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Flashcards in GI Deck (259):
1

Untreated esophageal SCC complications include

mediastinal invasion, tracheoesophageal fistula, regional lymph node metastasis, vascular invasion

1

Spontaneous Bacterial peritonitis occurs in

children w/ nephrotic syndrome, adults w/ alcoholic cirrhosis

2

Sialadenitis

inflammation of salivary glans d/t sialolithiaisis (stone)

3

Nerve plexus w/in the esophageal wall

Myenteric (Auerbach) Plexus

3

Barrett Esophagus

Metaplasia of the distal esophagus from squamous to non-ciliated columnar epithelium w/ Goblet cells (d/t acid injury & ulceration)

3

Temporary arrest of intestinal ileum peristalsis

Adynamic Ileus (Paralytic Ileus)

3

Anal neoplasm

SCC & condyloma acuminatum d/t HPV

4

Causes of Secondary Achalasia

Chagas, Polio, surgery, diabetes, infiltrative disease

6

Oral candidiasis

white plaques, often on the tongue, that easily scrapes off, associated w/ immunocompromise

6

esophageal atresia often arises at the level of the

tracheal bifurcation

7

Microscopic features of the duodenum

prominent villous epithelium w/ numerous goblet cells, + submucosal Brunner's glands

7

Preschooler w/ small bowel obstruction

intussusception

8

5 regions of the stomach

cardia, fundus, body, antrum, pylorus

9

Hairy Leukoplakia

white, rough/hairy patch on lateral sides of tongue, d/t EBV and associated w/ immunocompromise (AIDS)

10

10

Bile & pancreatic digestive enzymes enter the small intestine via

the ampulla of Vater

10

foamy macrophages in sm. intestine lamina propria w/ PAS+ granules

Whipple Disease

10

Acalculous cholecystitis

gallbladder stasis, inflammation and edema, cystic duct obstruction due to sludge

11

Gallbladder Carcinoma risk

F, >70, gallstones, porcelain gallbladder, irritative trauma, chronic inflammation, carcinogenic derivatives of bile acids

12

Metastasize from upper esophagus is to

cervical lymph nodes

13

SPINK1 or PSTI

Trypsin inhibitors

14

Non-neoplastic pancreatic cysts

thick-walled, cuboidal or flattened (stretching) epithelium

15

Complications of Ulcerative Colitis

toxic megacolon, adenomatous polyps -> dysplasia -> risk of carcinoma

16

Veins involved in portal HTN -> esophageal varices

distal esophageal vv -> left gastric v -> portal v

17

Peyer's patches are found

lymphoid follicles scattered throughout the ileum

17

Peptic ulcer disease risk factors

EtOH use, NSAID use, COPD, hyperthyroidism, chronic gastritis, severe burns, stress, hypovolemia

18

Gallbladder Adenocarcinoma

infiltrating, fundus/neck, well-differentiated

18

acinar cell injury

Blockage, alcoholism → edema → impaired blood flow, ischemia → acinar cell injury → activated enzymes

19

Flat, firm, irregular, rigid, gastric malignancy

Diffuse Adenocarcinoma - Linitis Plastica

19

Acute Pancreatitis Risks

Gallstones & EtOH

20

Most important prognostic feature of colon cancer is

cancer stage

21

Chronic Pancreatitis acinar cell injury causes

production of pro-fibrotic cytokines (TGF-β and PDGF)

22

Bloody mucoid stools w/ skip lesion stenosis

Crohn Disease

23

Most common malignancy arising in the esophagus

SCC

23

Chronic Pancreatitis Pathogenesis

oxidative stress d/t alcohol → AP-1, NF-KB pathways; IL-8 and monocyte chemo-attractant protein

24

increased # of eosinophils w/in the esophageal epithelium, hyperplasia of the basal zone, elongation of the epithelial papilla

Uncomplicated GERD

24

Causes of chemical esophagitis

Alkali & acidic chemicals, pill esophagitis

24

Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) Microscopically

“Poorly formed glands present in densely fibrotic stroma”

