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GI path Flashcards

1
Q

Pt with PAINLESS, moblie mass in parotid. Composed of?

A

Pleomorphic adenoma. Composed of cartilage and epithelium.

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2
Q

Pt with parotid mass. Biopsy shows cytic tumor with?

A

Warthin’s tumor. Germinal centers

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3
Q

Pt presents with PAINFUL parotid mass.

A

Mucoepidermoid CA

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4
Q

Dysphagia to solids and liquids due to loss of?

A

Acalasia. Loss of myenteric (Auerbach’s) plexus

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5
Q

Adult onset-asthma and cough?

A

GERD

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6
Q

Painless ESO bleeding due to what vessels?

A

left gastric and ESO veins.

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7
Q

Punched out lesions in mouth vs linear ulcers vs white pseduomembranes that can be scraped off vs white membrane that cannot be scraped off

A

HSV vs CMV vs Candidia vs EBV

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8
Q

Painful vomiting and heatemesis?

A

Mallory-Weiss

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9
Q

Dysphagia, glossitis and Fe deficiency?

A

Pulmmer-Vinson syndome

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10
Q

Pt with Apththous ulcers, genital ulcers and uveitis. due to?

A

Bechets. IC vasculitis

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11
Q

Pt with esophagitis and ulcers. Likely change in ESO tissue?

A

Barretts. Increased intestinal nonciliated columnar epithelium with goblet cells

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12
Q

Obese pt. SSC or adenoCA of ESO?

A

AdenoCA

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13
Q

ESO cancer to what lymph nodes?

A

1/3 cervical
2/3 medistinal and trachobronial
3/3 celiac and gastric

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14
Q

Pt with diarrhea, steatorrhea and weight loss. Responds to antibiotics?

A

Tropical sprue

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15
Q

Old man with diarrhea, steatorrhea and weight loss. Joint pain, cardiac symptoms and some neuro symptoms.

Biopsy will show?

A

Whipple’s

PAS-positive foamy macrophages.

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16
Q

Pt with diarrhea, steatorrhea and weight loss. Primarily affects jejunum.

Increased risk for what cancer?

A

Celiac sprue. T-cell lymphoma

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17
Q

Pt with diarrhea, steatorrhea and weight loss. Anti-endomysial antibodies.

Other Abs?

A

anti-transglutaminase

anti-gliadin

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18
Q

Pt after norwalk virus recovery. Bloating and diarrhea. Why?

A

Lactase at tips of intestinal villi. Can have temporary deficiency after viral diarrhea.

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19
Q

Child with diarrhea, steatorrhea and weight loss and neurologic symptoms. Low cholesterol.

mech of illness?

A

decreased synthesis of apolipoprotein B - cannot generate chlomicrons - fat accumulates in enterocytes.

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20
Q

Cystic fibrosis pt with diarrhea, steatorrhea and weight loss.

What vitamins deficienct?

A

Pancreatic insufficiency. Malapsorption of ADEK

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21
Q

Pt with cerebral edema. Effect on stomach? (Mech)

A

Up edema - up vegal stimulation - up ACh - up acid. Cushing’s ulcer

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22
Q

Pt with burn. Effect on stomach (mech)?

A

Loss of protective layer - curling ulcer

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23
Q

Pt with anemia and acholorhydria. Check for?

A

Abs to parietal cells (Type A chronic gastritis)

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24
Q

Bug that can cause MALT lymphoma invades what part of stomach?

A

H pylori. Antrum (Type B chronic gastritis)

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25
Q

Precancerous disease with protein loss and parietal cell atrophy and increased mucosal cells.

Appearance of stromach?

A

Menetrier’s disease. Stomach looks like brain gyri.

26
Q

Pt with Krunkenburg tumor. Histo/Gross appearance of stomach?

A

Krunkenburg tumor - indicative of Diffuse stomach cancer. Signet rings cells. Stomach theickened and leatherly.

27
Q

Pt with early satiety and supraclavicular node. Possible finding on skin of stomach and armpits?

A

Sister Mary Joseph’s Nodule or acanthosis nigracans.

28
Q

Pt with ucler with raised margins. Location?

A

Intestinal cancer of stomach. Lesser curvature

29
Q

Pt with pain that decreases with meals and H. pyori. Histo finding?

A

Duodenal ulcer. Hypertrophy of brunner’s glands

30
Q

Older patient taking NSAIDs. Pain in stomach. Worse or better with meals?

