Exam 2 - GI Flashcards by Austin Porter

Achalasia is a functional esophageal obstruction which involves a triad of what characteristics

1: Incomplete LES relaxation
2: Increased LES tone
3: esophageal aperistalsis

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Achalasia involves dilation of the distal esophagus t/f

False; Proximal

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Which is more common, Primary or Secondary Achalasia

Primary

idiopathic
loss of inhibitory innervation to LES

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Esophageal varicose are most commonly found in the (proximal/distal) esophagus and are most commonly secondary to what condition

Distal esophagus

MC secondary to liver cirrhosis

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MC cause of esophagitis

GERD - reflux esophagitis

25-40% of US adults

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“sour brash”, heartburn and dysphagia may be associated with what condition

GERD

>40 yrs old

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Infectious esophagitis is MC secondary to ______

an ulcer

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Mallory-Weiss tear is the MC cause of what condition

Esophageal lacerations
“mallory-weiss syndrome”
-alcoholics, bulimia
-longitudinal tear

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Which type of congenital hiatal hernia is MC; axial or non-axial (sliding or rolling)

Sliding (axial)

Bell shaped dilation
95%

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T/F majority of hiatal hernias are asymptomatic

True, 90%

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If symptoms are present with a hiatal hernia it is most likely which type

Rolling (non-axial)

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Males or Females are more likely to develop Barrett esophagus

Males; 4x

40-60yrs old

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MC esophageal cancer worldwide

Squamous cell carcinoma

-90% of esophageal CA

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Males or Females are more likely to develop adenocarcinoma

Males; 7x

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Esophageal adenocarcinoma commonly involves which segment of the esophagus

distal 1/3

-hence barrett esophagus increasing risk significantly

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Males or Females more likely to develop squamous cell carcinoma

Males; 4x

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African Americans or Caucasians more likely to develop squamous cell carcinoma

African Americans; 6x

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Hot beverages may cause irritation with squamous cell carcinoma t/f

True

alcohol, tobacco

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Esophageal squamous cell carcinoma commonly affects which portion of the esophagus

Middle 1/3

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Majority of chronic gastritis is caused by which organism

Helicobacter pylori

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Peptic ulcer disease is most likely to develop in which area of the GI tract

highly acidic areas—Proximal Duodenum (4x)

-possibly gastric antrum

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a Solitary “punched out” lesion is associated with which GI condition

Peptic ulcer disease

-granulation tissue

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Males or females more likely to develop peptic ulcer disease

Males

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T/F Majority of patients with a helicobacter Pylori infection will develop Peptic ulcer disease

False!
70-90% of PUD is caused by H. Pylori
BUT only 5-10% of H. pylori infections are PUD

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burning epigastric pain 1-3 hours after eating that is relieved by alkaline substances could be a sign of what condition

Peptic ulcer disease | -fatigue, cachexia, bloating

T/F perforation or hemorrhage with peptic ulcer dz. is a medical emergency

True

Gastric vs Duodenal Peptic Ulcer Dz.; which is immediately relieved by food, especially dairy

Duodenal | -4x more common

Gastric vs Duodenal Peptic Ulcer Dz.; which is irritated with an empty stomach or immediately after eating

Gas tank is empty | Gastric

Gastric polyps are commonly associated with acute or chronic gastritis

Chronic gastritis

Most common type of gastric polyps

Inflammatory and hyperplastic | 75%

>90% of all gastric cancers are what type

Gastric adenocarcinoma Malignant -Japan 20x more likely

Highly dysplastic adenomas usually develop into :

Gastric Adenoma

Intestinal obstructions are MC found in which area

Small Intestine

Volvulus

Twisting a loop of bowel | -possible infarction

Congenital, blind end out pouching of the Small intestine

Meckel's diverticulum | males, asymptomatic

Congenital aganglionic megacolon

Hirschsprung dz. | -rectum, sigmoid colon

Failure to pass meconium is a diagnosis for :

Hirschsprung dz.

Hirschsprung dz. is more common in males or females

more common in males BUT more severe in females

Hirschsprung dz. involves a severe dilation of the (proximal/distal) bowels

Proximal

Arteries involved in Ischemic Bowel Dz.

