GI Flashcards
(104 cards)
1
Q
3 Salivary gland tumors
A
- Pleomorphic adenoma
- Mucoepidermoid carcinoma
- Warthin tumor
2
Q
most common malignant tumor of salivary gland
A
Mucoepidermoid carcinoma
3
Q
Salivary gland’s benign cystic tumor with germinal centers.
A
Warthin tumor
4
Q
Most common salivary gland tumor
A
Pleomorphic adenoma
5
Q
Cancer (obstruction) cause dysphagia to solids or liq?
A
Solids –>liq (Achalasia cause liq–>solids)
6
Q
Achalasia increase risk of which cancer?
A
Squamous cell carcinoma of esophagus
7
Q
Endoscopy of Eosinophilic esophagitis shows?
A
Esophageal rings and linear furrows
8
Q
Eosinophilic esophagitis main symptom?
A
Dysphagia
9
Q
Varices located in what part of esophagus?
A
lower 1 ⁄3 of esophagus
10
Q
HSV-1 appearance in esophagitis infection?
A
punched-out ulcers
11
Q
CMV appearance in esophagitis infection?
A
linear ulcers
12
Q
Esophagitis caused by?
A
- reflux
- infection in immunocompromised
- caustic ingestion
- meds
13
Q
Candida infection of esophagus (esophagitis) appearance?
A
white pseudomembrane
14
Q
GERD associated with?
A
Associated with asthma
15
Q
Plummer-Vinson syndrome triad?
A
Triad of Dysphagia, Iron deficiency anemia, and Esophageal webs.
(“Plumbers” DIE).
16
Q
Plummer-Vinson syndrome increase risk of which esophageal cancer?
A
Increased risk of esophageal squamous cell carcinoma “Plumbers” DIE
17
Q
Sclerodermal esophageal dysmotility
A
Smooth muscle atrophy & decreased LES pressure–>dysmotility/reflux/dysphagia
18
Q
Acute gastritis 3 causes?
A
- NSAIDs
- Burns (Curling ulcer)
- Brain injury (Cushing ulcer)
19
Q
Chronic gastritis 2 causes?
A
- H Pylori
2. AI-Pernicious anemia
20
Q
Ménétrier disease MOA
A
Gastric hyperplasia of mucosa, parietal cell atrophy–can’t make acid
21
Q
Acid is made by which cells in stomach?
A
Parietal
22
Q
Parietal cells provide what 2 things in stomach?
A
- IF
2. Acid
23
Q
Gastric cancer types
A
- gastric adenocarcinoma
- lymphoma
- GI stromal tumor
- carcinoid
- Intestinal
- Diffuse
24
Q
Leser-Trélat sign is?
A
Sudden multiple seborrheic keratoses caused by stomach CA
25
Most commonly gastric CA?
adenocarcinoma
26
Rarest stomach CA?
carcinoid
27
Stomach CA associated with H. Plyori?
Intestinal
28
signet ring cells & linitis plastica associated with which kind of stomach CA?
Diffuse
29
Signet ring cells
mucin-filled cells with peripheral nuclei
30
Linitis plastica
stomach wall grossly thickened and leathery
31
involvement of left supraclavicular node by metastasis from stomach.
Virchow node
32
Bilateral metastases to ovaries. Abundant mucin-secreting, signet ring cells.
Krukenberg tumor
33
Subcutaneous periumbilical mets from stomach?
Sister Mary Joseph nodule
34
Most common cause of both stomach and duodenal ulcers?
H Pylori infection
35
In addition to H Pylori, stomach ulcers also caused by?
NSAIDs
36
In addition to H Pylori, duodenal ulcers also caused by?
ZES
37
Symptoms in perforation of stomach or duodenal ulcer?
- Free air under diaphragm
| - Referred pain to shoulder (via phrenic n)
38
3 Ulcer complications
1. Hemorrhage
2. Obstruction
3. Perforation
39
Pancreatic insufficiency causes malabsorption of?
1.
fat
2. fat-soluble vitamins (A, D, E, K)
3. B12.
40
Difference between Tropical Sprue & Celiac ?
Responds to Abx.
41
Tropical sprue assoc. w/ what anemia type?
megaloblastic anemia due to folate deficiency and, later, B12 deficiency
42
PAS ⊕
Whipple disease
43
Foamy macrophages in intestinal lamina propria
Whipple disease
44
Whipple disease 3 sxs.? (Mnemonic)
1. Cardiac
2. Arthralgias, and
3. Neurologic
"Foamy Whipped cream in a CAN"
45
Whipple disease MOA
Infection with Tropheryma whipplei (intracellular gram ⊕)
46
Rectum v Anus?
Rectum -->Anus (outside)
47
IBS: Recurrent abdominal pain associated with ≥ 2 of the following:
1. Pain improves with defecation
2. Change in stool frequency
3. Change in appearance of stool
48
Cause of appendicitis in kids?
lymphoid hyperplasia
49
Initial pain location in appendicitis?
Initial diffuse periumbilical pain migrates to McBurney point (1 ⁄3 the distance from right anterior superior iliac spine to umbilicus).
50
McBurney point
1 ⁄3 the distance from right anterior superior iliac spine to umbilicus
51
Sxs. Appendicitis?
