DOC. ANDAL - GIT part1 Flashcards
1
Q
common birth defect
near tracheal bifurcation
A
ATRESIA
2
Q
COMPLETE ABSENCE -
INCOMPLETE -
A
COMPLETE ABSENCE - AGENESIS
INCOMPLETE - ATRESIA
3
Q
MOST COMMON FORM OF CONGENITAL ATRESIA
FAILURE OF CLOACAL DIAPHRAGM TO INVOLUTE
A
IMPERFORATE ANUS
4
Q
INCOMPLETE FORM OF ATRESIA
LUMEN REDUCED IN CALIBER
BX FIBROUS THICKENING OF THE WALL
A
STENOSIS
5
Q
INCOMPLETE ‘FORMATION OF THE DIAPHRAGM
ABDOMINAL VISCERA TO HERNIATEINTO THORACIC CAVITY
A
DIAPHRAGMATIC HERNIA
6
Q
MOST COMMON LOCATION OF
DIAPHRAGMATIC HERNIA
A
LEFT - MOSTLY
7
Q
SPACE FILING EFFECT
CAN CAUSE PULMONARY HYPOPLASIA (INCOMPATIBLE WITHLIFE)
A
DIAPHRAGMATIC HERNIA
8
Q
INCOMPLETE CLOSURE OF ABDOMINAL MUSCULATURE
WITH SAC ( AMNION)
AMNION WITH PERITONEUM INSIDE SUPPORTED BY WHARTON GEL
A
OMPHALOCELE
OR
EXOMPHALMOS
9
Q
ALL LAYERS OF THE ABDOMINAL WALL
WITHOUT SAC
LIMITED TO INTESTINES
A
GASTROSCHISIS
10
Q
COMMON SITE
UPPER 1/3 ESOPHAGUS
CAN RESULT IN : [D-E-B-A]
- DYSPHAGIA
- ESOPHAGITIS
- BARRETS ESOPHAGUS
- ADENOCARCINOMA
A
ECTOPIA
ECTOPIC GASTRIC MUSCOSA
11
Q
LED FREQUENT
FOUND IN ESOPHAGUS/ STOMACH
ASYMPTOMATIC
A
ECTOPIC PANCREATIC TISSUE
12
Q
FAILED INVOLUTION OF VITTELINE DUCT
TRUE DIVERTICULUM
BLIND OUTPOUCHING (ALL LAYERS)
A
MECKEL DIVERTICULUM
13
Q
RULE OF 2s IN MECKEL DIVERTICULUM
A
= 2% OF POPULATION
2 FEET (60CM) OF THE ILEOCECAL VALVE)
=2INCHES (5CM) LONG
2X MORE IN MALES
2 Y/O SYMPTOMATIC
14
Q
3RD TO 6TH WEEK OF LIFE
MOST COMMON CONGENITAL
A
CONGENITAL HYPERTROPIC PYLORIC STENOSIS
15
Q
BIRD BEAK SIGN IN BARIUM SWALLOW
A
CONGENITAL HYPERTROPIC PYLORIC STENOSIS
16
Q
PYLORIC STENOSIS
INCREASED RISK FOR:
A
MONOZYGOTIC TWINS
TURNER SYNDROME
TRISOMY 18
ERYTHROMYCIN OR AZITHROMYCIN EXPOSURE
17
Q
OLIVE SHAPED
FIRM (1-2CM ABDOMINAL MASS)
ABNORMAL LEFT TO RIGHT HYPERPERISTALSIS PRIOR TO VOMITING
A
PYLORIC STENOSIS
18
Q
MICROSCOPIC FINDINGS
1. HYPERPLASIA OF PMP (PYLORIC MUSCULARIS PROPRIA)
2. EDEMA - MUCOSA AND SUBMUCOSA
A
PYLORIC STENOSIS
19
Q
10% CHILDREN - DOWN SYNDROME
5% - SERIOUS NEUROLOGICAL ABNORMALITIES
A
HIRSCHSPRUNG DISEASE
CONGENITAL AGANGLIONIC MEGACOLON
20
Q
FAILURE OF GANGLION CELLS TO MIGRATE TO WALL OF COLON