Superior and Inferior mesenteric | Celiac

Vascular lesion of the colon

Angiodysplasia - cecum or ascending colon - submucosal and mucosal vessels

MC vascular disorder of the GI tract

Hemorrhoids

T/F Most cases of celiac dz. are acquired

False; Familial - (HLA-DQ2 or DQ8)

Parent brings in 3yr old child complaining of fatty diarrhea (steatorrhea) after visiting a tropical island for vacation

Environmental enteropathy "tropical sprue" -2-3yr olds

T/F Most cases of lactase deficiency are congenital

False; Acquired in young adulthood

T/F congenital lactase deficiency can be life threatening

True

Vibrio cholerae is a gram (-/+) bacteria

Gram -

Cholera is MC found in which countries

Africa and India | -fecal oral H2O contamination

Patient presents with sudden vomiting and a watery "rice water"-like stool after recently visiting Africa

Cholera

MC bacterial enteric pathogen in US

Campylobacter jejuni

Rotavirus commonly affects (children/adults)

Children 6mo-2yrs

MC parasitic infection

Giardia Lamblia Giardiasis "beaver fever" -fecal contamination

"Beaver Fever"

Giardiasis

Colonic diverticulosis is aka

sigmoid diverticulitis

Colonic diverticulosis is an acquired diverticulum most commonly involving a defect in the _______ colon wall

Sigmoid colon | -MC multiple

Irritable Bowel Syndrome MC develops at what age

20-40 years - females - idiopathic - no cellular abnormalities

Crohn dz. is most commonly involved in which area of GI

terminal ileum | -affects entire GI tract

Right Lower Quadrant pain can be associated with appendicitis and what other condition

Crohn dz.

Ulcerative colitis always begins where in the GI and proceeds (proximally/distally)

rectum and proceeds proximally

T/F | Granulomas and skip lesions are associated with ulcerative colitis

FALSE , pseudopolyps | that is true of Crohn

T/F Smoking exacerbates ulcerative colitis

False | Smoking is actually inhibitory

Relapsing attacks of bloody and mucoid stringy stool lasting days to months is associated with:

Ulcerative colitis

Fibrosis is involved with Crohn or Ulcerative colitis

Crohn

T/F Adenomas are considered malignant until proven otherwise

True | dysplastic is high risk for aggressive adenocarcinoma

T/F Size is an important factor for malignancy of an adenoma

True | larger= higher risk of malignancy

more than 100 adenomas is a diagnosis criteria for :

Familial Adenomatous polyposis - 100% chance of cancer - APC gene mutation - Teenage onset

MC malignancy of the GI tract

Colorectal adenocarcinoma | -50-70yr old

Colorectal adenocarcinoma MC mets to ____

Liver

MC location of SI neoplasms

Duodenum

Life threatening variation of HSV

spread to brain Herpesviral encephalitis -MC HSV-1

MC oral fungal infection

Oral candidiasis candida albicans -opportunistic

Pseudomembranous candidiasis is aka

thrush

Reactive nodular mass found along the bite line

Fibroma | -NOT a real tumor

Pyogenic granuloma is MC found where

Gingiva - NO pus associated - NO granuloma / macrophage involvement

Leukoplakia (can/can't) be scraped off

CANT | thrush can

Males or females at higher risk for leukoplakia

Males; 2x, 40-70 yrs

25% of leukoplakia may develop into ______

squamous cell carcinoma

Which is more likely to develop into cancer; Leukoplakia or Erythroplakia

Erythroplakia 50% -red, velvety area -similar to leukoplakia

_____ leukoplakia involves EBV infection and immunosuppression (AIDs)

Hairy leukoplakia

95% of oral cancer is what type

Squamous cell carcinoma

Squamous cell carcinoma MC mets to :

cervical nodes

Squamous cell carcinoma associated with HPV-16 has a (better/worse) prognosis

Better b/c there are fewer mutations

Primary salivary gland disease are rare but the gland MC affected is the ______

Parotid gland b/c it is the biggest

Sjogren syndrome is an autoimmune dz. that involves inflammation of which types of glands

salivary and lacrimal | Dry eyes and dry mouth**

MC viral cause of sialadenitis

inflammation and enlargement | -Mumps- paramyxovirus

Mumps in pediatrics is self limiting while in adults can lead to :

Pancreatitis and Orchitis (enlarged testicles)

Blockage / rupture of glandular duct commonly found on the lower lip

Mucocele | aka ranula

Salivary gland neoplasms MC affect which gland

Parotid | BUT lowest chance of malignancy

Neoplasm of the sublingual gland has a (higher/lower) chance of malignancy than the parotid gland

Higher | Smaller gland is less common BUT higher malignancy

Majority of Parotid neoplasms

Pleomorphic adenoma -benign slow growing mixed tumor- epithelial and mesenchymal

Ectopia commonly affects which area of the esophagus

upper 1/3 | -asymptomatic

Esophageal varicose are commonly secondary to ________

Portal hypertension

Exam 2 - GI Flashcards

(92 cards)