GI ch 17

Question 1

In the gastrointestinal tract, the submucosal neural plexus is known as _______ and the myenteric plexus is known as________.

Answer 1

Meissner plexus
Auerbach plexus

google : The myenteric plexus controls mainly the gastrointestinal movements, and the submucosal plexus controls mainly gastrointestinal secretion and local blood flow.

Question 2

In esophageal atresia, the esophagus frequently communicates with the _____ by ______.

Answer 2

Trachea by a fistula

Question 3

Achalasia is characterized by

Answer 3

1) Aperistalsis of the esophagus
2) Incomplete relaxation of the lower esophageal sphincter with swallowing
3) Increased tone of the lower esophageal
sphincter.

google: Achalasia is a rare disorder that makes it difficult for food and liquid to pass from the swallowing tube connecting your mouth and stomach (esophagus) into your stomach. Achalasia occurs when nerves in the esophagus become damaged

Question 4

A hiatal hernia is defined as

Answer 4

Separation of the diaphragmatic crura and protrusion of the stomach into the thorax through the resulting gap

google: occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm.

Question 5

Longitudinal tears in the esophagus, most often associated with severe retching-vomiting secondary to alcohol intoxication, are known as_

Answer 5

Mallory-Weiss tears: often caused by violent coughing or vomiting.

Question 6

The most common and important cause of esophagitis is

Answer 6

reflux

Question 7

Barrett esophagus is characterized by ____________ and most frequently results from ________.

Answer 7

Intestinal metaplasia within the esophageal squamous mucosa
Chronic gastroesophageal reflux disease (p. 757)

Question 8

Esophageal diverticula occurring immediately above the upper esophageal sphincter are known as

Answer 8

Zenker diverticula

google: develops when the muscle between the throat and esophagus, known as the cricopharyngeus muscle, over-tightens, causing the throat above it to pouch out.

Question 9

Esophageal varices are most frequently caused by ________ ________ and are most often associated with __

Answer 9

Portal hypertension

Alcoholic cirrhosis

google: Esophageal varices are enlarged or swollen veins on the lining of the esophagus. Varices can be life-threatening if they break open and bleed.

Question 10

most common benign tumor of the esophagus is

Answer 10

google: Leiomyomas are benign tumors of smooth muscle origin that are most commonly seen in the uterus. Leiomyomas of the esophagus are rare tumors but the most common benign lesions of the esophagus originating from smooth muscle cells.

Question 11

Name two of the most common environmental influences linked to squamous cell carcinoma of the esophagus.

Answer 11

Alcohol consumption
tobacco use

Question 12

most common location of SCC of esophagus

Answer 12

middle third

Question 13

name 4 anatomic regions of the stomach

Answer 13

Cardia, fundus, body, antrum

Question 14

Name the four major cell types found within the gastric mucosa.

Answer 14

Foveolar cells
, parietal cells,
chief cells,
endocrine or G cells.

Question 15

Projectile nonbilious vomiting in infants is most frequently caused by what anatomic lesion of the stomach?

Answer 15

Congenital hypertrophic pyloric stenosis

Question 16

The most important etiologic factor associated with chronic gastritis and increased risk for peptic ulcer disease and gastric carcinoma is infection with

Answer 16

Helicobacter pylori

Question 17

Autoimmune gastritis can lead to a deficiency of Vitamin B12 resulting in _______, and is associated with loss of:

Answer 17

Pernicious anemia
Parietal cells

Question 18

Define and differentiate Cushing and Curling ulcers.

Answer 18

Ulcers occurring in the proximal duodenum and associated with severe burns or trauma are called Curling ulcers.

Gastric, duodenal, and esophageal ulcers arising in patients with intracranial disease are termed Cushing ulcers and carry a high incidence of perforation.

Question 19

most common site of peptic ulcers is

Answer 19

Proximal duodenum

Question 20

peptic ulcers most often multiple or solitary

Answer 20

Solitary

Question 21

4 conditions that cause duodenal ulcers?
Hint: HCC alcoholics

Answer 21

Alcoholic cirrhosis, chronic obstructive pulmonary disease, chronic renal failure, hyperparathyroidism

Question 22

Approximately 75% of all gastric polyps are

Answer 22

Inflammatory or hyperplastic polyp

google:
Inflammatory polyps are often called pseudopolyps and they do not turn into cancer. About half of all colon polyps are hyperplastic. These polyps develop in the lower portion of the colon and rectum and have little or no risk to develop into cancer.

Some types of polyps (called adenomas) have the potential to become cancerous

Question 23

most common reason for frozen for gastric ulcer

Answer 23

stupid question, all frozen are to rule out malignancy

Question 24

Name the two histologic patterns of gastric adenocarcinoma.