25

Mesocolon

adipose tissue that attaches to the serosa to the abdominal cavity

25

Right-sided Adenocarcinoma

hemoccult test (+), no gross blood in stool

26

Linitis Plastica

highly malignant, DIFFUSE adenocarcinoma that infiltrates the underlying stroma & fibromuscular wall creating a rigid, thick, leather-like gastric mucosa & wall

27

Diverticula above the LES or diaphragm

Epiphrenic Diverticula

28

Most common location for a peptic ulcer

proximal dudoenum

28

Pancreatic enzymes

enzymes secreted in inactive state (except: amylase, lipase)

29

Celiac Sprue

AI disease, flattened villi, duodenum, malabsorption, lymphocyte infiltrate in lamina propria

30

Pancreatic Cystic neoplasms - Serous cystadenoma

lined by cuboidal epithelium without atypia

31

High LES pressure

achalasia

31

Rokitansky-Aschoff sinus –

herniation of gallbladder mucosa into muscular layer

32

Complications of Crohn Disease include

fistulas, strictures

33

Angiodysplasia

severe gastrointestinal bleeding, site of mucosal bleeding cannot be identified

34

Epiploic appendices

finger-like projections of the mesocolon

34

Omentum

sheath of adipose tissue over the intestines

35

Acute Cholecystitis

enlarged, tense, bright red or blotchy/violaceous/green-black (subserosal hemorrhages), serosa has fibrin exudate , cloudy bile

35

Pancreatic Cystic neoplasms - Mucinous cystadenoma

lined by columnar epithelium w/ dense “ovarian” stroma

36

Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma)

in head, hard, stellate, gray-white, poorly defined, somewhat resemble normal ductal epithelium by forming glands and secreting mucin, invade early, elicit intense desmoplastic response

37

Colon cancer has a high

5-year survival rate

37

Metastasize from middle esophagus is to

mediastinum, peritracheal, & tracheobronchial nodes

37

Most common malignancy of the stomach

carcinomas

38

Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) Genetics

oncogene KRAS mutation → inactivation of p16 tumor suppressor gene → inactivation of other tumor suppression genes (TP53, SMAD4, BRCA2)

39

Obstruction of the proximal duodenum

PUD

40

Most common location of diverticular disease

sigmoid colon along the tenia coli

41

Choledocholithiasis

pigmented stones and ass. w/ biliary tract infections; often w/ ascending cholangitis

43

Most common benign tumor of the salivary glands

Pleomorphic adenoma - stromal & epithelial tissue, in parotid w/o n. involvement; mobile, painless, circumscribed mass at angle of jaw

44

Myenteric plexus of the D, J, I is found in which layer

submucosa

44

Cholangitis Sx

sepsis (high fever and chills), abdominal pain, jaundice

45

Pseudomembranous Colitis infiltrate

segmented neutrophil infiltrates

46

Hypertrophic Gastropathy

prominent enlargement of gastric rugal folds d/t hyperplasia of mucosal epithelial cells

46

Pancreatic Cystic neoplasms - Intraductal papillary mucinous neoplasms (IPMN)

extend into ductal system

47

Most common malignancy of the appendix

carcinoid

48

Mucin producing tumors composed of malignant intestinal or signet ring cell types forming glandular structures

Esophageal adenocarcinoma

48

Angiodysplasia is most common

Cecum & right colon d/t high wall tension

49

Parietal cells secrete

HCl & Intrinsic Factor

49

Chronic Ischemic Change

Inflammation, ulceration, fibrosis, & ultimate stricture formation

49

Annular pancreas

pancreas forms a ring around the duodenum → risk of duodenal obstruction

50

Sialadenitis leads to an infection caused by which organism

S. aureus

50

Mucocele:

appendix dilation d/t abdundant mucin secretion

52

SCC of oral mucosa

often on the flood of the mouth w/ leukoplakia (that doesn't easily scrape off) & erythroplakia

