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Pathology 1st aid > GI Path > Flashcards

GI Path Flashcards

1
Q

Most common site for Salivary gland tumors

A

Parotid

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2
Q

Most common salivary gland tumor

A

Pleomorphic adenoma

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3
Q

benign cystic tumor of salivary glands with germinal centers

A

warthin’s tumor

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4
Q

most common malignant tumor of the salivary glands

has mucinous and squamous components

painful mass

A

Mucoepidermoid CA

Pain due to VII involvement

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5
Q

Painless mobile mass of salivary gland

benign

cartilage and epithelium components

A

Pleomorphic adenoma

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6
Q

Bird’s beak sign with Ba swallow

failure of LES to relax

loss of Auerbach’s plexus

Dysphagia to solid foods

A

Achalasia

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7
Q

Achalasia has increased risk of

A

Squamous cell CA of esophagus

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8
Q

Achalasia associated with

A

CREST

Chagas Disease

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9
Q

White psuedomembrane esophagitis

A

Candida

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10
Q

Punched out lesions esophagitis

A

HSV-1

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11
Q

Linear ulcers esophagitis

A

CMV

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12
Q

Mucosal lacerations from severe vomiting (alcoholics and bulimics)

A

Mallor-Weiss Tears

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13
Q

Transmural esophageal rupture due to violent retching

A

BoerHaave Strictures

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14
Q

Plummer Vinson Triad

A

Dysphagia (esophageal webs)

Glossitis

Fe def. anemia

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15
Q

Barrett’s esophagus

A

Non-keratinized Sq. epithelium replaced with nonciliated columnar in distal esophagus (dysplasia)

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16
Q

Cancer risk of Barrett’s esophagus

A

Esophageal adenocarcinoma

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17
Q

Most common esophageal CA in US? World?

A

US–adenocarcinoma

World–Sq. Cell CA

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18
Q

Malabsorption that responds to Abx and effects entire small bowel

A

Tropical Sprue

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19
Q

PAS+ foamy Macrophages

Cardiac Sx
Arthralgias
Neurologic Sx

A

Whipple’s Disease

T. whipplei

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20
Q

Celiac Sprue

A

Gluten insensitivity (Ab to gliadin)

distal duodenum and proximal jejunum

Villous Atrophy–histo

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21
Q

Most common disaccharidase deficiency

A

Lactase (milk intolerance)

at tips of villi–can occur post infxn, injury

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22
Q

Decreased synthesis of abetalipoprotein B
inability to synthesize chylomicrons or VLDL/LDL

