Ch 17: Gastrointestinal System Flashcards
(137 cards)
1
Q
what is an omphalocele
A
defect of the anterior abdominal wall
sack shows mostly liver and has the umbilical cord inserting into it
2
Q
what is gastroschisis
A
congenital paraumbilical defect of the anterior abdominal wall
bowel herniates outwards
3
Q
what is the outermost layer of the esophagus
A
adventita - no serosa
4
Q
what is esophageal atresia
A
two ends of the esophagus don’t connect
5
Q
what is an esophageal fistula
A
esophagus connects to the trachea
6
Q
is aquired or congenital esophageal stenosis more common
A
aquired
7
Q
what is zenker diverticulum
A
outpouching of esophagus immediately above the upper esophageal sphincter
8
Q
what is achalasia
A
swallowing disorder
9
Q
what are the three things that make up achalasia (swallowing disorder)
A
incomplete lower esophageal sphincter relaxation
increased LES tone
aperistalsis
10
Q
what is the primary cause of achalasia
A
neuron failure in the distal esophagus
11
Q
what is the secondary cause of achalasia
A
chagas disease (trypanosoma cruzi infection)
12
Q
what is ectopia
A
inlet patches of gastric mucosa in the proximal esophagus
13
Q
what are schatzki rings
A
circumfrential bands of mucosa in the esophagus
14
Q
what are the three complications of esophagitis
A
lacerations
mucosal injury
infections
15
Q
what are mallory-weiss tears
A
longitudinal linear lacerations in the EGJ caused by puking or coughing
16
Q
punched out ulcers of the esophagus are a characteristic of which infection
A
herpes simplex virus (HSV)
17
Q
shallow ulcers of the esophagus are a characteristic of which infection
A
cytomegalovirus (CMV)
18
Q
gray plaques/pseudomembrane are a characteristic of which infection
A
candidiasis
19
Q
what is black esophagus
A
complication of multiple, large necrotizing ulcers
can be associated with HSV
20
Q
what is eosinophilic esophagitis
A
eosinophilic esophageal inflammation associated with food allergies
presents with stacked, circular rings or a “feline esophagus”
21
Q
feline esophagus is a characteristic of which condition
A
eosinophilic esophagitis
22
Q
what is a hiatal hernia
A
protrusion of stomach into thorax
can be sliding or paraesophageal
23
Q
what are cameron lesions
A
gastric erosions or ulcers in the diaphgram near site of hiatal hernia
24
Q
what is Barrett esophagus
A
chronic splashing of acid into the esophagus
leads to change of esophagus mucosa to gastric mucosa
can become pre-cancerous and then cancerous
25
what is the characteristic color of Barrett esophagus
salmon
26
what is the change of tissue in Barrett Esophagus
esophagus goes from stratified squamous epithelium to columnar epithelium
27
what typically causes adenocarcinoma and where is it most prominant in the esophagus
usually caused by barrett esophagus
found in the distal 1/3rd of the esophagus
28
where is SCC of the esophagus most commonly located
proximal esophagus - mostly middle third
29
what is plummer-vinson syndrome (PVS)
associated with SCC
characterized dysphagia, anemia, and esophageal webbing
30
what are the two most common risk factors of SCC of the esophagus
alcohol and tobacco use
31
what is the most common benign tumor of the esophagus
leiomyoma
32
what is gastritis
mucosal injury in the presence of inflammatory cells
33
what is gastropathy
mucosal injury without inflammatory cells
34
what causes a stress ulcer and where are they most commonly found
shock
sepsis
severe trauma
mostly found in the stomach
35
what causes a curling ulcer and where are they most commonly found
severe burns
trauma
mostly found in the duodenum
36
what are Cushing ulcers and where are they most commonly found
found in those with intracranial (CNS) disease
found in the stomach, duodenum, and esophagus
commonly perforate
37
in which condition would you see coffee-ground hematemesis
long standing stress related mucosal diseases
38
what is the most common cause of chronic gastritis
helicobacter pylori
39
where is chronic gastritis most commonly seen
stomach antrum or duodenum
40
what does atrophic gastritis look like
loss of rugae
41
what does hypertrophic gastritis look like
heaped up rugae
42
what does erosive (hemorrhagic) gastritis look like
shallow ulcers, little to no rugae
43
what are the two effects of autoimmune gastritis
decrease in acid production from loss of parietal cells
decreased intrinsic factor and therefore a B12 deficiency
44
what is intestinalization
when glandular epithelium is replaced by mucus-secreting goblet cells