53

G-cells secrete

Gastrin

55

Chief cells secrete

pepsinogen I & II

55

Small gray-white plaques in the epithelial surface

esophageal SCC

56

Metastasize from distal esophagus is to

celiac & gastric nodes

57

Lymphoplasmacytic sclerosing pancreatitis

auto-immune pancreatitis with duct-centric inflammatory cell infiltrate, venulitis, ↑IgG4-producing plasma cells – can mimic pancreatic cancer – responds to steroids

58

Complete Metabolic Profile (CMP)

Albumin: 3.9 to 5.0 g/dL ALP/Alkaline phosphatase: 44 to 147 IU/L ALT (alanine aminotransferase): 8 to 37 IU/L AST (aspartate aminotransferase): 10 to 34 IU/L BUN (blood urea nitrogen): 7 to 20 mg/dL Calcium: 8.5 to 10.9 mg/dL Chloride: 96 - 106 mmol/L CO2: 20 to 29 mmol/L Creatinine: 0.8 to 1.4 mg/dL ** Glucose test: 70 to 100 mg/dL Potassium test: 3.7 to 5.2 mEq/L Sodium: 136 to 144 mEq/L Total bilirubin: 0.2 to 1.9 mg/dL Total protein: 6.3 to 7.9 g/dL

59

Most common location for a peptic ulcer in the stomach

lesser curvature of the antrum

60

esophageal SCC risk factors

Hx of smoking, EtOH use, tylosis, Plummer-Vinson

61

Krukenberg Tumor

diffuse gastric adenocarcinoma w/ signet ring that metastasizes to bilateral ovaries

61

Signet ring cell infiltrates

diffuse gastric adenocarcinoma - linitis plastica

61

Adenocarcinoma accounts for 50% of

distal esophageal cancers

62

Turcot Syndrome

FAP + CNS tumors (gliomas)

63

base & margins show superficial fibrinoid debris

peptic ulcer

64

Villous Adenoma structure/location

sessile/ sigmoid & rectum

64

periumbilical pain localizing to RLQ, nausea, vomiting, rebound tenderness, fever, peripheral neutrophilic leukocytosis

Acute Appendicitis Sx

65

Chronic Pancreatitis Imaging

see calcifications on CT or U/S, hypoalbuminemic edema, contrast studies show “chain of lakes” pattern d/t dilation of pancreatic ducts

66

Mallory-Weiss Syndrome

Longitudinal lacerations of mucosa at the EGJ d/t the sudden increase in pressure of severe vomiting

66

Diverticulitis

obstruction + inflammation of the diverticula, may lead to pericolonic abscess -> rupture -> peritonitis

67

prognosis of esophageal adenocarcinoma

poor

68

Ulcerative Colitis

begins at rectum, continuous spread proximally, mucosa & submucosa, ulcers pseudopolyps crypt abscess w/ loss of haustra

69

Polyp associated w/ rectal bleeding in children

juvenile polyp

69

Biliary Atresia

biliary obstruction w/in first 2mo of life

71

3 factors that promote HCl secretion

neural/vagal ACh, endocrine/gastrin, histamine

72

What would be elevated in a metabolic panel during a mumps infection?

Serum amylase; d/t pancreatitis & salivary gland involvement

74

Type of polyp - greatest risk for colorectal adenocarcinoma

villous adenomatous polyp

75

Flattened villi and non-specific inflammation that improves w/ ABX

Tropical sprue

76

Gallstones & Gallbladder Carcinoma

ONLY 0.5% OF PTS. W/ GALLSTONES DEVELOP GALLBLADDER CARCINOMA, but 90% of cases of gallbladder carcinoma have gallstones

77

Mallory-Weiss Syndrome occurs in

alcoholics & bulemics commonly

78

benign neoplasms of the esophagus

mesenchymal origin

79

Epithelial benign tumors of the stomach

polyps & adenomas

81

Primary carcinoma is least often seen in which segment of the GIT

small intestine

82

Invasive Diarrhea (Destruction & dysentery) agents w/ Heavy infiltrates of segmented neutrophils