early childhood presentation with malabsorption and neuro manifestations

A

Abetalipoproteinemia

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23
Q

Neutral fat in stool

Vitamin A, D, E, and K defficiency

A

Pancreatic insufficiency

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24
Q

Pancreatic insufficiency causes

A

cystic fibrosis
obstructing cancer
chronic pancreatitis

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25
Celiac Sprue associated with HLA
HLA-DQ2 and DQ8
26
screening test for celiac sprue
serum levels of tissue transaglutinase
27
Skin manifestation of celiac
Dermatitis Herpetiformis
28
Celiac increased risk of what cancer
T cell Lymphoma
29
Curling Ulcer
Associated with burns Volume depletion --> sloughing of gastric mucosa
30
Cushing ulcer
Brain injury (inc. ICP) increased vagal stimulation --> increased ACh -- >increased H+ production
31
NSAID ulcer mechanism
decreased PGE2 --> decreased gastric mucosa
32
Type A Chronic Gastrits
Ab against parietal cells pernicious anemia achlohydria
33
Type B Chronic Gastritis
most common type H. Pylori MALT lymphoma risk
34
Protein Loss Parietal Cell atrophy increased mucoous cells hypertrophied rugae in stomach--look like brain gyri
Menetrier's Disease
35
most common type of stomach cancer
adenocarcinoma
36
Virchow's Node
Left supraclavicular node involved in mets from stomach
37
Krukenberg's tumor
bilateral mets to ovaries from stomach
38
Sister Mary Joe Nodule
Subcutanous mets around umbilicus from stomach
39
Stomach cancer often presents with what skin condition
Acanthosis Nigracans
40
Intestinal Stomach Cancer associated with
``` H. pylori smoked foods (nitrosamines) achlorhydria chronic gastritis TYPE A blood ```
41
Ulcer with raised edges found on greater curcature
Intestinal stomach cancer
42
Diffuse Stomach cancer
Signet ring cells not asscociated with H pylori linitis plastica (thickened stomach wall)
43
Major cause of Duodenal ulcers
``` H pylori (100%) Zollinger Ellison Syndrome ```
44
Artery at risk from greater curvature ulcer
left gastric a.
45
Artery at risk with ulcer of posterior duodenal wall
gastroduodenal
46
Cell type that mediates damage for UC and crohn's
UC--TH2 | Crohn's--TH1
47
Crypt abscesses loss of haustra rectum involvement mucosal and submucosal inflammation
Ulcerative colitis
48
``` Skip lesions Fistula string sign on barium swallow creeping fat Noncaseating granulomas ```
Crohn's Disease
49
Crohn's Tx
``` Corticosteroids Azathiprine MTX Inflixumab (TNF alpha) adalimumab (TNF alpha inh) ```
50
UC Tx
ASA preperations (sulfasalazine) 6-mercaptopurine infliximab colectomy
51
IBS Sx (2+)
Pain that improves with pooping Change in stool frequency change in stool appearance
52
Appendicitis causes (adult and kids)
Adults--fecalith Kids--lymphoid hyperplasia
53
Most common site for diverticulum
sigmoid colon
54
True vs false diverticulum
True--all 3 layers False--only mucosa/submucosa
55
Many false diverticua
Diverticulosis
56
Inflammation of diverticula LLQ pain, fever, leukocytosis colovesical fistula
Diverticulitis
57
Diverticulitis Tx
Abx
58
Halitosis Dysphagia Obstruction upper esophageal pouch
Zenker's Diverticulum (false)
59
where is a zenker diverticulum?
mucosal herniation at killian's triad between thyropharyngeal and cricopharyngeal parts of inferior pharyngeal constrictor
60
Meckel's Diverticulum
True Persistent viteline duct may have gastric or pancreatic tissue 2", 2' from ileocecal valve, 2 types of tissue
61
Meckel's Diverticulum Sx
``` Melena RLQ pain intussusception volvulus obst. near terminal ileum ```
62
Cystic dilation of viteline duct
omphalomesenteric cyst
63
Current Jelly Stools compormised blood supply Child
Intussuseption
64
most common site for intussuseption
Ileocecal jxn
65
Volvulus
Twisting of portion of bowel around mesentary can cause obst. or infarct cecum or sigmoid colon elderly