A
HIRSCHSPRUNG DISEASE
CONGENITAL AGANGLIONIC MEGACOLON
21
Q
GANGLION CELLS - IHC
WHAT IS ABSENT IN THE INVOLVED SEGMENT
A
ACETYLCHOLINESTERASE
22
Q
HIRSCHSPRUNG DISEASE
CONGENITAL AGANGLIONIC MEGACOLON
ALWAYS AFFECTED -
MOST AFFECTED -
SEVERE CASES -
A
ALWAYS AFFECTED - RECTUM
MOST AFFECTED - SIGMOID & RECTUM
SEVERE CASES - ENTIRE COLON
23
Q
LOSS OF FUNCTION MUTATIONS
IN RECEPTOR TYROSINE KINASE RET
A
HIRSCHSPRUNG DISEASE
24
Q
FAILURE TO PASS MECONIUM
A
HIRSCHSPRUNG DISEASE
25
SEVERE CASES OF HIRSCHSPRUNG DISEASE
[P-E-P-E]
PERFORATION
ENTEROCOLITIS
PERITONITIS
ELECTROLYTE DISTURBANCES
26
25 CM
FROM FOREGUT
3RD WEEK AOG
ESOPHAGUS
27
PROTECT AIRWAY
UPPER ESOPHAGEAL JXN
28
PROTECT ESOPHAGUS
LOWER ESOPHAGEAL JXN
29
MUSCLES IN ESOPHAGUS ARE UNCOORDINATED
INTENSE HIGH AMPLITUDE CONTRACTIONS
DISTAL ESOPHAGUS
NUTCRACKER ESOPHAGUS
30
DIAGNOSIS IN NUTCRACKER ESOPHAGUS
MANOMETRY
31
CORKSCREW ESOPHAGUS
DIFFUSE ESOPHAGEAL SPASM
32
REPETITIVE SIMULTANEOUS CONTRACTIONS
DISTAL ESOPHAGEAL SMOOTH MUSCLE
DIFFUSE ESOPHAGEAL SPASM
33
LEADS TO DEVELOPMENT OF SMALL DIVERTICULA
EPIPHRENIC DIVERTICULUM
HYPERTENSIVE LE SPHINCTER
34
FALSE DIVERTICULUM
UNCOMMON
HALITOSIS
REGURGITATION
ZENKER DIVERTICULUM
OR
PHARYNGOESOPHAGEAL DIVERTICULUM
35
NAROWING OF THE LUMEN
SUBMUCOSA FIBROUS THICKENING
MUSCULARIS PROPIA ATROPHY
SECONDARY EPITEHIAL DAMAGE ( DUE TO RADIATION OR CHRONIC REFLUX)
ESOPHAGEAL STENOSIS
36
LEDGE LIKE PROTRUSIONS
ASSOCIATED WITH GERD
ESOPHAGEAL MUCOSAL WEB
37
AKA SCHATZKI RINGS
SIMILAR TO WEBS BUT CIRCUMFERENTIAL AND THICKER
INCLUDES MUCOSA AND SUBMUCOSA + MUSCULARIS PROPRIA
ESOPHAGEAL RINGS
38
IN SCHATZKI RING
DISTAL ESOPHAGUS ( SQUAMOUS MUCOSA)
A RING
39
IN SCHATZKI RING
SCJ OF LOWER ESOPHAGUS
B RING
40
TIGHT LES (LOWER ESOPHAGEAL SPHINCTER)
ACHALASIA
41
TRIAD OF ACHALASIA
1. INCOMPLETE LES RELAXATION
2. INCREASED LES TONE
3. APERISTALSIS OF ESOPHAGUS
42
DYSPHAGIA OF SOLIDS AND LIQUIDS
DIFFICULTY OF BELCHING
CHEST PAIN
ACHALASIA
43
DISTAL ESOPHAGEAL INHIBITORY NEURONAL DEGENERATION
CAUSE UNKNOWN - RARE
PRIMARY ACHALASIA
44
CHAGAS DISEASE
TRYPANOSOMA CRUZI (T. CRUZI) INFECTION
DESTRUXCTION OF MYENTERIC PLEXUS