1. Pain,
2. Nausea,
3. fever
52
Physical signs with appendicitis?
1. psoas,
2. obturator, and
3. Rovsing signs
53
Rovsing's sign=
Pain in right lower abdomen w/ palpation left abdomen.
54
Appendicitis Ddx.
Differential: diverticulitis (elderly), ectopic pregnancy (use β-hCG to rule out).
55
“True” diverticulum definition?
all 3 gut wall layers outpouch
56
Meckel is true or fake diverticulum?
True
57
“False” diverticulum or pseudodiverticulum—
only mucosa and submucosa outpouch. Occur especially where vasa recta perforate muscularis externa.
58
MC location of diverticulum?
Most often in sigmoid colon.
59
Sxs. of diverticulosis?
1. Often asymptomatic or
2. vague discomfort
3. bleeding (painless hematochezia),
4. diverticulitis.
60
Melena is?
black, tarry stools.
61
Hematochezia is?
brb fresh blood per anus, usually in or with stools.
62
Complications of diverticulitis?
1. Abscess
2. Fistula (colovesical fistula=pneumaturia)
3. Obstruction (inflammatory stenosis)
4. Perforation -->peritonitis
63
Zenker is true or pseudo diverticulum?
Pseudo
64
Zenker diverticulum location?
Pharyngoesophageal
65
Zenker diverticulum sxs? (mnemonic)
"Elder MIKE has bad breath"
Elderly
Males
Inferior pharyngeal constrictor
Killian triangle
Esophageal dysmotility
Halitosis
66
Vitelline duct?
a long narrow tube that joins the yolk sac to the midgut lumen of the developing fetus.
67
Location of Meckel's diverticulum?
distal ileum, usually within 60–100 cm (2 feet) of the ileocecal valve
68
Meckel's Mnemonic?
```
"The six 2’s":
2 times as likely in males.
2 inches long.
2 feet from the ileocecal valve.
2% of population.
first 2 years of life.
2 types of epithelia (gastric/
pancreatic).
```
69
Risk for Hirschsprung is increased with what condition?
Down's Syndrome
70
Hirschsprung disease associated with mutations in what gene?
RET
71
characterized by lack
| of ganglion cells/enteric nervous plexuses (Auerbach and Meissner plexuses) in distal segment of colon.
Hirschsprung
72
Hirschsprung MOA
Due to failure of neural crest cell migration.
73
Normal portion of the colon proximal to the aganglionic segment is dilated, resulting in a “transition zone.”
Hirschsprung
74
Failure to pass meconium within 48 hours
Hirschsprung
75
Hirschsprung 3 sxs.
1. bilious emesis,
2. abdominal distention
3. failure to pass meconium in 48 hrs.
76
Anomaly of midgut rotation during fetal development
Malrotation
77
Ladd bands?
fibrous bands in Malrotation
78
Malrotation can lead to what 2 conditions?
volvulus, duodenal obstruction.
79
Twisting of portion of bowel around its mesentery;
| lead to obstruction and infarction
Volvulus
80
Volvulus type more common in elderly?
Sigmoid volvulus (v. midgut in infants/kids)
81
Intussusception MOA?
Telescoping A of proximal bowel segment into distal segment
82
Intussusception location?
commonly at ileocecal junction
83
Most common pathologic lead point to form Intussusception?
Meckel diverticulum
84
Bull’s-eye appearance on ultrasound.
Intussusception
85
Intussusception in adults due to?
associated with intraluminal mass or tumor that acts as lead point that
is pulled into the lumen
86
Intussusception seen after what illness MC?
adenovirus
87
“Currant jelly” stools in what 2 conditions?
1. Intussusception
| 2. Acute mesenteric ischemia
88
POOP
Acute mesenteric ischemia
89
Acute mesenteric ischemia due to occlusion of what BV?
Superior mesenteric artery (SMA)
90
Chronic mesenteric ischemia sxs.?
postprandial Crampy epigastric pain followed by hematochezia.
“Intestinal angina”
91
Chronic mesenteric ischemia MOA
atherosclerosis of celiac artery, SMA, or IMA
92
Commonly occurs at watershed areas (splenic flexure, distal colon)
Colonic ischemia
93
Tortuous dilation of vessels causing hematochezia
Angiodysplasia
94
Angiodysplasia MC where?
Most often found in cecum, terminal ileum, ascending colon
95
Angiodysplasia Dg.?
angiography
96
Most common cause of small bowel obstruction
Adhesion
97
Intestinal hypomotility without obstruction
Ileus
98
Ileus sxs.
constipation and decrflatus; distended/tympanic abdomen with decrbowel sounds
99
Ileus causes
abdominal surgeries, opiates, hypokalemia, sepsis
100
Ileus tx.?
Treatment: bowel rest, electrolyte correction, cholinergic drugs (stimulate intestinal motility).
101
Meconium ileus occurs in?
CF
102
Seen in premature, formula-fed infants with immature immune system.
Necrotizing enterocolitis
103
meconium plug obstructs intestine, preventing stool passage at birth.
Meconium ileus
104
Necrosis of intestinal mucosa (primarily colonic) with possible perforation, which can lead to pneumatosis intestinalis
Necrotizing enterocolitis