Salmonella typhimurium, Salmonella typhi, Invasive E. coli & Shigella

83

Mucosal atrophy & intestinal metaplasia + infiltrates of segmented neutrophils

Chronic superficial active gastritis

85

Type of polyp - lowest risk for colorectal adenocarcinoma

tubular adenomatous polyp

86

Hyperplastic Polyps

areas of hyperplastic colonic epithelium

88

Chronic superficial active gastritis caused by

H. pylori infection - focal infiltrates of segmented neutrophils

89

Juvenile Polyps

Hamartomatous, associated w/ Juvenile Polyposis Syndrome, prolapse or rectal bleeding in children

89

Cholangitis

Bacterial infection of the bile ducts, d/t obstruction often Choledocholithiasis

90

Appendix is a residual portion

of the cecum found adjacent to the ileocecal valve

91

Acute Cholecystitis S/S

acute RUQ or epigastric pain, mild fever, anorexia, tachycardia, sweating, nausea, vomiting, mild-moderate leukocytosis, ↑AP

93

Crohn Disease

Creeping fat distribution, Skip lesions, Aphthous Ulcers, Cobblestone mucosa, Fistula, non-caseating granuloma, transmural

95

Flattening of villi w/ non-specific infiltrates

celiacs or tropical sprue

96

Chronic Pancreatitis leads to pancreatic insufficiency & DM

malabsorption, weight loss, steatorrhea, fat-soluble vit deficiencies

97

Menetrier Disease

Hyperplasia of the surface mucus cells w/ glandular hypertrophy

99

Flattened villi, lymphocytes in lamina propria

Celiacs or Tropical Sprue

100

Protective mechanisms of the stomach

mucin, HCO3, tight junctions, blood flow

101

Gastric mucosa consists of

columnar epithelium lined by mucus producing foveolar cells

102

Acinar cell carcinoma

Acinar cell differentiation w/ zymogen granules containing, may develop metastatic fat necrosis

103

Risk Factors for SCC of oral mucosa

Tobaccoa & EtOH

103

Peutz-Jeghers Syndrome

benign hamartomatous polyps

104

Pancreas Divisum

Duct of Wirsung is separated from the rest of the pancreatic ductal system

105

Location of G-cells

Antrum of the stomach, pylorus & duodenum

106

Chief cells are found in which region of the stomach

Body of the stomach

108

Esophageal mucosa is lined by

stratified squamous

109

Tumor marker for colon Adenocarcinoma

CEA

109

Pancreatoblastoma

Children 1-15 y/o; Squamous islands admixed w/ acinar cells

111

Causes of infectious esophagitis

Candidiasis, CMV, HSV

111

Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) in the tail

silent

112

acute necrotizing pancreatitis

acinar/ductal tissues and islets are necrotic, red-black hemorrhagic areas, foci of yellow-white chalky fat necrosis, extra-pancreatic and extra-abdominal fat involved

113

Appendix wall layers

mucosa + submucosa

115

Patients w/ large intestine resections are prone to

dehydration

116

Hereditary disorders of Cholelithiasis

ATP Binding Casette (ABC) transporters, genes ABCG5 & ABCG2 or D19H

117

Zollinger-Ellison Syndrome

Gastric gland hyperplasia secondary to ectopic tumor

119

How does PGE play a protective role in the stomach?

regulates mucin production

120

Acalculous cholecystitis S/S

more insidious, symptoms obscured by underlying conditions, early recognition is critical otherwise complications quickly develop

122

Most significant risk factor for adenomatous polyps to transition to adenocarcinoma

polyp type (villous)

123

FAP

Inherited polyposis syndrome (mutated APC gene)

124

Tubulovillous Adenoma

Villous component has epithelial cells that form pointed fronds projecting form the polyp surface; Intermediate risk of malignancy

125

2 types of gastric adenocarcinomas

linitis plastica (diffuse w/ signet ring cells) & intestinal (intestinal gland)

127

Ileocecal valve is not a sphincter bc

it is not surrounded by SM that contracts/relaxes, rather it opens as pressure builds