66
failure of neural crest to migrate to bowel constipated baby
Hirschprung's disease
67
double bubble on x-ray Down's Syndrome Bilious vomiting
duodenal atresia
68
virus associated with intussuseption
adenovirus
69
Meconium Ileus causes
CF | meconium plug obstruction
70
Necrotizing enterocolitis
necrosis of intestinal mucosa--most commonly colon
71
Ischemic colitis
reduced blood supply to GI pain out of proportion with findings Pain after eating, weight loss
72
Adhesion
Fibrous band of scar tissue often post surgery
73
Most common cause of small bowel obstruction
Adhesion
74
Angiodysplasia
Totuous dilation of vessels --> hematochezia cecum, terminal ileum, ascending colon
75
Precancerous colon polyps with villous histology and epithelial dysplasia
adenomatous polyps
76
most common non-neoplastic colon polyp
hyperplastic
77
Juvenile polyps
kids < 5 80% rectum risk of adenocarcinoma
78
Peutz-Jeghers polyp
Single benign polyp
79
multiple nonmalignant hamartomas througout GI | Hyperpigmented mouth, lips, hands, genitalia
Peutz-Jeghers Syndrome increased risk of colorectal cancer
80
Familial Adenomatous Polyposis Mutation
APC gene on Chromosome 5q Autosomal Dominant 2 hit hypothesis--thousands of polyps
81
FAP+ osseous and soft tissue tuors congenital hypertrophy of retinal pigment epithelium
Gardner's Syndrome
82
FAP+ malignant CNS tumor
Turcot's Syndrome
83
Hereditary nonpolyposis cancer (HNPCC/Lynch Syndrome)
AD Mutation of DNA mismatch repair proximal colon always involved
84
Endocarditis and colon cancer
S. bovis
85
Fe defficiency in male/post menopausal woman
Colorectal cancer until proven otherwise
86
Barium enema x ray findings of colorectal cancer
apple core lesion
87
Monitoring recurrence of Colorectal cancer
CEA
88
Molecular pathogenesis of CRC
Loss of APC --> K-RAS mutation --> Loss of p53
89
Tumor of neuroendocrine cells 5HT secreting dense core bodies appendix, ileum, rectum
Carcinoid tumor
90
``` Wheezing Increased 5HT right sided heart murmur diarrhea flushing ```
Carcinoid tumor outside of GI (no liver 1st pass) Carcinoid Syndrome
91
Tx Carcinoid Tumor
Resection | Octreotide (somatostatin)
92
Cirrhosis increased risk of
HCC
93
ALT > AST
Viral Hepatitis
94
AST > ALT
Alcoholic Hepatitis
95
ALP marker for
Obstructive liver disease bone disease bile duct disease
96
GGT marker for
increased in various liver/biliary diseases but NOT bone
97
Acute Pancreatitis Labs
Amylase--also mumps | Lipase
98
Decreased Ceruloplasmin
Wilson's disease
99
``` Childhood Hepatoencephalopathy Mitochondrial Abnormalities Fatty liver coma hypoglycemia vomiting Viral infection + aspirin in kid ```
Reye's Syndrome
100
Mechanism of Reye's syndrome
Aspirin decreases ß oxidation by reversibly inhibiting mitochondrial enzyme
101
Mallory Bodies
Alcoholic hepatitis buzz intracytoplasmic eosinophilic inclusions
102
shrunken liver with hobnail appearance sclerosis around central vein (zone III)
Alcoholic Hepatitis
103
#1 malignant tumor of liver
HCC
104
HCC findings
Alpha fetoprotein Hematogenous spread
105
Benign liver tumor 30-50 yrs high risk of hemorrhage--no Bx
Cavernous hemangioma
106
Benign liver tumor related to oral contraceptives and steroids spontaneous regression
Hepatic adenoma
107
Malignant tumor of liver endothelial origin arsinic polyvinyl Chloride esposure
Angiosarcoma
108
Causes of nutmeg liver
heart failure | Bud-Chiari Syndrome
109
Occlusion of IVC or hepatic veins with centrilobar congestion and necrosis leading to congestive liver disease
bud Chiari
110
Bud-Chiari associated with
Hypercoagulable state polycythemia vera pregnancy HCC
111
Cirrhosis PAS+ globules in liver panacinar emphysema misfolded protein aggregates in hepatocellular ER
A1AT deficiency
112
Hepatocellular Jaundice labs
Increased Direct/indirect bilirubin Increased Urine bilirubin normal/dec. urine urobilinogen
