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lymphoreticular pathology > GI PATHOLOGY > Flashcards

GI PATHOLOGY Flashcards

1
Q

Types of cells in stomach

A

Parietal
Chief
Foveolar cells
Endocrine

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2
Q

Parts of stomach

A

Fundus
Cardia
Pylorus
Antrum

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3
Q

Mucosal protection in the stomach

A 
Mucus secretion
Bicarbonate secretion
epithelial barrier
mucosal blood flow
prostagladin protection
neural and muscular components
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4
Q

congenital pyloric stenosis

A

hypertrophy or hyperplasia of muscularis propria causing persistent GOO

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5
Q

Causes of gastritis

A 
NSAIDS
Excessive alcohol consumption
Cytotoxic drug therapy
Uremia
stress
ischemia and shock
irradiation
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6
Q

morphology of gastritis

A

edema
hyperemia
neutrophils

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7
Q

sequelae in chronic gastritis

A 
chronic inflammatory cells
mucosal atrophy
epithelial metaplasia
dysplasia
carcinoma
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8
Q

pathogenesis of chronic gastritis

A

infection by h.pylori
immunologic
toxic - alcohol and cigarette

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9
Q

enzymes secreted by h.pylori

A

urease
protease
phospholipases

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10
Q

conditions caused by h.pylori

A

peptic ulcer
gastric carcinoma
lymphoma

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11
Q

Classification of chronic gastritis

A

Autoimmune. usually h.pylori negative. corpus
H.pylori gastritis. antral predominant
both

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12
Q

what other conditions is autoimmune gastritis associated with

A

Diabetes
Addison
Crohn disease

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13
Q

h.pylori pathogenesis

A

Releases ammonia from urea. raise local ph. acts on antral G cells, release of gastrin, hypergastrinemia, result in hypergastrinemia, result in hypersecretion of gastric acid.
cause production of proinflammatory cytokines by mucosal epithelial cells, activate neutrophils and macrophages, release of lysosomes, ros, impair mucosal .
some cytokines also mediate gastrin release. leading to increased acid secretion.

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14
Q

gastric ulcer

A

Breach in mucosa of alimentary tract extending into submucosa or deeper.

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15
Q

common location of ulcer

A

1st part of duodenum
gastric antrum lesser curvature
barrett’s mucosa
gastro-enterostomy margin

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16
Q

conditions associated with duodenal ulcer

A 
Alcoholic cirrhosis
copd
crf
hyperacidity
phychological and social stress
ingestion of hot liquid and spicy food
steroid therapy
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17
Q

pathophysiology of ulcer

A 
stress
smoking
nsaids
h.pylori
ze
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18
Q

how does cigarette cause ulcer

A

impairs mucosal blood flow and healing

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19
Q

how does alcohol cause ulcer

A

direct injury to mucosal cells

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20
Q

morphology of ulcer

A

punched out defect

oedematous reddened surrounding

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21
Q

histology

A

necrotic fibrinoid debris
inflammatory cells mainly neutrophils
granulation tissue

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22
Q

complications of ulcer

A 
hemorrhage
perforation
GOO
Malignant transformation
intractable pain
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23
Q

types of ulcer

A

Menetrier disease - hyperplasia of surface mucous glands
cushing’s ulcer from intercranial injury
Curling’s ulcer from severe burns

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24
Q

tumors of the stomach

A 
non-neoplastic polpys(inflammatory or hyperblastic)
Neoplastic ae
adenomas
proliferative dysplastic epithelium
pedunculated or sessile
adenomatous polyposis of the stomach
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25
Q

Gastric carcinoma

A

90-95% of gastric cancers

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26
Q

other carcinomas of the stomach aside gastric carcinoma

A

lymphomas
carcinoids
malignant spindle cells

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27
Q

pathobiological classification by Lauren

A

Types Intesinal type with better prognosis
associated with hp and chronic gastritis

difffuse type
poorly differentiated with signet ring appearance and associated krukenberg syndrome

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28
Q

pathogenesis

A

environmental like diet
host factors like disease states like gastritis, h.pylori infection
Genetic. those with blood group A

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29
Q

morphology of the gastric ulcers

A

mainly antral and lesser curvature

linitis plastica

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30
Q

triad of zollinger ehler syndrome

A

hypergastrinemia
increased acid secretion
multiple and recurrent peptic ulcer

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31
Q

source of bleeding in duodenal ulce

A

GD artery

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32
Q

source of bleeding in gastric ulcer

A

left gastric artery

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33
Q

do peptic ulcer in duodenum become malignant?

