CHAPTER: GI Path Flashcards Preview

LCK STEP > CHAPTER: GI Path > Flashcards

Flashcards in CHAPTER: GI Path Deck (53):
1

3 different types of salivary gland tumors

Warthin = B, germinal centers (kind of makes sense b/c parotid sep from lymph tissue late in development)
Pleomorphic adenoma = B, recurs, stroma + epi
Muco-epi-dermoid carcinoma = M, mucinous + squamous
Malignancy esp if CN 7 palsy

2

Achalasia vs peptic stricture

Both tight LES
Peptic - scarring, normal peristalsis above
Achalasia - lose myenteric (movement, musc prop), uncoord or no peristalsis above

3

HSV 1 esophagitis

Punched out ulcers

4

Sclerodermal esophageal dysmotility - cause

Atrophy SM -> ↓LES -> acid reflux

5

Esophageal varices are dilation of what vien

L gastric

6

4 parts mumps

↑amylase due to 1 + 2
1. Bilat parotid swelling
2. Pancreatitis
3. Ochitis
4. ASEPTIC MENINGITIS

7

Alcohol ↑risk of what type eso cancer

SQQ only (upper 2/3)

8

What oral cavity ulcer is painful, resolves on own and is red with a gray base? 2 disease you'd see in

Apthous ulcer
1. Behcet - recurrent apthous, genital ulcers, ureitis
2. HSV 1

9

Most common location for cancer in the oral cavity? Is hairy leukoplakia precancerous?

Floor mouth
Hairy = EBV @ lateral tongue, hyperplasia so NOT precursor

10

H.Pylori ↑risk what 2 types cancer

Stomach adenocarcinoma
MALToma - makes sense since this is an infection

11

What is Menetrier disease

Hyperplasia gastric mucosa
Looks like brain gyri on scans
Parietal cell atrophy = ↓acid
Pre-cancerous

12

What is going on if a pt has gastric tissue around belly button and in supraclavicular LN

Gastric cancer mets
Virchow = L supraclav LN - everything below belly button drains via thoracic duct to L
Sister Mary Josephy nod w/ intestinal type stomach cancer

13

Which ulcers hemm vs perf

Hemm
1. Gastric - L gastric art (less curve)
2. POST duo - gastroduodenal art
Perf = ANT duo
Shoulder pain b/c free air in ab aggravates diaphragm (phrenic nerve)

14

What GI disease can cause a T cell lymphoma

Celiac
Ab - antigen complex (AI) -> APC present on MHC 2
Th mediated cell damage

15

How does stool pH change with lactose intol? Why?

More acidic
Bacteria ferment lactose not being absorbed -> short FAs

16

Cause of lactase def

Absent gene = inherited
Change to gene expression with age - make less of it

17

Histo + symptoms of Whipple disease

Intracell GP bact - not gonna show on stains
PAS + foamy macrophages (looks like fat)
@ LP of GI + mesenteric LNs
+ cardiac
+ staetorrhea
+ arthralgia
+ neuro
"Foamy whipped cream in CANS"

18

What layers of tissue are affected by UC

Mucosa + submucosa
Lose haustra -> lead pipe

19

Crohn's vs UC
Where's the pain
Which can have perianal disease
Associated diseases

Crohn's= RLQ, perianal disease (fistulas b/c transmural inflam), Ca ox stones
UC = LLQ pain, crypt abscess, p-ANCA 1ary sclerosing cholangitis

20

Extra-GI manifestations of Crohn's and UC

Rash
Eye inflam
Oral ulcers
Arthritis - peripheral or spondylitis

21

If you see red cells w/ stippling nuclei after appendectomy, what was it?

Carcinoid tumor in appendix
Either caused appendicitis if at base occluding or incidental if at tip

22

GI infection can cause what complications in kids after resolution (lymphoid hyperplasia causes)

Appendicitis
Leading edge for intussception often @ ileocecal jxn -> blood stools

23

Stress on the R colon vs L

L: diverticulum @ sigmoid colon (no muscularis externa b/c go through @ vasa recta)
R: angiodysplasia = dilation of vessels causes blood poop

24

If a pt is presenting with poop in their urine and LLQ pain, what are you thinking?