113
Obstructive Jaundice labs
Increased Direct Bilirubin Increased urine bilirubin Decreased urine urobilinogen
114
Hemolytic Jaundice Labs
Increased indirect bilirubin NO URINE BILIRUBIN increased urine bilinogen
115
Baby with jaunice due to what immature enzyme? Tx?
UDP-glucuronyl transferase Tx with phototherapy
116
Gilbert's Syndrome
increased unconjugated bilirubin decreased UDP-glucuronyl transferase or defective bili uptake into liver Bili inc. with fasting and stress
117
Crigler-Najjar Syndrome Type I
Absent UDP-Glucuronyl transferase increased unconjugated bili jaundice kernicterus
118
Crigler-Najjar Syndrome Tx
Type 1: plasmapheresis and phototherapy Type 2: Phenobarbitol (inc. enzyme synth)
119
Dubin Johnson Syndrome
Increased conjugated bilirubin black liver problem with liver excretion of bilirubin Rotor's is less severe form with no black liver
120
``` Decreased Ceruloplasmin Kayser-fleisher Rings in cornea HCC Cu accumulation basal ganglia degeneration asterixis dementia ```
Wilson's Disease
121
Wilson's disease mutation
Chromosome 13 ATP7B gene copper transporting ATPase
122
``` Cirrhosis DM Skin pigmentation CHF Testicualar atrophy Fe deposition ```
Hemochromatosis
123
Hemochromatosis gene mutation
C282Y or H63D mutation on HFE gene Chromosome 6 associated with HLA-A3
124
Hemochromatosis Tx
phlebotomy deferasirox deferoxamine
125
Onion skinning bile duct fibrosis beading intra/extrahepatic ducts
1º sclerosing cholangitis
126
2º biliary cirrhosis
Extrahepatic biliary obstruction | increased pressure in duct --> stasis and fibrosis
127
1º biliary cirrhosis
Autoimmune rxn --> lymphcytic infiltration and granulomas Increased mitochondrial Abs (IgM)
128
Biliary Cirrhosis labs
Increased conjugated bili, cholesterol, alkaline phosphatase
129
1º biliray cirrhosis associated with
other autoimmune conditions CREST RA Celiac disease
130
Gallstone risk factors
Fat Fertile Forty Female
131
Charcot's Triad for gallstones
Jaundice Fever RUQ pain
132
Radiolucent Gallstone
Cholesterol
133
Pigment Gallstone causes
Black--Hemolysis (bilirubin) Brown--Infection
134
Biliary Colic
RUQ pain due to CCK causing GB contraction | forces stone into duct
135
Air in biliary tree | stone obstructing ileocecal valve
gallstone ileus fistular between small intestine (ileum) and GB due to stone
136
Gallstone Dx
Ultrasound | HIDA scan
137
Gallstone Tx
Cholecystectomy
138
Virus that causes cholecystitis
CMV
139
Cholecystitis
Inflammation of GB increased Alkaline phosphatase Caused by GALLSTONES, ischemia, infection
140
Mechanism of Acute pancreatitis
Autodigestion of pancreas
141
Acute pancreatitis causes
``` ETOH scorpion sting Gallstones Trauma steroids mumps hypercalcemia hypertriglyceridemia ERCP Rx ```
142
Complications of acute pancreatitis
ARDS, DIC, diffuse fat necrosis, hypocalcemia, psuedocyst formation, hemorrhage, infxn Multiorgan failure
143
Pancreatic Pseudocyst
lined by granulation tissue NOT epithelium can rupture and hemorrhage Contains pancreatic enzymes
144
Major cause of Chronic Pancreatitis
Alcholism
145
Chronic Pancreatitis
Calcified pancreas due to chronic inflammation atrophy less elevted AML and LIP
146
Pancreatic Adenocarcinoma tumor marker
CA-19-9
147
Pancreatic Adenocarcinoma risk factors
Tobacco--NOT ETOH Chronic Pancreatitis > 50 Jew or black
148
Abdominal Pain radiating to back Weight loss (malabs) Migratory Thrombophlebitis Obstructive Jaundice Courvoisier's Sign
Pancreatic Adenocarcinoma
149
Tx pancreatic adenocarcinoma
Whipple Procedure chemotherapy radiation
150
Trousseau's Sign
Redness and tenderness on extremities due to thrombophlebitis Associated with pancreatic adenocarcinoma
151
Courvoisier's Sign
Obstructive Jaundice | palpable non-tender GB

Pathology 1st aid (11 decks)

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