FAILURE PERISTALSIS
ESOPHAGEAL DILATION
SECONDARY ACHALASIA
45
TREATMENT OF ACHALASIA
MYOTOMY
PNEUMONIC BALLOON DILATION
BOTOX (BOTULINUM TOXIN)
46
TRIPLE A SYNDROME
ALLGROVE SYNDROME
1. ACHALASIA
2. ALACRIMA
3.ACH RESISTANT
47
SEVERE RETCHING/ VOMITING
SECONDARY TO ALCOHOL INTOXICATION
MALLORY-WEISS TEAR
48
LONGITUDINAL MUCOSAL TEARS
NEAR GASTROESOPHAGEAL JUNCTION
INVOLVES MUCOSA AND SUBMUCOSA
MALLORY-WEISS TEAR
49
INTENTIONALLY EAT MANY THEN VOMIT
REFLUX ESOPHAGITIS
50
SUPERFICIAL LACERATIONS
HEMATEMESIS
MELENA (UPPER GI BLEED)
51
TRANSMURAL TEARING RUPTURE OF DISTAL ESOPHAGUS
BOERHAAVE SYNDROME
52
BOERHAAVE'S SYNDROME
WHAT IS THE SIGN?
HAMMAN SIGN
53
PUNCH PUT ULCERS
HSV
VIRAL ESOPHAGITIS
54
SHALLOWER ULCERS
CMV
VIRAL ESPHAGITIS
55
MOST COMON CAUSE OF GERD
IS TRANSIENT LES RELAXATION
REFLUX ESOPHAGITIS
56
HIGH CHANCE OF BARRET ESOPHAGUS
INCREASE CHANCE OF CARCINOMA
R/O MI
REFLUX ESOPHAGITIS
57
BASAL ZONE HYPERPLASIA
ELONGATION LAMINA PROPRIA
EOSIONOPHILS RECRUITED
REFLUX ESOPHAGITIS
58
FELINE ESOPHAGUS
STACKED CIRCULAR RINGS
EOSIONOPHILIC ESOPHAGITIS
59
PRODUCE GERD LIKE SYMPTOMS
EOSINOPHILIC ESOPHAGITIS
60
2ND MOST COMMON CASE OF HEPATIC SCHISTOSOMIASIS
ESOPHAGEAL VARICES
61
TORTOUS DILATED VEINS
ESOPHAGEAL VARICES
62
INCREASED PORTAL PRESSURE IN DEVELOPMENT OF COLLATERAL CHANNELS
ESOPHAGEAL VARICES
63
INTESTINAL METAPLASIA
ESOPHAGEAL SQUAMOUS CARCINOMA
BARRET ESOPHAGUS
64
LAMINA PROPRIA INVASION
DYSPLASIA (LOW/HIGH GRADE)
BARRET ESOPHAGUS
65
MICROSCOPIC: REPLACEMENT OF SQUAMOUS ESOPHAGEAL EPITHELIUM BY INTESTINAL METAPLASIA WITH GOBLET CELLS
BARRET ESOPHAGUS
66
DIAGNOSIS FOR BARRET ESOPHAGUS
1. ENDOSCOPY
2. BIOPSY
67
FEATURES SEEN IN DYSPLASIA
1. ATYPICAL MITOSES
2. NUCLEAR HYPERCHROMASIA
3. IRREGULAR CLUMP CHROMATIN
4. INCREASED N-C RATIO
5. IMMATURE EPITHELIAL CELLS
68
MC ESOPGHAGEAL TUMOR/ CANCER
WORLDWIDE
SQUAMOUS CELL CARCINOMA
69
MOST COMMON BENIGN TUMOR IN ESOPHAGUS
LEIMYOMAS
70
FROM BARRET ESOPHAGUS
DISTAL 1/3 OF ESOPHAGUS
ADENOCARCINOMA
71
TP53 MUTATION
DOWNREGULATION OF CDKN2A OR P16 OR INK4A
ADENOCARCINOMA
72
MICROSCOPIC: PRODUCE MUCIN AND FORM GLANDS
ADENOCARCINOMA
73
ADENOCARCINOMA
WHAT SIGN?