129

Mumps infection may involve which organs

parotid gland, orchitis, pancreatitis, and aseptic meningitis

130

Chronic Pancreatitis features

dilation of pancreatic ducts, protein plugs in lumens, decreased # of acini

130

Pancreatic Pseudocyst

collections of necrotic-hemorrhagic material rich in pancreatic enzymes after acute pancreatitis

131

Behcet Syndrome

recurrent aphthous ulcers, IC-vasculitis (maybe d/t viral inf)

131

Omentum function

protective, may help wall off infections or ruptured appendix, etc

132

Distended mucosal crypts w/ mucopurulent exudate streaming from crypts into the pseudomembrane

Pseudomembranous Colitis

133

Major risk of Mumps in teenagers

Sterility d/t orchitis

135

how do afferent neurons play a protective role in the stomach

cause vasodilation when toxins & secretions breach the epithelium

136

Tx for Tropical sprue

broad-spectrum ABX

137

Barretts esophagus develops as

Complication of long-standing GERD (~10% of pts)

139

Diaphragmatic hernia

Absence of a portion of the diaphragm (usually on the L) w/ Herniation of the stomach, small bowel, or liver

140

hemorrhagic pancreatitis

extensive parenchymal necrosis w/ dramatic hemorrhage within the pancreas

142

Most common tumor of the vermiform appendix

Carcinoid

142

dilation of the deep esophageal glands; Numerous, saccular, flask-shaped, diverticula

Diffuse Intramural Diverticulosis

144

Linitis plastica commonly metastasize to the _____ & are called

ovaries; Krukenberg tumors

145

Most common malignant tumor of the salivary glands

Mucoepidermoid carcinoma - mucinous & squamous cells, in parotid w/ facial n. involvement

145

Pyloric stenosis Sx

2-6 wks after birth, non bilious projectile vomiting, olive mass

147

Menetrier Disease

Hyperplasia of the surface mucus cells w/ glandular hypertrophy -> large rural folds

149

Hyperplasia of the parietal & chief cells

Hypertrophic-Hypersecretory Gastropathy

150

Gardner Syndrome

FAP + osteomas, fibromatosis, & epidermal cysts

151

Pseudomucocele Peritonei:

abundant mucin secretion into the peritoneal cavity d/t peritoneal implants of malignant cells

151

Agents causing Cholangitis

enteric gram-negative bacteria: E. coli, Klebsiella, Enterococcus, Enterobacter, Clostridium + Bacteroides mixed infection

152

Mucin production protects the stomach from

effects of pepsin

153

Acute Pancreatitis Hereditary Risks

Mutations in cationic trypsinogen gene (PRSS1) or Mutations in serine protease inhibitor Kazal type I (SPINK1)

155

Pathognomonic finding in mumps infection

b/l parotid gland inflammation

157

Gastrin causes

increased H+ secretion, growth of the gastric mucosa, and increased gastric motility

158

Pancreatic carcinoma tumor antigens

CEA and CA19-9 antigen tests

159

Achalasia

absence of myenteric plexus in esophagus (LES fails to relax + proximal dilation of esophagus)

160

Plummer-Vinson (Paterson-Kelly) Syndrome

Esophageal web + Severe iron deficiency anemia + Glossitis

162

esophageal ring

distal esophagus, circumferential, thick hypertrophied ring -> stenosis

163

failed migration of neural crest cells

Congenital Aganglionic Megacolon (Hirschsprung Disease)

164

PUD is more likely to result in carcinoma if

large diameter, exophytic

165

Pseudomembrane

plaque-like fibropurulent necrotic adhesions & mucus to the surface of damaged colonic mucosa (lacks epithelium

167

sharply demarcated infarcts

acute arterial occlusion (SMA, IMA)

168

Tubular Adenoma

cells form tubules w/in the polyp; Lowest risk for malignancy

169

Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma) in the head

biliary obstruction

171

Mucosal atrophy & intestinal metaplasia (not erosive) w/ lymphocyte & plasma cell infiltrates