45
what are the three complications of chronic gastritis
peptic ulcer disease
mucosal atrophy and intestinal metaplasia
dysplasia
46
where are peptic ulcers usually found
duodenum
47
what are the two most common types of gastric polyp
inflammatory and hyperplastic polyps
48
what is familial adenomatous polyposis (PAP)
more than 100 fundic gland polyps
49
what is the most common type of stomach cancer
gastric adenocarcinoma
50
what are two causes of gastric adenocarcinoma
H. pylori
EBV
51
what is the main feature of the intestinal type of gastric adenocarcinoma
well defined lesions
52
what is the diffuse type of gastric adenocarcinoma
linitis plastica
53
which condition presents with a thickened gastric wall "leather bottle"
linitis plastica (diffuse type gastric adenocarcinoma)
54
what is MALT
mucosal associated lymphoid tissue
55
what is the most common type of gastric lymphoma
marginal zone B-cell lymphoma
56
neuroendocrine carcinoid tumors can be associated with which syndrome
Zollinger-Ellison syndrome
57
what is Zollinger-Ellison syndrome
gastrinomas from the pancreas or duodenum that secrete gastrin
58
which tumors pop up under the mucosa and are white/yellow on cut section
neuroendocrine carcinoid tumors
59
what is the most common mesenchymal tumor of the abdomen
gastrointestinal stromal tumor (GIST)
60
where do most gastrointestinal stromal tumors (GIST) occur
stomach
61
which marker is used to test for a gastrointestinal stromal tumor (GIST)
KIT (CD117)
62
what is a type of nerve sheath tumor
schwannomas
63
what is a type of nerve tumors that resemble glomus bodies in the nail beds
glomus tumor
64
what is the most frequent cranial birth injury leading to hemorrhage of the scalp
cephalohematoma
65
which structures holding up the connection between the duodenum and jejunum
ligament of treitz
66
where are peyer's patches most commonly found
ileum
67
what do brunners glands do
found in the duodenum and produce alkaline secretions to proctect the small intestine
68
what are the two ways to orient yourself to the cecum
1st - find appendix
2nd - find ICV
69
what is the mesorectal envelope
area of rectum/anus that is retroperitoneal and becomes a margin once removed
70
what is the most common congenital defect/anomaly of the GI tract
mekels diverticulum
71
what are the three parts to the rule of 2's for mekels diverticulum
2% of population
2 ft from ileocecal valve in adults
2 in long in adults
72
what is a mekels diverticulum made of
pancreas or gastric mucosa
73
who, male or females, is more at risk for developing appendicitis
males
74
what is the most common cause of appendicitis
fecalith
75
what is the most common tumor of the appendix
carcinoid at tip of appendix
76
what causes a mucocele of the appendix
epithelial perforation due to mucin accumulation
77
what does LAMN stand for
low grade appendiceal mucinous neoplasm
78
what is pseudomyxoma peritonei
rupture or extension from a mucinous appendiceal neoplasm with numerous gelatinous globules of mucin
79
where is the most common location to have an obstruction of the GI tract
small intestine
80
what is intussusception
when a segment of the intestine telescopes into the distal segment
81
what is the most frequent cause of intestinal obstruction worldwide
hernias
82
what three factors determine the severity of ischemic bowel disease
severity of vascular compromise
amount of time obstructed
vessels affected
83
what are the 4 most common watershed zones (areas particularly susceptible to ischemia)
superior and inferior mesenteric artery (affects transverse and left colon)
inferior mesenteric and hypogastric artery (affects sigmoid)
84
what is dysentery
painful, small amounts of bloody diarrhea containing contaminated food/water
85
how does cystic fibrosis affect a newborns GI tract
leads to meconium ileum (thick meconium adherent to the wall of the small bowel)
86
what is the main characteristic of cells affected by celiac disease
villous atrophy
87
dermatitis herpetiformis is seen in which condition
celicac disease
88
what is abetalipoproteinemia
recessive disease where you can't secrete triglyceride rich lipoproteins
leads to fat build up within the cells
89
spur cells are seen in which condition
abetalipoproteinemia
90
what are the two types of microscopic colitis
collagenous colitis
lymphocytic colitis
91
what is the main feature of collagenous colitis
dense subepithelial collagen layer
92
what is the main feature of lymphocytic colitis