A

Never

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34
Q

MEN 1 is associated with which kind of gastric disease

A

Zollinger ehler

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35
Q

length of esophagus

A

25cm

36
Q

3 main points of narowing

A

at cricoid cartilage
crossing of left main bronchus and atrium
at diaphragm

37
Q

two physiologic high pressure zones of esophagus

A

upper esophageal sphincter at the level of cricopharyngeus muscle
lower esophageal sphincter at the GE junction

38
Q

congenital anomalies of esophagus

A

atresia

fistula

39
Q

plummer vinson syndrome

A

upper esophageal web
glossitis
iron deficiency anemia
cheliosis

40
Q

Achalasia

A

failure of esophagus to relax

41
Q

3 major abnormalities of achalasia

A

aperistalsis
partial relaxation of LES with swallowing
increased LES pressure

42
Q

achalasia is associated with type of carcinoma

A

squamous cell carcinoma

43
Q

achalasia may be secondary to which types of diseases

A

diabetic neuropathy
malignancy
chagas disease
amyloidosis

44
Q

Schatzki rings

A

lower esophagus web

lined by squamous mucosa in the upper esophagus and undersurface has gastric epithelium

45
Q

types of hiatal hernia

A

sliding(axial)

paraesophageal

46
Q

complications of hiatal hernia

A

bleeding and perforation

strangulation

47
Q

types of diverticulum and location

A

Zenker - above the upper sphincter
Traction diverticulum - midpoint and associated with mediastinitis
Epiphrenic - above the LES

48
Q

Boerhave syndrome

A

rupture of the mucosa deep enough to perforate

49
Q

cause of esophagitis

A 
altered LES tone
hiatal hernia
ingestion of mucosal irritants
infection like herpes simplex, CMV, Candida
cytotoxic anticancer drug
50
Q

microscopy of esophagus

A

inflammatory cells in epithelial layer.
basal zone hyperplasia
elongation of lamina propria papillae

51
Q

complication of oesophagitis

A

Barrett esophagus

52
Q

herpes and cmv produce which types of ulcers

A

punched out

53
Q

where is cmv found

A

in capillary endothelium and stomal cells

54
Q

eosinophilic esophagitis

A

exposure to allergen. associated with asthma

55
Q

what happens in barrett esophagus

A

distal squamous mucosa replaced by metaplastic columnar epithelium

56
Q

two types of dysplasia seen in barrett esophagus

A

low grade with basal orientation of nuclei

high grade with nuclei reaching the apex of the epithelial cells

57
Q

complication of BE

A

Adenocarcinoma

58
Q

most common benign tumor of esophagus

A

Leiomyomas

59
Q

other benign tumor of esophagus

A 
fibroma
lipoma
hemangiomas
squamous papillomas
inflammatory polyps
60
Q

malignant tumors

A

SCC

Adenocarcinoma

61
Q

most common site of SCC

A

middle third of esophagus

62
Q

pathogenesis of SCC

A 
Genetic predisposition minor role
Alcohol and tobacco use
fungus contaminated and nitrosamines
hpv
p53 mutations, p16, allelic loss
no Kras or APC gene mutation
63
Q

Morphology of SCC

A

exophytic
flat
excavated necrotic ulceration

64
Q

Adenocarcinoma

A

overexpression of p53

allelic losses in 17p

65
Q

location of adenocarcinoma

A

distal esophagus

66
Q

length of small intestine

colon

A

6m

1.5m

67
Q

meckel’s diverticulum

A

persistence of vitelline duct on anti mesenteric border

rule of 2s

68
Q

vascular disorders of small intestine

A

occlusive and non-occlusive
arterial thrombosis and embolism venous thrombosis

non occlusive - shock, heart failure, dehydration

69
Q

difference between diarrhea and dysentery

A

dysentery is low volume, painful diarrhea

70
Q

difference between crohn’s and ulcerative

A

skip lesions in crohn
non-caseating granulomas
affects both ileum and colon
greater risk of carcinoma for ulcerative

71
Q

where is colonic diverticulosis usally found

A

distal colon

72
Q

Complications of colonic diverticulosis

A 
Bleeding
Diverticulitis
Pericolic abscesses
sinus tract
chronic blood loss
peritonitis
73
Q

Bowel obstruction types

A

hernia
intussusception
volvulus
adhesions

74
Q

tumors commmon in large or small intestine

A

large

75
Q

tumor mostly epithelial

A

true

76
Q

non-neoplastic polyp in the intestine

A

hyperplastic polyp
harmatomatous polyps - juvenile and Peutz Jegher polpys
inflammatory polpys
lymphoid polyps

77
Q

neoplastic epithelial lesions

A

benign
tubular adenoma
tubulovillous adenoma
villous adenoma

malignant
adenocarrcinoma
carcinoid tumor
anal zone carcinoma

78
Q

neoplastic mesenchymal lesions

A

Benign lesions
Leiomyoma, neuroma
Lipoma, angioma

Malignant lesions
-Leiomyosarcoma
Liposarcoma
malignant spindle cell tumor
Kaposi saracoma 
lymphoma
79
Q

tubular adenomas

A

mostly small and pendunculated

80
Q

villous adenomas

A

large and sessile.

81
Q

Familial adenomatous polyposis

A

100 percent risk of progression into cancer

82
Q

FAP IS associated with

A

Gardner’s syndrome

Turcot syndrome

83
Q

Colonic carcinoma gross in caecum nd asc. colon

A

Polypoid fungating masses

84
Q

Distal colorectum gross morphology carrcinoma

A

Annular masses

85
Q

type of carcinoma seen in anorectal

A

squamous cell carcinoma

basal cell carcinoma

lymphoreticular pathology (7 decks)

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