Chronic gastritis

172

how does the muscularis mucosa play a protective role in the stomach

limits inflammation to the superficial mucosa

173

carcinoid of the appendix

neuroendocrine, appendectomy is curative

174

Chronic cholecystitis

supersaturation of bile, or inflammation d/t microbes resulting in fibrosis, adehesions, fairly clear, green/yellow, mucous bile, usually stones, ROKITANSKY-ASCHOFF sinus

176

Most common malignancy in the sm. intestine

Non-Hodgkin Lymphoma > Carinoid > Adenocarcinoma

178

Inflammatory Polyps

Pseudopolyp: epithelial proliferation in response to ulceration &/or inflammation of adjacent tissue causes prominence of the mucosal folds

179

Pepsin acts to

digest proteins

180

Sequelae to fibrosing mediastinal reaction

Traction diverticula

181

ulceration of the esophageal epithelium, which may become infected

Complicated GERD

182

most common malignancy of extra-hepatic biliary tract

Carcinoma

183

Chronic Pancreatitis Risks

Alcoholic, Cystic Fibrosis in kids, obstruction, hereditary

184

Acute Pancreatitis Complications

pancreatic abscess, pancreatic pseudocyst, infection of necrotic material, DIC, fluid sequestration, ARDS, diffuse fat necrosis, peripheral vascular collapse, acute tubular necrosis, periumbilical and flank hemorrhage

186

Ileocecal valve function

prevent reflux of digested liquid back into sm bowel & prevent colonic bacteria from entering

187

Myenteric plexus maintains

unidirectional peristalsis

188

Erosion: loss of superficial epithelium + segmented neutrophil infiltrate

acute gastritis

190

linitis plastica

diffuse, signet ring cell, invasive, rigid, thick, leathery gastric wall

192

Acute peritonitis agents

E. coli, S. aureus, C. perfringens

193

Pleomorphic adenoma has a high rate of

recurrence d/t incomplete resection bc of irregular margins

194

Intestinal adenocarcinoma

ulcer + intestinal metaplasia

195

Complications of Chronic cholecystitis

Porcelain gallbladder – shrunken, hard gallbladder d/t chronic inflammation, fibrosis, and dystrophic calcification, Xanthogranulomatous cholecystitis, Hydrops of gall bladder

196

Migratory thrombophlebitis (Trousseau sign)

Pancreatic carcinoma (AKA infiltrating ductal adenocarcinoma)

197

Strong risk factor for Crohn Disease is

Smoking

198

Chronic cholecystitis S/S

recurrent attacks of nonspecific mild RUQ pain esp. after eating, intolerance for fatty/fried food, +/- nausea and vomiting

200

pyloric stenosis presents how & most commonly in who?

1st born male 2-6 weeks after birth

201

Chronic Pancreatitis Labs

↑amylase, ↑AP

203

esophageal SCC S/S

weight loss, progressive dysphagia w/ diet change from solids to liquids

204

Most common death in cirrhosis

ruptured esophageal varices

205

Labs for Acute Pancreatitis

↑amylase (

206

W/in the gastric crypts are neck cells which are

progenitors of foveolar cells and gastric gland cells

208

Erythematous gastric mucosa, segmented neutrophils in lamina propria & gastric crypts, muscularis mucosa intact

Chronic Superficial active gastritis

209

Hyperplastic polyp

is not neoplastic, not associated w/ risk for carcinoma

210

Development of diverticula require:

Focal weakness + Increased luminal pressure

212

hypertrophy of the pylorus

Pyloric stenosis

213

Spontaneous Bacterial peritonitis agents

E. coli, pneumococci

214

LES fails to relax + proximal dilation of esophagus

achalasia

215

Function of the large colon

water reabsorption & fecal storage

216

Complications of Acute Appendicitis

Suppurative Appendicitis, Gangrenous Appendicitis, Rupture -> Peritonitis

218

Colonic carcinoma frequently metastasizes to the

liver

220

Type of polyp - juvenile

hamartoma

221

Villous Adenoma

Villous fronds w/in the polyp Sessile, large (10cm), velvety consistency, friable, & fragment w/ ease; Highest risk of malignancy