Answer 24

1) Intestinal variant - bulky tumor composed of glandular structures
2) Diffuse variant - infiltrative growth signet-ring cells

Question 25

A diffuse infiltration, diffuse rugal flattening, and a rigid, thickened wall may impart a leather bottle appearance caused by cancer

Answer 25

google: Linitis plastica is a type of adenocarcinoma. Adenocarcinoma is the most common form of stomach cancer. Linitis plastica spreads to the muscles of the stomach wall and makes it thicker and more rigid. This means that the stomach can’t hold as much and doesn’t stretch or move as it should when you’re digesting food.

Question 26

Malignant gastric epithelial cells, which contain mucin vacuoles that expand the cytoplasm and push the nucleus to the periphery, are known as

Answer 26

Signet-ring cells

Question 27

When gastric cancer metastasizes to the ovaries, these lesions

Answer 27

Krukenberg Tumors

google: is a rare metastatic signet ring cell tumor of the ovary, accounting for 1–2% of all ovarian tumors, mucin-rich signet-ring adenocarcinoma that primarily arises from a gastrointestinal site

Question 27

When gastric cancer metastasizes to the ovaries, these lesions

Answer 27

Krukenberg Tumors

google: is a rare metastatic signet ring cell tumor of the ovary, accounting for 1–2% of all ovarian tumors, mucin-rich signet-ring adenocarcinoma that primarily arises from a gastrointestinal site

Question 28

Brunner glands are found in which part of the small intestine

Answer 28

Duodenum

Question 29

ligament of Treitz demarcates

Answer 29

duodenum from jejunum

Question 30

Persistence of a vestigial remnant of the vitelline duct is known as a _______ and most frequently occurs in the__

Answer 30

Meckel diverticulum
Ileum, within two feet (60 cm) of the ileocecal valve

Question 31

examinations of the lesions noted above should be performed for evidence of ___ or ___ which maybe present with occult bleeding

Answer 31

answer: Gastric or pancreatic mucosa
google:
occult bleeding :Occult gastrointestinal bleeding is defined as gastrointestinal bleeding that is not visible to the patient or physician, resulting in either a positive fecal occult blood test, or iron deficiency anemia with or without a positive fecal occult blood test.

Meckel’s diverticulum symptom passage of a large amount of dark red blood from the rectum

Question 32

List three of the most common causes of arterial infarctions of the small intestine hint A.S.S.

Answer 32

Severe atherosclerosis, systemic vasculitis, aortic aneurysm

Question 33

Name some of the more common causes of venous mesenteric thrombosis.

Answer 33

Hypercoagulable states, cirrhosis, abdominal masses

pneumonic: hyper-circuit- abs

Question 34

Name three different terms for granulomatous enteritis and list the most frequently involved site

Answer 34

Terminal ileitis, regional enteritis, Crohn disease

terminal ileum

Question 35

Differentiate Crohn disease and ulcerative colitis.

Answer 35

Ulcerative colitis is a severe ulcerating inflammatory disease that is limited to the colon and rectum and extends only into the mucosa and submucosa.
In contrast, Crohn disease may involve any area of the GI tract and is typically transmural.

personal nemonic : Cr. Chron adjust your whole body =)

Question 36

Carcinoid tumors most frequently occur in what part of the GI tract and are characteristically _______on gross examination?

Answer 36

Appendix
Solid, yellow-tan

Question 37

Celiac disease, also known as __________ and _______ is characterized histologically by _____ and felt to be caused by _______.

Answer 37

Gluten-sensitive enteropathy
Celiac Sprue
Intraepithelial lymphocytes, crypt hyperplasia, and villous atrophy Sensitivity to gluten (p. 782)

Question 38

Define and differentiate intussusception and volvulus.

Answer 38

Intussusception occurs when one segment of the small intestine constricted by a wave of peristalsis, suddenly becomes telescoped into the immediately distal segment of bowel. Once trapped, the invaginated segment is propelled by peristalsis farther into the distal segment, pulling its mesentery along behind it.
Volvulus is complete twisting of a loop of bowel about its mesenteric base of attachment, which also produces intestinal obstruction and infarction. Most often occurs in the sigmoid colon.

google: occurs when a loop of intestine twists around itself and the mesentery that supplies it, causing a bowel obstruction.

Question 39

pathogenesis of congenital aganglionic megacolon or __ is an __

Answer 39

Hirschsprung disease
Absence of ganglion cells in the Meissner submucosa and the Auerbach myenteric plexus.

google: is a birth defect in which some nerve cells are missing in the large intestine, so a child’s intestine can’t move stool and becomes blocked.

