Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
What is the prognosis for esophageal carcinoma?
Poor prognosis due to late presentation
What are the symptoms for esophageal carcinoma?
progressive dysphagia (solids to liquids), weight loss, pain, and hematemesis.
In addition to the symptoms for esophageal carcinoma what may squamous cell carcinoma additionally present with?
hoarse voice (recurrent laryngeal nerve involvement) and cough (tracheal involvement).
In esophageal carcinoma what determines the location of lymph node spread?
it depends on the level of the esophagus that is involved
For esophageal carcinoma involvement of the upper 1/3 of the esophagus results in what lymph node spread?
For esophageal carcinoma involvement of the middle 1/3 of the esophagus results in what lymph node spread?
mediastinal or tracheobronchial nodes
For esophageal carcinoma involvement of the lower 1/3 of the esophagus results in what lymph node spread?
celiac and gastric nodes
What is gastroschisis?
congenital malformation of the anterior abdominal wall leading to exposure of abdominal contents
What is omphalocele?
Persistent herniation of bowel into umbilical cord
What is omphalocele due to?
failure of herniated intestines to return to the body cavity during development, the contents are covered by peritoneum and amnion of the umbilical cord
What is pyloric stenosis?
congenital hypertrophy of pyloric smooth muscle; more common in males
How does pyloric stenosis classically present?
two weeks after birth as; 1. Projectile nonbilious vomiting 2. Visible peristalsis 3. Olive-like mass in the abdomen
What is the treatment for pyloric stenosis?
What is acute gastritis?
Acidic damage to the stomach mucosa
What is acute gastritis due to?
imbalance between mucosal defenses and acidic environment
What do the defenses of acute gastritis include?
mucin layer produced by foveolar cells, bicarbonate secretion by surface epithelium, and normal blood supply (provides nutrients and picks up leaked acid).
How is a severe burn a risk factor for acute gastritis?
(Curling ulcer) Hypovolemia leads to decreased blood supply.
How are NSAIDs a risk factor for acute gastritis?
How is increased intracranial pressure a risk factor for acute gastritis?
(Cushing ulcer) Increased stimulation of vagus nerve leads to increased acid production
What is the relationship between shock and acute gastritis?
Multiple (stress) ulcers may be seen in ICU patients
What are the risk factors for acute gastritis?
1. Severe burn 2. NSAIDs 3. Heavy alcohol consumption 4. Chemotherapy 5. Increased intracranial pressure 6. Shock.
In acute gastritis what does acid damage result in?
superficial inflammation, erosion (loss of superficial epithelium), or ulcer (loss of mucosal layer)
What is chronic gastritis?
Chronic Inflammation of stomach mucosa
What is chronic gastritis divided into?
two types based on underlying etiology: chronic autoimmune gastritis and chronic H pylori gastritis
What is chronic autoimmune gastritis due to?
autoimmune destruction of gastric parietal cells
Where are the gastric parietal cells located?
in the stomach body and fundus.
What is chronic autoimmune gastritis associated with?
antibodies against parietal cells and/or intrinsic factor; useful for diagnosis, but pathogenesis is mediated by T cells (type IV hypersensitivity)
What are the clinical features for chronic autoimmune gastritis?
1) Atrophy of mucosa with intestinal metaplasia 2) Achlorhydria with increased gastrin levels and antral G-cell hyperplasia 3) Megaloblastic (pernicious) anemia due to lack of intrinsic factor 4) Increased risk tor gastric adenocarcinoma (intestinal type)
What is chronic H pylori gastritis due to?
H pylori-induced acute and chronic inflammation