LLQ = diverticulitis
That cause coloverical fistula

25

Where do Zenker diverticulums form

Bet thryro-pharyngeal and crico-pharyngeal parts of inf pharyngeal constrictor
Behind thyroid cartilage
Elderly men false eso diverticulum

26

What is the damaged tissue in Hischsprung

Both plexi - can't relax - contracted tissue is bad

27

Describe presentation of malrotation

Bad MIDGUT rotation during development
Fibrous bands can cause duo obstruction
"From cecum + R colon to retro"

28

Site of volvulus in kids vs adults

Kids = midgut around SMA
Adults = sigmoid around IMA

29

Which art do emboli usually occlue causing acute mesenteric ischemia

SMA - pain out of proportion

30

What is an ileus

Hypomotility w/o obstruction = constipation w/o gs
Associated with hypoL

31

Where hyperplastic polyps

Recto-sigmoid
Not cancer

32

2 types adenomatous polyps - mutation

Villous worse than tubular
APC/KRAS (FAP)

33

HNPCC
Mutation
Type polyp
Area of colon

AD
X DNA mismatch repair (BRAF)
MIS
Prox colon always
Serrated polyps = saw tooth crypts
Arises de novo - not from polyp
↑risk GYN + CRC cancer

34

Mut + area of colon involved with FAP

Chr 5q APC mutated tumor suppressor gene, AD
Always rectum
Adenomatous polyps

35

Cancer risk for Peutz Jeghers vs juvenille polyposis syndrome

Both AD
PJ = hamartomatous polyps + hyperpig mucosal freckles, ↑breast + GI cancer
JPS = hamartomatous polyps, ↑CRC

36

Cytokine that cause fibrosis in cirrhosis

TGF beta

37

What does gamma glutamyl transferase tell you

Liver or biliary disease causing ↑ALP

38

Histo Reye syndrome

ASA X mito enzymes (↓B ox)
Mitochondrial abnormalities + fatty liver change

39

What is in a Mallory body

Alcoholic hepatitis - eos intra-cytoplasmic inclusions
Damaged keratin

40

Treat hepatic encephalopathy

Lactulose
Rifaximin or neomycin - ↓bacteria making NH4 in the gut

41

Mechanism by which Aspergillus causes HCC

p53 mut

42

Cell marker for HCC

↑AFP

43

2 chemicals that ↑risk angiosarcoma

Arsenic
Vinyl chloride

44

Gilbert synd
Crigler Najjar
Dubin Johnson
Rotor
Physiologic jaundice of newborn

UDP glucuronosyltransferase makes CBR
G: ↓UDP, benign
CN: XUDP = jaundice, kernicterus, death
DJ: defective liver excretion = black liver (incidental)
Rotor: milder DJ, no black liver
PJN: ↓UDP to start

45

Acute vs chronic hepatitis histo

Acute: inflam lobules + portal tract, hepatocyte apoptosis
Chronic = > 6mo, portal tract inflam

46

Mut + trt Wilson disease

Ch 13 AR mut liver Cu transporting ATPase
Penicillamine, trientine, oral Zn

47

Mut + presentation + trt hemochromatosis

Ch 6 AR, bad sensing, liver thinks you're deplete, ↑intestinal absorption
Cirrhosis + diabetes + skin pig (bronze diabetes)
Ca pyrophos @ jts
Phlebotomy
Chelate: deferasirox, deferoxamine, oral deferiprone

48

Cause of 1ary biliary cirrhosis

AI - granulomas of intralob bile ducts
+ Anti mitoAb

49

Pt w/ pruritus + ↑ALP thinking

Biliary tract disease

50

Which GB stones can you seen on imaging - causes for both

Cholesterol - E therapy, statins, cholestyramine, rapid weight loss
Pigment = BR = see on imaging
Infections - ascaris lumbricoides, clonorchis
TPN
Chronic hemolysis
Alcoholic cirrhosis : ↓bile salt prod
Crohns: ↓bile salt reabsorb

51

Causes of acute pancreatitis

Ones you know +
AI
Scorpion string
↑TGs
ERCP

52

What lines pancreatic pseudocysts

Granulation tissue (NOT epi)

53

What cells does pancreatic adenocarcinoma arise from

Ducts -> histo therefore glandular
Migratory thrombophelbitis - redness + tenderness on palpation of extremities
+ palpable non-tender GB