GI Flashcards
Increased level of the serotonin metabolite ___ in a 24-hour urine sample is the most useful initial test for confirming carcinoid syndrome.
5-hydroxyindoleacetic acid (5-HIAA)
Anal Squamous cell carcinoma, as well as multiple other anogenital (eg, cervical, penile, vaginal) and oropharyngeal SCCs, is strongly associated with ___ virus
human papillomavirus (HPV).
Mutations of ____ genes are associated with hereditary nonpolyposis colon cancer (ie, Lynch syndrome), an autosomal dominant disease that results in colonic, endometrial, and ovarian cancer.
DNA mismatch repair
This elderly patient with weight loss, anorexia, and iron deficiency anemia (IDA) likely has ___ cancer
colon
Colon adenocarcinoma is the most common GI cancer.
___-sided lesions = likely to bleed and cause iron deficiency anemia aka fatigue/pallor;
___-sided lesions = obstructing symptoms ( altered bowel habits, constipation, abdominal distension, N/V).
Right (ascending)
left (descending/ sigmoid)
Constipation that alternates with diarrhea is characteristic of ___ syndrome.
irritable bowel
Tenesmus (ineffectual/painful straining on defecation) and small-caliber stool are characteristic of ___ adenocarcinoma
rectal
Patient with epigastric pain, occasional melena, and left supraclavicular lymphadenopathy (ie, Virchow node) has intestinal-type ____ adenocarcinoma
gastric
*most common primary gastric malignancy.
Lesion visualized endoscopically as an ulcerated mass with irregular folded or heaped-up edges.
Glandular structures containing intestinal-like columnar (or cuboidal) cells.
Occurs with the highest incidence in patients from Eastern Asia, Eastern Europe, and South America
Due to salt-preserved foods diets
gastric adenocarcinoma
Esophageal ____ presents mostly in the proximal two-thirds of the esophagus and frequently metastasizes to the mediastinal lymph nodes.
Histology = keratin pearls and intercellular bridges
squamous cell carcinoma
Familial Adenomatous Polyposis is caused by a germline mutation to the tumor suppressor gene ______
adenomatous polyposis coli (APC)
Carcinoembryonic antigen (CEA) cannot be used to diagnose colon cancer, but it is helpful for detecting residual disease and ___.
recurrence
___ cancer is the most common cause of hepatic metastases due to direct blood flow to the liver via the portal venous circulation.
Colorectal
__ is the most important environmental risk factor for pancreatic cancer.
Smoking
____ adenocarcinoma should be considered in any patient with painless obstructive jaundice (elevated bilirubin, dark urine, pale stools) and weight loss.
Courvoisier sign (painless palpable gallbladder in a jaundiced patient) can also raise suspicion, but not specific.
Pancreatic
Hepatic ______ is associated with exposure to carcinogens such as arsenic, thorotrast, and polyvinyl chloride.
Tumor cells express CD 31, an endothelial cell marker.
angiosarcoma
Octreotide is a synthetic somatostatin analog used to control the symptoms of ___ syndrome.
carcinoid
Malignant hepatic lesions are most OFTEN from metastasis from another primary site (like ______ )
primary liver neoplasms (hepatocellular carcinoma) are much less common.
breast, lung, colon
Patient with chronic gastroesophageal reflux disease (GERD) now has dysphagia with solid foods, weight loss, and a mass in his lower esophagus, raising strong suspicion for
esophageal adenocarcinoma
Major risk factors for esophageal adenocarcinoma are:
Chronic GERD \_\_\_\_\_\_\_ Smoking Medications (nitroglycerin) Consumption of processed meats
Obesity - increases intragastric pressure, frequency of lower esophageal sphincter relaxation, and rates of hiatal hernia, which promote GERD
Carcinoid tumors are malignant transformations of ___ cells, most commonly located in the gastrointestinal tract (small intestine, rectum, APPENDIX) and the lungs
neuroendocrine
____ pattern of liver injury defined by elevated alkaline phosphatase & bilirubin
cholestatic (gallbladder obstruction)
Diphenoxylate is an opioid anti-diarrheal agent. It binds to mu opiate receptors in the gastrointestinal tract and slows __.
motility
*Overuse can lead to euphoria and physical dependence. To discourage abuse, diphenoxylate is combined with atropine, which induces adverse effects if taken in high doses.
Clostridioides difficile infection is associated with yellow-white, patchy pseudomembranes on the bowel mucosa. Contains fibrin and necrotic epithelium.
Patients may develop a nonobstructive
colonic dilation (toxic megacolon)
can lead to colonic perforation
