GI Path

Question 1

a thin, noncanalized cord replaces a segement of esophagus; congenital abnormality

Answer 1

atresia

Question 2

atresia is most commonly at or near …

Answer 2

the tracheal bifurcation

Question 3

aspiartion, suffocation, pneumonia, and severe fluid and electrolytes imbalances; congenital abnormality

Answer 3

fistula

Question 4

herniation of the abdominal viscera into the thoracic cavity due to incomplete formation of the diaphargm; pulmonary hypoplasia; congenital abnormality

Answer 4

diaphragmatic hernia

Question 5

herniation of the abdominal viscera into a ventral membranous sac due to incomplete closure of the abdominal musculature; congenital abnormality

Answer 5

omphalocele

Question 6

gastric mucosa in esophagus; congenital abnormality

Answer 6

ectopia

Question 7

a true diverticulum as a blind outpouching of the alimentary tract communicating with the lumen and includes all 3 layers; congenital abnormality

Answer 7

meckel diverticulum

Question 8

hyperplasia of the pyloric muscularis propria; increased risk with Turner syndrome and trisomy 18; regurgitation, projectile, nonbilious vomiting after feeding; erythromycin and azithromycin exposure and increased incidence; congenital abnormality

Answer 8

pyloric stenosis

Question 9

idiopathic ledge-like protrusions of mucosa that may cause obstruction; associated with GI reflux, chronic graft vs host disease, or blistering skin diseases; nonprogressive dysphagia; esophagus

Answer 9

esophageal mucosal webs

Question 10

upper esophagus webs; iron deficiency anemia; glossitis; and cheilosis; increased risk of cancer

Answer 10

plummer vinson syndrome

Question 11

“failure to relax”; incomplete lower esophageal sphincter relaxation; aperistalsis; dysphagia, difficulty in belching, and chest pain; increased risk of esophageal cancer

Answer 11

achalasia

Question 12

distal esophageal inhibitory neuronal degeneration

Answer 12

primary achalasia

Question 13

chagas disease, tyrpanosoma cruzi infection causing myenteric plexus destruction; diabetic autonomic neuropathy; inflitrative disorders; lesions of dorsal motor nuclei; down syndrome; sjogren or autoimmune thyroid disease

Answer 13

secondary achalasia

Question 14

mucosal tears near the gastroesophageal junction; associated with severe retching or vomiting secondary to acute alcohol intoxication

Answer 14

mallory-weiss tears

Question 15

herpes simplex virus particularly in immunocompromised and candidiasis

Answer 15

infectious esophagitis

Question 16

adherent gray-white pseudomembranes covering esophageal mucosa

Answer 16

candidiasis

Question 17

punched out ulcers

Answer 17

esophagitis, herpes virus

Question 18

most common cause of esophagitis

Answer 18

reflux of gatric contents into the lower esophagus (GERD)

Question 19

most common cause of GERD

Answer 19

lower esophageal sphincter relaxation

Question 20

treatment of GERD

Answer 20

proton pump inhibitors

Question 21

major complication of GERD

Answer 21

Barrett esophagus

Question 22

a congested subepithelial and submucosal venous plexi within the distal esophagus and proximal stomach; cause of esophageal bleeding

Answer 22

esophageal varices

Question 23

most common cause of esophageal varices

Answer 23

portal hypertension

Question 24

portal hypertension, in cirrhotic patient, most commonly associated with …

Answer 24

alcoholic liver disease

Question 25

2nd most common cause of esophageal varices

Answer 25

hepatic schistosomiasis

Question 26

a complication of GERD characterized by columnar metaplasia within the esophageal squamous mucosa; increased risk of esophageal adenocarcinoma

Answer 26

Barret esophagus

Question 27

most common benign tumor of esophagus

Answer 27

leiomyoma

Question 28

malignant tumors of esophagus

Answer 28

adenocarcinoma and squamous cell carcinoma

Question 29

more than 1/2 of all esophageal cancers in US; most cases from Barret esophagus (obesity related GERD)

Answer 29

adenocarcinoma

Question 30

decreased risk of esopharyngeal adenocarcinoma with ... due to gastric atrophy-->decreased acid secretion and reflux-->decreased Barret

Answer 30

Helicobacter pylori

Question 31

alcohol and tobacco use, poverty, caustic esophageal injury, achalasia, tylosis, plummer-vinson, fruit/veggie deficiency, very hot beverages

Answer 31

squamous cell carcinoma

Question 32

a mucosal inflammatory process; stomach

Answer 32

gastritis

Question 33

gastritis in presence of neutrophils

Answer 33

acute

Question 34

a diverse set of disorders marked by gastric injury or dysfunction with no inflammatory cells

