nocturnal regurgitation

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11
Q

What causes esophageal varies?

A

Secondary to portal hypertension – can lead to massive hemorrhage
Mortality 40-50%

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12
Q

What are some histological features of reflux esophagitis?

A
  1. Elongation of the lamina propria papillae
  2. Reactive epithelial changes
  3. Acute and chronic inflammatory cells
  4. Basal and supra-basal cell hyperplasia
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13
Q

What are some general consequences of reflux?

A

Bleeding
Ulceration
Stricture development
Barrett’s esophagus

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14
Q

What are some features of eosinophilic esophagitis?

A
  1. GERD symptoms
  2. No response to GERD therapy
  3. Characteristic endoscopic appearance (rings)
  4. Allergic etiology?
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15
Q

What does the histology look like for eosinophilic esophagitis?

A

Basal cell hyperplasia

>20 eosinophils per high power field

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16
Q

What type of cells are prominent in Barrett’s Esophagus?

A

Goblet cells in the intestinal metaplasia

17
Q

Where do most esophageal adenocarcinomas arise?

A

Near the GE junction in Barrett’s esophagus

Occurs after age 40, mean age of 60

18
Q

What are some common presentations of squamous cell carcinoma of the esophagus?

A

Occurs after age 50

Male predominance

19
Q

What are some factors associated with development of squamous cell cancer?

A

Dietary
Lifestyle
Predisposing esophageal disorder
Genetics

20
Q

Regurgitation and projectile vomiting
Palpable mass, visible peristalsis
No bile in vomit
2-4 weeks of age

A

Hypertrophic pyloric stenosis

21
Q

What does acute gastritis pathology look like?

A

Punctate erosions with dark adherent blood

22
Q

What is chronic gastritis?

A

Chronic mucosal inflammatory changes leading to atrophy and metaplasia
Set-up for dysplasia and neoplasia

23
Q

What are some causes of chronic gastritis?

A

Chronic infection (H. pylori) - type B
Immunologic (in association with pernicious anemia) - type A
Toxic
Post surgery

24
Q

How does the morphology of chronic gastritis appear?

A 
Lymphocytic mucosal infiltrate -- neutrophils in epithelium and gastric pits
Regenerative change
Metaplasia
Atrophy 
Dysplasia
25
Q

In autoimmune gastritis, what are the antibodies against?

A

Parietal cells and intrinsic factor –> achlorhydia, hypergastrinemia, and pernicious anemia

26
Q

Name some diseases associated with H. pylori.

A

Chronic gastritis
Peptic Ulcer Disease
Gastric carcinoma
Gastric MALToma

27
Q

What layer does PUD penetrate?

A

The muscularis mucosa

28
Q

Where is the most common location for PUD?

A

Duodenum, first part
Stomach, antrum
Within Barrett mucosa

29
Q

What is the most frequent complication of PUD?

A

Bleeding – may be life threatening

30
Q

Curling ulcers and Cushing ulcers are types of what?

A

Acute Gastric Ulceration

31
Q

What causes curling ulcers?

A

Proximal duodenum associated with severe burns or trauma

32
Q

What causes Cushing ulcers?

A

Associated with intracranial injury, operations or tumors; high incidence of perforation

33
Q

What are some types of hypertrophic gastropathy?

A

Menetrier disease – massive hyperplasia of surface mucous cells
Hypertrophic-hypersecretory gastropathy – hyperplasia of parietal and chief cells
Gastric gland hyperplasia due to excessive gastrin secretion – setting of gastrinoma: ZE syndrome

34
Q

Are polyps common in the stomach?

A

No – majority are associated with chronic gastritis and are non-neoplastic but must remove when seen because they can bleed and transform

35
Q

What is a Virchow node?

A

involvement of the left supraclavicular node from metastasis from the stomach

36
Q

What is Sister Mary Joseph nodule?

A

Local spread of gastric carcinoma to periumbilical region

37
Q

What is Krukenberg tumor?

A

bilateral metastases to the ovaries, abundant mucus, signet ring cells

38
Q

What is Linitis plastica?

A

When the stomach wall is grossly thickened and leathery – due to diffuse type gastric carcinoma

GI (34 decks)

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