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Flashcards in Gastro 1 Deck (27)
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1

small, painful, discrete ulcerations of oral squamous mucosa from food or viral infection

Aphthous ulcers
-typically self-limited inflammatory sores commonly referred to as canker sores

2

Oral candidiasis (Thrush) caused by

fungal infection with Candida albicans
-Most common presentation is pseudomembranous form characterized by superficial whitish coating

3

Fibroma:

Submucosal nodular fibrous masses showing connective tissue hyperplasia following chronic irritation
Treatment by surgery

4

Pyogenic granuloma:

Pedunculated masses usually occurring on the gingiva
Highly vascularized that may bleed
Granulation tissue consisting of dense proliferation of immature blood vessels

5

Leukoplakia:

White patch that cannot be scraped off
Refers to oral lesions that do not fall under other any other known etiology
5-25% represent premalignant lesions
Histologically appears as dysplasia

6

Erythroplakia:

Presents as a red, velvety, flat lesion
> risk of malignant transformation than leukoplakia

7

Oral leukoplakia presents most often in _____ and the biggest risk factor

Both types of lesions present in adults, > males
Tobacco use is considered biggest risk factor

8

Predominant oral tumor is

squamous cell carcinoma

9

oral squamous cell carcinoma

strongly associated with tobacco use, high alcohol consumption & HPV infection
Poor overall prognosis (

10

oral squamous cell carcinoma is Superimposed on a background of

erythroplakia or leukoplakia
Epithelial dysplasia usually precedes invasive squamous cell carcinoma
Lymph nodes are at risk for metastasis with cervical lymph nodes for regional metastasis and mediastinal lymph nodes, lungs & liver as sites for distant metastases

11

Xerostomia:

dry mouth
Can arise from (autoimmune) disease, result of radiation therapy, medications

12

Stones (lithiasis) can develop in _____ causing

ducts of salivary glands (sialolithiasis);
obstruction & inflammation
-Obstructions/stones may promote infections

13

inflammation of the salivary glands

Sialadenitis;
-Most common form is viral sialadenitis from mumps affecting parotid glands

14

most common inflammatory lesion of salivary glands

Mucocele
-Arises from blockage/rupture of gland duct to release saliva into connective tissue
-Presents in young pts as swelling of lower lip containing cysts lined with inflammatory granulation tissue or fibrous CT

15

the most common tumor of the salivary gland

Pleomorphic adenoma (mixed tumor)
-Benign, encapsulated tumor of myoepithelial cells & heterogeneous glandular elements
-Often overexpresses transcription factor PLAG1
Generally,

16

Mucoepidermoid carcinomas

contain mixtures of squamous & mucus-secreting cells, occur mainly in the parotid
Non-encapsulated, can grow to large sizes
Often infiltrate surrounding tissues
Associated with rearrangements of MAML2, coding for signaling protein in the Notch pathway

17

incomplete relaxation of the lower esophageal sphincter due to neuronal defects resulting in functional esophageal obstruction

Achalasia
-Example of dysmotility of esophagus

18

Portal hypertension lead to ______ (tortuous dilated veins) to bypass the obstruction to portal venous return

varices

19

Rupture of esophageal varices can be

fatal
-Commonly associated with alcoholic liver disease

20

Odynophagia

pain when swallowing
Lacerations from severe vomiting can promote an inflammatory esophageal reaction
Chemicals (medications) can also cause esophageal injury & inflammation

21

Reflux esophagitis:

esophagus is sensitive to acid damage
Conditions that compromise esophageal motility/tone can promote acid reflux from stomach = gastroesophageal reflux disease (GERD)
Pts > 40 years old, heartburn dysphagia, sour-tasting regurgitation

22

Reflux of gastric contents into the tubular esophagus often from abnormal function of

the lower esophageal sphincter
-Usually see eosinophils in mucosa, hyperemia (redness)
-Complications include ulceration, stricture development, Barrett’s esophagus

23

Prolonged reflux can result in metaplasia of the gastric mucosa at the gastroesophageal junction to that in the small intestine (with Goblet cells) known as

Barrett's esophagus
-White males 40-60 yrs most affected, incidence rising
-increases risk for adenocarcinoma

24

Two most common cancers of the esophagus are

adenocarcinoma & squamous cell carcinoma

25

Adenocarcinoma: usually arises from

GERD/ Barrett’s esophagus

26

Esophageal Adenocarcinoma

Risk increased by tobacco use, obesity (diet), prior radiation therapy
Highest in Western countries, > males
Incidence rising, can be associated with mutations in p53 gene
Pts present with dysphagia, weight loss, vomiting, chest pain
When diagnosed at late stage due to lymphatic spread, 5-yr survival

27

Esophageal Squamous Cell Carcinoma

Squamous cell carcinoma found > males, > 45 yrs, more common in African Americans
Strongly associated with smoking and heavy alcohol consumption
HPV and/or environmental/nutritional factors may increase risk for squamous cell carcinoma
Tumors occur in middle 1/3 of esophagus often causing strictures
Tumors easily metastasize via lymph nodes surrounding esophagus
5-yr survival