Question 40

Acetylcholinesterase stain

Answer 40

special stain used on frozen tissue to aid in the diagnosis of Hirschsprung disease

Question 41

The segment of colon most commonly involved with diverticular disease is

The occasional confusion between colonic cancer and diverticulitis is caused by what histomorphologic changes?

Answer 41

Sigmoid colon

inflammation leading to marked fibrotic thickening in and about the colon wall, or stricture formation

Question 42

A characteristic yellow green inflammatory exudate covering the colonic mucosa is characteristic of ________ colitis and is associated with ______therapy

which organism is it associated with

Answer 42

Pseudomembranous

Antibiotic

clostridium difficile

Question 43

pinworm disease is caused by what parasite

Answer 43

Enterobius vermicularis

Question 44

Name four different types of polyps of the colon.

Answer 44

Hyperplastic polyps, inflammatory polyps, Peutz-Jeghers (hamartomatous) polyps, adenomatous polyps

google:
adenomas- 3 growth patterns
tubular - most common
villous- large pedunculate and grow in cauliflower shape
tubovillous- mixture of tubular and villous growth

serrated adenomas-Sessile serrated polyps low risk of becoming cancerous

hyperplastic-typically benign

inflammatory-types of polyps occur most often in people with inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis. Some people may also refer to these as pseudopolyps, as they are not true polyps but a reaction to inflammation in the colon.

hartomas -hamartomatous polyposis syndromes have a malignant potential for the development of colorectal cancer as well as extracolonic cancers

Question 45

colorectal adenomas, the most important characteristic that correlates with the risk of malignancy is

Answer 45

size

Question 46

syndrome that combines intestinal adenomas and CNS tumors is known as

Answer 46

google: Turcot syndrome is the association of primary brain tumors with colorectal cancer. Hereditary non-polyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP) are the 2 most well-known inherited colorectal cancers. If a brain tumor arises in a patient with either HNPCC or FAP, then the patient is considered to have Turcot syndrome

Question 47

findings of multiple hamartomatous polyps of the GI tract and mucocutaneous hyperpigmentation are characteristic of what syndrome

Answer 47

Peutz-Jeghers syndrome
google: a rare disorder in which growths called polyps form in the intestines

Question 48

napkin ring tumor of the colon is most frequently seen on which part? Tumors of the other end of the colon are usually _____

Answer 48

answer: Distal colon
Polypoid, exophytic masses

google: circumferential tumors, also known as a napkin ring tumor extend around the circumference of the rectum

better explained :
Grossly, colorectal carcinomas can be exophytic masses or deeply infiltrative ulcers. The exophytic lesions are more common in the proximal colon and they appear as a bulky polypoid mass with rolled edges that are clearly demarcated from the adjacent normal mucosa. Tumors in proximal colon rarely cause obstruction due to large caliber of cecum and ascending colon. In distal colon, the exophytic lesions tend to be annular and can cause �napkin-ring constriction� of the bowel lumen. The ulcerating infiltrative masses are not raised and may be flat or depressed than surrounding mucosa.

Question 49

greatest percentage of all carcinomas of the colon are

Answer 49

adenocarcinoma

google: acncer that forms in the glandular tissue, which lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices, and other fluids.

Question 50

most common tumor of the appendix is the

Answer 50

Carcinoid

Question 51

histologic criterion for diagnosis of acute appendicitis

Answer 51

Neutrophilic infiltration of the muscularis propria

Question 52

malignant counterpart of a benign mucocele of the appendix

Answer 52

Mucinous cystadenocarcinoma

Question 53

Exudation of tenacious, semisolid mucin within the peritoneal cavity associated with mucinous carcinomas of the appendix or ovary is known as

Answer 53

Pseudomyxoma peritonei

google:
How does pseudomyxoma peritonei spread?
Pseudomyxoma peritonei doesn’t act like most cancers. It rarely spreads through the bloodstream or the lymphatic system to any other part of the body.

Instead, it spreads inside the abdomen. The cancer cells generally spread by following the peritoneal fluid flow. They attach to the peritoneum at particular sites. Here they produce mucus which collects inside the abdomen and eventually causes symptoms. Without treatment, it will take over the peritoneal cavity. It can press on the bowel and other organs.

This condition develops very slowly. It might be years before you have any symptoms of this type of cancer. Because of this, it has usually spread beyond the appendix before diagnosis.

Question 54

The most common primary malignant soft tissue tumor to develop within the peritoneum and retroperitoneum

Answer 54

Desmoplastic small round cell tumor

google:
growths often form on the tissue that lines the inside of the abdomen and pelvis. This tissue lining is called the peritoneum.

Desmoplastic small round cell tumors are a type of soft tissue sarcoma. Soft tissue sarcoma is a term used to describe a large group of cancers that all start in the tissues that connect, support and surround other body structures.