SIGNET RING CELL ( POORLY UNDIFFERENTIATED)
74
MOST COMMON WORLDWIDE
MIDDLE 1/3 ESOPHAGUS
SQUAMOUS CELL CARCINOMA
75
AMPLIFICATION OF SOX2 AND CYCLIN D1
TP53 MUTATION
E-CADHERIN
NOTCH 1
SQUAMOUS CELL CARCINOMA
76
SCC GROWS AS
1. POLYPOID
2. EXOPHYTIC
77
SCCA FORMED LIKE?
SHEETS
OR TILE FLOORS
78
***ROUTES OF METASTASIS OF SCCA
UPPER 3RD ESOPHAGUS -
MIDDLE 3RD -
LOWER 3RD -
UPPER 3RD ESOPHAGUS - CERVICAL LN
MIDDLE 3RD - MEDIASTINAL, PARATRACHEAL & TRACHEOBRONCHIAL LN
LOWER 3RD - GASTRIC & CELIAC NODES
79
LN METS IS WORST PROGNOSIS
INSIDIOUS ONSET
SIGNS & SYMPTOMS
- DYSPHAGIA
- ODYNOPHAGIA
SQUAMOUS CELL CARCINOMA (ESOPHAGUS)
80
MUCOSAL INFLAMMATORY PROCESS
CALLED ACUTE
NEUTROPHILS PRESENT
ACUTE (GASTRITIS)
81
MUCIN PRODUCING PART OF STOMACH
CARDIA
PYLORUS
82
G CELLS (GASTRIN)
ANTRUM
83
PARIETAL CELLS - GASTRIN
CHIEF CELLS - PEPSIN
BODY
FUNDUS
84
INFLAMMATION BUT WITHOUT NEUTROPHILS
GASTROPATHY
85
CAUSES GASTROPATHY
[N-A-B-S]
NSAIDS
ALCOHOL
BILE
STRESS
86
OSMOTIC DIARRHEA
TGF-ALPHA
EGFR
MENETRIER DISEASE
87
HYPERPLASTIC LIVER
HYPERPLASTIC PANCREAS
GI TRACT
MUSCLE & ADIPOSE TISSUE
PSORIASIS
MENETRIER DISEASE
88
AT RISK OF ADENOCARCINOMA
+ BODY AND FUNDUS
LYMPHACYTOSIS
CORKSCREW APPEARANCE
MENTRIER DISEASE
89
GASTRIN - SECRETE NEUROENDOCRINE TUMORS (GASTRINOMAS)
INCREASE GASTRIN (TRIGER PARIETAL CELLS ) TO
HYPERPLASIA BX OF INCREASE ACID PRODUCTION
ZOLLINGER-ELLISON SYNDROME
90
ZOLLINGER - ELLISON SYNDROME
HOW TO DIAGNOSE:
UTZ
SOMATOSTATIN RECEPTOR SCINTIGRAPHY
PPI
91
MOST COMMON IN INDIVIDUALS WITH SHOCK,SEPSIS, OR SEVERE TRAUMA
STRESS ULCERS
92
ULCERS OCCURIN THE PROXIMAL DUODENUM
ASSOC. WITH SEVERE BURNS OR TRAUMA
CURLING ULCERS
93
GASTRIC, DUODENAL AND ESOPHAGEAL ULCERS ARISING IN PERSONS WITH INTRACRANIAL DISEASE ARE TERMED ULCERS ADN ACRY HIGH INCIDENCE PERFORATION
CUSHING ULCERS
94
ABNORMAL SUBMUSCAL ARTERIOLE
MC IN THE LESSER CURVATURE, NEAR GE JXN
DIEULAFOY LESION
95
WATERMELON STOMACH
GAVE ( GASTRIC ANTRAL VASCULAR ECTASIA)
96
NON VARICEAL UPPER GI BLEEDING
LONGITUDINAL STRIPES OF EDEMATOUS ERYTHEMATOUS MUSOCA ALTERNATE WITH LESS SEVERELY INJURED PALER MUCOSA
GASTRIC ANTRAL VASCULAR ECTASIA