A

Gastric tumor. Pain greater with meals.

31
Q

Rupture of duodenal ulcer. Causes bleeding from what artery (what wall is ulcer likely on)

A

gastroduodenal artery (posterior wall)

32
Q

Duodenal Ulcer Hemorrhage vs Ulcer perforation (re location)

A

posterior vs anterior

33
Q

creeping fat. Immune response mediated by?

A

Crohn’s. Th1 cells.

34
Q

rectal sparing. Histo?

A

Crohn’s. Noncaseating granulomas.

35
Q

cobblestone mucosa. X-ray finding?

A

Crohn’s. String sign

36
Q

IBD with Migratory polyarteritis and erythema nodosum. Tx?

A

Crohn’s Azathioprine, methotrexate, infliximab, adalimumab

37
Q

IBD: inflamm limited to mucosa and submucosa. loss of?

A

UC. Loss of haustra.

38
Q

Often seen with necrosis ulcers on legs and inflammation of intrahepatic and extrahepatic bile ducts?

A

pyoderma gangrenosum and Primary sclerosing cholangitis seen with UC.

39
Q

Often seen with red lumps under the skin and pain in multiple joints.

A

erythema nodosum and Migratory polyarteritis seen with Crohn’s.

40
Q

TX for UC?

A

ASA, 6-Mercaptopurine, infliximab

41
Q

Drug for both UC and Crohns?

A

infliximab

42
Q

Middle aged, female pt with alternating diarrhea/constipation improves on defecation. Stools have varying appearances.

A

IBS

43
Q

False diverticula occur frequently in areas of the bowel in which…?

A

where vasa recta perforate muscularis externa

44
Q

65 year old pt with hematochezia. Low fiber diet.

Lesion where?

A

Diverticulosis (age, sx, RF).

Sigmoid colon

45
Q

Hematochezia with LLQ pain and fever. Complication?

A

Diverticulitis. colovesical fistula

46
Q

Pt with bad breath, diffcultly swallowing and an obstruction.

Where is lesion?

A

Zenker’s diverticulum. Between thyropharyngeal and cricopharyngeal parts of inferior pharyngeal constrictor.

47
Q

Bowel anomaly that may contain ectopic acid-secreting gastric mucosa and pancreatic tissue.

Persistence of?

A

Meckel’s diverticulum. Vitelline duct

48
Q

Pt presents with melana, RLQ pain, intissucesption/volvulus near terminal illeum.

when does it present?

A

Meckel’s diverticulum. First 2 years of life

49
Q

Abdominal emergency in children that can lead to obstruction and infarction?

Linked to what virus?

A

Intussception. Adenovirus

50
Q

Abdominal emergency in eldrery that can lead to obstruction and infarction. Location?

A

Volvulus. Cecum and sigmoid colon

51
Q

Child with current jelly stools. Where is lesion?

A

Intussception. ileocecal junction

52
Q

infant with failure to pass meconium. Chronic constipation. Failure of?

A

Hirschsprung’s disease. Neural crest migration (lack of auerbach and meissner’s plexuses)

53
Q

Down syndrome baby with bilious vomiting.

X-ray sign?

A

Duodenal atresia. Double-bubble sign.

54
Q

Premature baby can get a GI perforation from?

A

Necrotizing enterocolitis

55
Q

Eldery patient with servere pain after eating leading to weight loss. Imaging studies don’t show much. Mechanism and typical location of pain?

A

Ischemic colitis. Reduction in intestinal blood flow causes ischemia and pain esp at splenic flexure.

56
Q

Pt post surgery with obstruction. Histo?

A

Adhesion. Fibrous band of scar tissue with necrotic zones.

57
Q

Older patient with hematochezia and tortuous dilation of vessels?

A

Angiodysplasia

58
Q

2 types of colonic polyps? Which has a greater risk of cancer?

A

tubular or villous. Villous has increased cancer risk.

59
Q

Pt with lower GI bleed, partial obstruction and secretory diarrhea. Non-neoplastic?

A

Adenomatous polyp

60
Q

Child with lower GI bleed, partial obstruction and secretory diarrhea. Increased risk of adenoCA?

A

Juvenile polyposis syndrome

61
Q

Pt with hyperpigmented mouth, lips, hands, genitalia. Examination of bowel will likely show?

A

Peutz-Jeghera. multiple nonmaligantn hamartomas (but increased risk of CRC)

GI (5 decks)

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