Answer 34

gastropathy

Question 35

causes of gastropathy

Answer 35

NSAID, alcohol, bile, stress induced injury

Question 36

most common cause of chronic gastritis

Answer 36

H. pylori

Question 37

enzyme the causes increase in pH and allows for survival of H. pylori

Answer 37

urease

Question 38

mutation of which gene in H. pylori results in many different toxins

Answer 38

CagA

Question 39

histopathologic features of H pylori gastritis

Answer 39

spiral shaped H. pylori, silver stain; neutrophils within epithelium/lamina propria; lymphoid aggregates, subepithelial plasma cells

Question 40

complication of chronic gastritis; chronic mucosal ulceration affection duodenum/stomach; associated with H pylori, NSAIDs, smoking

Answer 40

peptic ulcer disease

Question 41

multiple peptic ulcerations in the stomach, duodenum, and even jejunum owing to excess gastrin secretion by a tumor-->excess gastric acid production

Answer 41

Zollinger Ellison syndrome

Question 42

giant cerebriform enlargement of the rugal folds due to epithelial hyperplasia; no inflammation; excessive growth factor; ex: Zollinger-Ellison

Answer 42

hypertrophic gastropathies

Question 43

4 causes of gastric polyps

Answer 43

hyperplasia; inflammation; ectopia; neoplasia

Question 44

most common polyps?

Answer 44

inflammatory or hyperplastic

Question 45

risk of developing adenocarcinoma in gastric adenomas that are greater than ....

Answer 45

2 cm

Question 46

distorted, irregular glands lined with epithelium demonstrating crowded, pleomorphic nuclei overlapping with losing of normal polarity; seen in gastric adenomas

Answer 46

epithelial dysplasia

Question 47

most common malignancy of stomach

Answer 47

gastric adenocarcinoma

Question 48

risk factors for gastric cancer:

Answer 48

H. pylori; host (genetic background); diet/habit (low vit. C, high salt/nitrate, smoking)

Question 49

precursor conditions of gastric cancer

Answer 49

hypochlorhidia; atrophic body gastritis; intestinal metaplasia; dysplasia

Question 50

mitotic figures

Answer 50

gastric adenocarcinoma

Question 51

main difference between small and large intestine

Answer 51

large intestine has no villi

Question 52

aggregate lymphoid nodules (peyers patches) found in...

Answer 52

ileum

Question 53

defective absorption of fats, vitamins, proteins, carbs, electrolytes and minerals, and water; present as chronic diarrhea; steatorrhea as hallmark

Answer 53

malabsorption

Question 54

most common disorders in US causing malabsorption

Answer 54

pancreatic insufficiency, celiac disease, crohn disease

Question 55

an important cause of malabsorption and diarrhea following allogenic hematopoietic stem cell transplantation

Answer 55

intestinal graft vs host disease

Question 56

an immune mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals; loss of villi

Answer 56

celiac disease

Question 57

a chronic condition resulting from inappropriate mucosal immune activation

Answer 57

inflammatory bowl disease

Question 58

2 disorders that comprise inflammatory bowl disease

Answer 58

ulcerative colitis; crohn disease

Question 59

skip lesions; transmural inflammation; ulcerations, fissures

Answer 59

crohn disease

Question 60

continuous colonic involvement beginning in rectum; pseudopolyps; ulcers

Answer 60

ulcerative colitis

Question 61

result of immune response in IBD is production of ...

Answer 61

TNF

Question 62

factors involved in IBD

Answer 62

luminal microbial antigens; genetic susceptibility; immune response; environmental triggers

Question 63

skip lesions; aphthous ulcer as earliest lesion; anti-TNF antibodies for treatment

Answer 63

crohn disease

Question 64

oral manifestations of crohn disease

Answer 64

lip swelling; linear ulcer/aphthous like ulcer (characteristic in vestibule)

Question 65

non-caseating granulomatous inflammation (granuloma formation)

Answer 65

crohn disease

Question 66

ulcers/pseudopolyps; limited to colon/rectum; bloody diarrhea and abdominal pain; no granuloma formation

Answer 66

ulcerative colitis

Question 67

pyostomatitis vegetans (oral)

Answer 67

ulcerative colitis

Question 68

most common malignancy of GI tract

Answer 68

adenocarcinoma of colon

Question 69

low intake unabsorbable vegetable fiber and high intake of refined carbs and fat

Answer 69

increased rates of colorectal cancer

Question 70

chemoprevention of colorectal cancer-->inhibtion of COX 2--->inhibition of epithelial proliferation

Answer 70

aspirin and NSAIDs

Question 71

mutation of ... early in the neoplastic process in up to 80% of sporadic colon cancers

Answer 71

APC (adenomatous polyposis coli)

Question 72

2 most important prognostic factors of adenocarcinoma of colon

Answer 72

depth of invasion and presence of lymph node metastases