97
MOST COMON CAUSE OF CHRONIC GASTRITIS
H. PYLORI
98
SPIRAL SHAPED
CURVED BACILLI
FECAL ORAL ROUTE TRANSMISSION
HELICOBACTER PYLORI GASTRITIS
99
INVOLVES ANTRUM (ANTRAL GASTRITIS)
PROMOTE METAPLASIA
HELICOBACTER PYLORI GASTRITIS
100
VIRULENCE FACTORS OF H. PYLORI GASTRITIS
1. FLAGELLA - MOTILE
2. UREASE - GENERATES AMMONIA
3. ADHESINS - ADHERE FOVEOLAR CELLS
4. TOXINS - CagA
101
SEEN IN SILVER STAIN
MC IN ANTRUM
SUPERFICIAL MUCUS
LINES
1. FOVEOLAR CELLS
2. MUCOUS NECK CELLS
3. GASTRIC PITS
HELICOBACTER PYLORI
102
H. PYLORI GASTRITIS
MC USED TEST - UREA BREATH TEST
1. INTRAEPITHELIAL NEUTROPHILS
2. SUBEPITHELIAL PLASMA CELLS
103
SPARE ANTRUM & CARDIA
ASSOC. WITH HYPERGASTRINEMIA
AUTOIMMUNE ATROPHIC GASTRITIS
104
IN AUTOIMMUNE ATROPHIC GASTRITIS
DEFECTIVE GASTRIC ACID SECRETION
ACHLORHYDRIA
105
INCREASE GASTRIN STIMULATION
HYPERPLASIA OF ANTRAL G CELLS
HYPERGASTRINEMIA
106
LOSS OF FOLDS
ATROPIC GLOSSITIS
107
ALLERGY TO COW AND SOY MILK
EOSINOPHILIC GASTRITIS
108
AFFECTS ENTIRE STOMACH
ASSOC. WITH CELIAC DISEASE
LYMPHOCYTIC GASTRITIS
VARIOLIFORM GASTRITIS
109
ASSOC. WITH CROHNS DISEASE
HORSE SHOE SHAPE ( LANGHANS GIANT CELLS)
GRANULOMATOUS GASTRITIS
110
MC. PROXIMAL DUODENUM
MC SECONDARY T H. PYLORI
CC : EPIGASTRIC BURNING OR ACHING PAIN
PEPTIC ULCER DISEASE
111
PUD IN THE BODY AND FUNDUS ACCOMPANIED BY
LESSER ACID SECRETION
112
GASTRIC PEPTIC ULCERS
LOCATED IN:
LESSER CURVATURE OF THE STOMACH
113
HEAPED UP MARGINS (PUD)
CANCER
114
PSEUDOTUMOR
MISTAKEN FOR INVASIVE CARCINOMA
GASTRITIS CYSTICA
115
Chronic gastritis exposes the epithelium to
inflammation related free radical damage and
proliferative stimuli - LEADS TO CARCINOMA
DYSPLASIA
116
** GASTRITIS CYSTICA
FOUND IN SUBMUCOSA-
FOUND IN DEEPER LAYERS -
FOUND IN SUBMUCOSA -GASTRITIS CYSTICA POLYPOSA
FOUND IN DEEPER LAYERS - GASTRITIC CYSTICA PROFUNDA
117
20% ——-> DYSPLASIA (>1CM POLYPS)
CHRONIC GASTRITIS
118
APC GENE
MUTYH
FAP (dysplastic)
CAUSES:
PPIs
INCREASE GASTRIN
INCREASE OXYNTIC GLAND
FUNDIC GLAND POLYPS
119
INCREASED IN INDIVIDUALS WITH FAP
LESIONS OF > 2CM IN DIAMETER —- HIGHER RISK OF DEVELOPING ADENOCARCINOMA
GASTRIC ADENOMA
120
