GI-esophagus & stomach (2) Flashcards Preview

Unit 6: Pathology > GI-esophagus & stomach (2) > Flashcards

Flashcards in GI-esophagus & stomach (2) Deck (40):
1

what patients do you seen esophageal varices

cirrhosis and portal HTN

2

what is the symptom if an esophageal varice ruptures?

painless hematemesis

3

what does odynophagia mean

pain on swallowing

4

what disease
"disordered esophageal motility with inability to relax LES"

achalasia

5

how does achalasia appear on barium swallow

bird beak sign

6

what causes achalasia?

damaged ganglion cells in myenteric plexus

7

where is the myenteric plexus?

in between the inner circular and outer longitudinal layer (layers in the muscularis propria)

8

what is a common cause of alchalasia in latin america?

chagas disease that damages the myenteric plexus

9

besides the bird beak sign, what are some other clinical features of alchalasia

dysphagia for solids & liquids
putrid breath
high LES Pressure on esophgeal manometry

10

with alchalasia there is increased risk for..

esophageal squamous cell carcinoma

11

what causes GERD?

decreased LES tone

12

what are some risk factors for GERD

alcohol, tobacco, obesity, fat rich diet, caffeine, hiatal hernia

13

what is the most common type of hiatal hernia

sliding hiatal hernia

14

what is a sliding hiatal hernia?

part of the stomach (cardia) goes up into the esophagus

15

how does a sliding hiatal hernia appear on barium swallow? why?

hour glass appearance of stomach
because the LES is still in tact (so bulge of stomach-LES-stomach)

16

what is a para-esophageal hernia? what causes it?

stomach herniates up next to the esophagus due to defect in diaphragmatic connective tissue membrane

17

what hernia will you hear bowel sounds in lower lung fields?

para-esophageal hernia

18

tell me what the metaplasia of the esophagus epithelium is (what it was and what it becomes)

from non keratinizing squamous epithelium to non ciliated columnar cells with goblet cells
=Barrett's esophagus

19

what are some clinical presentations of GERD

heart burn
asthma and cough
damage to teeth enamel
ulceration with stricture

20

what is the most common type of esophageal cancer in the US (and the western world)

adenocarcinoma

21

what is the most common type of esophageal carcinoma in the world?

squamous cell carcinoma

22

where does adenocarcinoma usually arise int he esoophagus

lower 1/3

23

where in the esophagus does squamous cell carcinoma usually arise?

upper or middle 1/3

24

what are some risk factors for squamous cell carcinoma?

anything that irritates the mucosa
alcohol & tobacco
very hot tea
achalasia
celiac sprue
chronic esophagitis
esophageal web
esophageal injury

25

an esophageal carcinoma of the upper 1/3 likes to spread to which lymph nodes?

cervical nodes

26

an esophageal carcinoma of the middle 1/3 likes to spread to which lymph nodes?

mediastinal or tracheobronchial nodes

27

an esophageal carcinoma of the lower 1/3 likes to spread to which lymph nodes?

celiac and gastric nodes

28

what is gastrochisis

"splitting of the stomach"
abdominal wall is actually split
congenital malformation

29

what is omphalocele? what causes it?

persistent herniation of bowel into umbilical cord. due to failure of herniated intestines to return to body cavity during development

30

how is gastrochisis different from omphalocele?

in omphalocele the abdominal contents are enclosed in a bubble whereas in gastrochisis the contents are exposed

31

when does a baby with pyloric stenosis present?

they are born normal and it takes 2 weeks to develop because it is a congenital hypertrophy of the pyloric stomach muscle

32

is the vomiting in pyloric stenosis billous or non billious?

non billious because the content that is being vomited has yet to reach the intestines

33

what disease do you feel an "olive like mass" in the abdomen?

pyloric stenosis

34

what is acute gastritis

burning of the stomach by acid

35

what are the defenses against acid in the mucosa?

foviolar cells produce mucus
bicarb secreted to neutralize acids
normal blood supply to provide nutrients to protection layer and to "take away" the acid

36

whats a curling ulcer? what is it a risk factor for

a severe burn on a person-->hypovolemia-->less blood flow to mucosa of GI-->less nutrients and unable to sweep away acids-->acute gastritis

37

why can NSAIDs lead to acute gastritis

prostaglandins are needed for creating the protective barrier by decreasing acid production, stimulating the ability of cells to produce mucus & bicarb and by increasing blood flor to the mucosal barrier

38

why is alcohol a risk for acute gastritis

will directly damage the mucosal cells

39

what is a cushing ulcer? what can it lead to

increased intracranial pressure-->increased vagal stimulation-->increased Ach-->binds parietal cells and increases acid production
-->acute gastritis

40

what are 3 things that trigger acid secretion from parietal cells?

Ach
gastrin
histamine