222

Organism enters the Peyer patches in submucosa & replicates w/in

Yersinia

223

Acute Pancreatitis S/S

abdominal pain referred to upper back/left shoulder, anorexia, nausea, vomiting

224

Charcteristic tumor cell associated w/ linitis plastica

signet ring cell

225

Primary carcinoma is most often seen in which segment of the GIT

Large intestine

226

Schatzki ring

encircles lower esophagus just superior to the gastroesophageal junction; Under surface of the ring is lined by columnar epithelium

227

Gallbladder Adenocarcinoma Prognosis

Poor - At diagnosis most have invaded liver, cystic duct, portal-hepatic lymph nodes

228

Absorption in the small intestine occurs via

specialized epithelial cells lined by microvilli

229

Adenocarcinoma S/S

fatigue, weakness, iron-deficient anemia

230

Order of Esophageal CT layers from outside to inside

Stratified squamous epithelium, submucosa, muscularis propria, & adventitia (lacks serosa)

231

Congenital Aganglionic Megacolon (Hirschsprung Disease)

Functional obstruction w/ colonic dilation & hypertrophy proximal to the affected segment

232

Gastric adenomas are most common

in the antrum

234

Warthin Tumor

Benign cystic tumor w/ lymphocytes & germinal centers in parotid

235

Toxic Diarrhea (preformed toxins) agents

S. aureus, Vibrio cholera, C. perfringens – produce preformed toxins Enterotoxigenic E. coli – secrete toxins in vivo

236

semi circumferential thin protrusion of vascularized squamous epithelium

esophageal web

238

Left-sided Adenocarcinoma

gross blood in stool

239

duodenal atresia is associated w/

Downs

240

Pleomorphic adenoma has a low rate of

transformation to carcinoma

241

Lymphoid Polyps

Hyperplastic lymphoid follicles d/t inflammation or other stimuli creating the appearance of a polyp

242

Meconium Ileus

associated w/ Cystic Fibrosis

243

MALT lymphomas are associated w/

H. pylori infections

244

Peptic ulcer disease description

sharply demarcated, punched out ulceration (extends through muscular is mucosa)

245

Infarcted bowel with sharply demarcated area

acute arterial occlusion -> transmural infarct

246

pyloric stenosis S/S

non-bilious projectile vomiting, peristalsis, olive-mass in abdomen

247

Premature activation of pancreatic enzymes ->

→ inflammation and edema + proteolysis + fat necrosis + hemorrhage → acute pancreatitis

248

Distal colon Adenocarcinoma

annular ring w/ “napkin ring” constriction; “apple core” lesion on x-ray

249

Parietal cells are found in which region of the stomach

fundus of the stomach

250

Meckel Diverticulum

Failure of the vitelline duct to involute; ileum; True diverticulum

251

Hematemesis following severe vomiting

Mallory-Weiss Syndrome

252

Basic Metabolic Profile (BMP)

BUN: 7 to 20 mg/dL CO2: 20 to 29 mmol/L Creatinine: 0.8 to 1.4 mg/dL Glucose: 64 to 128 mg/dL Serum chloride: 101 to 111 mmol/L Serum K+: 3.7 to 5.2 mEq/L Serum Na+: 136 to 144 mEq/L

253

Gallbladder Adenocarcinoma S/S

mild cholecystitis in elderly women

254

Biliary Atresia pathogenesis

inflammation and fibrosis of inter/extra-hepatic bile ducts, cirrhosis

255

Type 1; Type 2 Biliary Atresia

1 – obstruction at level of common bile duct 2 – obstruction at level of common hepatic duct

256

Biliary Atresia S/S

Jaundice, normal stools → acholic (pale) stools; ↑bilirubin, ↑aminotransferase and AP

257

Choledochal Cysts

dilatations of the common bile duct

258

Choledochal Cysts Sx

jaundice, recurrent abdominal pain/biliary colic

259

Choledochal Cysts Complications

predisposes pt. to stone formation, stenosis, structure, pancreatitis, obstructive biliary complications in liver, ↑ risk of bile duct carcinoma (in older pts.)