MOST COMMON MALIGNANCY OF THE STOMACH
GASTRIC ADENOCARCINOMA
121
GASTRIC ADENOCARCINOMA TYPE
- BULKY
- EXOPHYTIC
INTESTINAL TYPE
122
GASTRIC ADENOCARCINOMA TYPE:
- INFILTRATIVE
- THICKENS GASTRIC WALL
DIFFUSE TYPE
123
CHRONIC GERD AND OBESITY
DX. ADVANCED AND METASTATIC
GASTRIC ADENOCARCINOMA
124
CDH1
E-CADHERIN
DIFFUSE TYPE
GASTRIC ADENOCARCINOMA
125
APC TUMOR SUPPRESSOR GENE
INTESTINAL TYPE
GASTRIC ADENOCARCINOMA
126
MORE ON GASTRIC ANTRUM
IN THE LESSER CURVATURE
SIGNET RING
DIFFUSE TYPE
GASTRIC ADENOCARCINOMA
127
IN GROSS:
LEATHER BOTTLE APPEARANCE
OR LIMITIS PLASTICA
GASTRIC ADENOCARCINOMA
(DIFFUSE TYPE)
128
COMMON SITES OF METS
IN GASTRIC ADENOCARCINOMA
1. VIRCHOW NODE
2. SISTER MARY JOSEPH NODE
3. KRUKENBERG TUMOR
4. IRISH NODE
5. POUCH OF DOUGLAS
129
ANYWHERE IN GI
MOST COMMON IS IN STOMACH
LYMPHOMA
130
GUT TUMORS OFTEN REFFERED AS:
MALT (MUCOSA-ASSOCIATED LYMPHOID TISSUE)
OR MALTomas
(in peyer patches) - MC. INDUCED MALTOMA
131
MALTOMA
MUTATED MALT LYMPHOMA
MLT GENE
CHROMOSOME 11
CHROMOSE 18
132
LYMPHOCYTIC INFILTRATES IN LAMINA PROPRIA
MONOCYTOID APPEARANCE
MULTIPLE PAPULES
LYMPHOMA
133
MALTOMAS EXPRESS THE B-CELL MARKERS
CD19
CD20
134
MALTOMAS DO NOT EXPRESS
CD5
CD10
135
WELL DIFFERENTIATED NEUROENDOCRINE TUMORS
AKA CARCINOID TUMOR
136
NEUROENOCRINE TUMOR
ARISE INOXYNTIC MUCOSA
ASSOCIATED DISEASES:
MEN1
ZOLLINGER - ELLISON SYNDROME
137
YELLOW OR TAN IN COLOR
VERY FIRM
NEUROENDOCRINE TUMOR
138
DENSE & FIBROUS
NOT SHOW DYSPLASIA
WITH DESMOPLASTIC STROMA
SALT & PEPPER APPERANCE
NEUROENDOCRINE TUMOR
139
ORIGIN: INTESTINAL CELLS OF CAJAL (PACEMAKER CELLS) ICC
CLINICALLY SILENT
GASTROINTESTINAL STROMAL TUMOR
140
IN GIST
THERE IS A CHROMOSOMAL PROBLEM IN
CHR. 9, 14, 22
141
ABN IN GIST
PDGFRA
KIT
142
INHERITED IN GERMLINE AND CONFER AN INCREASED IN GIST
CARNEY-STRATAKIS SYNDROME
143
WHORLED CUT APPEARANCE
SOLITARY
WELL CIRCUMSCRIBED
GIST
144
TYPE OF GIST
- THIN ELONGATED
SPINDLE CELL STYPE (GIST)
145
TYPE OF GIST
- PLUMPER
- EPITHELIAL CELL APPEARING
EPITHELOID TYPE (GIST)
146
IHC OF GIST
CD117 (c-KIT) TO STAIN ICC
147
GIST TREATMENT
COMPLETE RESECTION
IMATINIB (SONITINIB ,if with resistance)