lots of T lymphocytes
93
which disease is common in those who receive transplants
graft-versus-host disease (GVHD)
94
what is the main cause of pseudomembranous colitis
c. difficile
95
how is pesudomembranous colitis treated
fecal transplant
96
what is the most common cause of severe childhood diarrhea
rotavirus
97
what is irritable bowel syndrome
chronic, relapsing abdominal pain, bloating, and change in bowel habits
98
what is inflammatory bowel disease
chronic condition that leads to inappropriate mucosal immune activation
two types: Crohn disease and ulcerative colitis
99
what are four characteristics of Crohn disease
transmural (entire thickness)
skip lesions
cobblestone appearance
creeping fat
100
what are two characteristics of ulcerative colitis
limited to colon and rectum
mucosa and submucosal involvement
101
which, ulcerative colitis or crohn disease, is more likely to become malignant
ulcerative colitis
102
what is the word for a single out pouching in diverticulosis
diverticulum
103
what is the word for multiple out pouching in diverticulosis
diverticula
104
who is most at risk for diverticulosis
those over the age of 60
105
what is diverticulosis and where are they typically found
out pouchings of the mucosal wall in the colon, typically on the mesenteric side of the sigmoid colon
106
what is a hamartomatous polyp
disorganized, tumor-like growth made of the same cell of the area
can occur in any area of the wall
107
what are juvenile polyps
a type of hamartomatous polyp of rectum in children
108
what is juvenile polyposis syndrome
a juvenile polyp that has become malignant
109
what is peutz-jeghers syndrome
dominant disorder that is characterized by both epithelial hamartomatous polyps and mucocutaenous hyperpigmentation
110
are hyperplastic polyps typically malignant?
no
111
what is a colon adenoma
polyp with epithelial dysplasia
most common and clinically important in developing neoplasia
raspberry appearance
size determines risk for malignancy (>4cm)
112
what are the three types of colon adenoma structures
tubular
tubulovillous
villous
113
hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome increases your risk for cancer where
colorectal
endometrial
ovarian
114
what is the most common malignancy of the GI tract
colon adenocarcinoma
115
where is the most common place for an adenocarcinoma of the colon
large bowel
116
what is microsatellite instability
a proposed genetic cause of colon adenocarcinoma
117
what are the two main pathways involved in colon cancer
APC catenin mutation pathway
micro satellite instability pathway
118
tumors most commonly found in the distal colon and rectum can have which key feature
napkin ring obstruction
119
which type of tumors are common in the right colon
exophytic tumors
120
what are the three main important colon cancer prognostic factors
depth of invasion (most important)
lymph node metastasis
distant metastasis to lung or liver
121
what is the peritoneal reflection
line of demarkation between the sigmoid (peritoneal) and the rectum/anus (retroperitoneal)
122
what is the dentate/pectinate line
divides the anal canal into upper and lower parts
123
where will you find SCC in the distal large colon
anus
124
what type of cancer would you find in the rectum
adenocarcinoma
125
what are the two broad categories pathologists use to stage cancers of the GI tract
endocrine and gastrointestinal
126
what is most important when staging appendix neuroendocrine tumors
size then invasion
127
what is most important when staging colon neuroendocrine tumors
size then invasion
128
what is most important when staging duodenum and ampulla neuroendocrine tumors
size then invasion
129
what is most important when staging jejunum and ileum neuroendocrine tumors
invasion
130
what is most important when staging stomach neuroendocrine tumors
invasion
131
what is most important when staging anal gastrointestinal tumors
size then invasion
132
what is most important when staging appendix gastrointestinal tumors
perforation and mucin
133
what is most important when staging colon and rectum gastrointestinal tumors
invasion
134
what is most important when staging esophagus gastrointestinal tumors
invasion - especially of the adventitia
135
what is most important when staging gastrointestinal stromal tumors
size
136
what is most important when staging small intestine gastrointestinal tumors
invasion
137
what is most important when staging stomach gastrointestinal tumors
invasion
