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lymphoreticular pathology > GI PATHOLOGY > Flashcards

GI PATHOLOGY Flashcards

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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
Gastric carcinoma
90-95% of gastric cancers
26
other carcinomas of the stomach aside gastric carcinoma
lymphomas carcinoids malignant spindle cells
27
pathobiological classification by Lauren
Types Intesinal type with better prognosis associated with hp and chronic gastritis difffuse type poorly differentiated with signet ring appearance and associated krukenberg syndrome
28
pathogenesis
environmental like diet host factors like disease states like gastritis, h.pylori infection Genetic. those with blood group A
29
morphology of the gastric ulcers
mainly antral and lesser curvature | linitis plastica
30
triad of zollinger ehler syndrome
hypergastrinemia increased acid secretion multiple and recurrent peptic ulcer
31
source of bleeding in duodenal ulce
GD artery
32
source of bleeding in gastric ulcer
left gastric artery
33
do peptic ulcer in duodenum become malignant?
Never
34
MEN 1 is associated with which kind of gastric disease
Zollinger ehler
35
length of esophagus
25cm
36
3 main points of narowing
at cricoid cartilage crossing of left main bronchus and atrium at diaphragm
37
two physiologic high pressure zones of esophagus
upper esophageal sphincter at the level of cricopharyngeus muscle lower esophageal sphincter at the GE junction
38
congenital anomalies of esophagus
atresia | fistula
39
plummer vinson syndrome
upper esophageal web glossitis iron deficiency anemia cheliosis
40
Achalasia
failure of esophagus to relax
41
3 major abnormalities of achalasia
aperistalsis partial relaxation of LES with swallowing increased LES pressure
42
achalasia is associated with type of carcinoma
squamous cell carcinoma
43
achalasia may be secondary to which types of diseases
diabetic neuropathy malignancy chagas disease amyloidosis
44
Schatzki rings
lower esophagus web | lined by squamous mucosa in the upper esophagus and undersurface has gastric epithelium
45
types of hiatal hernia
sliding(axial) | paraesophageal
46
complications of hiatal hernia
bleeding and perforation | strangulation
47
types of diverticulum and location
Zenker - above the upper sphincter Traction diverticulum - midpoint and associated with mediastinitis Epiphrenic - above the LES
48
Boerhave syndrome
rupture of the mucosa deep enough to perforate
49
cause of esophagitis
``` altered LES tone hiatal hernia ingestion of mucosal irritants infection like herpes simplex, CMV, Candida cytotoxic anticancer drug ```
50
microscopy of esophagus
inflammatory cells in epithelial layer. basal zone hyperplasia elongation of lamina propria papillae
51
complication of oesophagitis
Barrett esophagus
52
herpes and cmv produce which types of ulcers
punched out
53
where is cmv found
in capillary endothelium and stomal cells
54
eosinophilic esophagitis
exposure to allergen. associated with asthma
55
what happens in barrett esophagus
distal squamous mucosa replaced by metaplastic columnar epithelium
56
two types of dysplasia seen in barrett esophagus
low grade with basal orientation of nuclei | high grade with nuclei reaching the apex of the epithelial cells
57
complication of BE
Adenocarcinoma
58
most common benign tumor of esophagus
Leiomyomas
59
other benign tumor of esophagus
``` fibroma lipoma hemangiomas squamous papillomas inflammatory polyps ```
60
malignant tumors
SCC | Adenocarcinoma
61
most common site of SCC
middle third of esophagus
62
pathogenesis of SCC
``` 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
Morphology of SCC
exophytic flat excavated necrotic ulceration
64
Adenocarcinoma
overexpression of p53 | allelic losses in 17p
65
location of adenocarcinoma
distal esophagus
66
length of small intestine | colon
6m | 1.5m
67
meckel's diverticulum
persistence of vitelline duct on anti mesenteric border | rule of 2s
68
vascular disorders of small intestine
occlusive and non-occlusive arterial thrombosis and embolism venous thrombosis non occlusive - shock, heart failure, dehydration
69
difference between diarrhea and dysentery
dysentery is low volume, painful diarrhea
70
difference between crohn's and ulcerative
skip lesions in crohn non-caseating granulomas affects both ileum and colon greater risk of carcinoma for ulcerative
71
where is colonic diverticulosis usally found
distal colon
72
Complications of colonic diverticulosis
``` Bleeding Diverticulitis Pericolic abscesses sinus tract chronic blood loss peritonitis ```
73
Bowel obstruction types
hernia intussusception volvulus adhesions
74
tumors commmon in large or small intestine
large
75
tumor mostly epithelial
true
76
non-neoplastic polyp in the intestine
hyperplastic polyp harmatomatous polyps - juvenile and Peutz Jegher polpys inflammatory polpys lymphoid polyps
77
neoplastic epithelial lesions
benign tubular adenoma tubulovillous adenoma villous adenoma malignant adenocarrcinoma carcinoid tumor anal zone carcinoma
78
neoplastic mesenchymal lesions
Benign lesions Leiomyoma, neuroma Lipoma, angioma ``` Malignant lesions -Leiomyosarcoma Liposarcoma malignant spindle cell tumor Kaposi saracoma lymphoma ```
79
tubular adenomas
mostly small and pendunculated
80
villous adenomas
large and sessile.
81
Familial adenomatous polyposis
100 percent risk of progression into cancer
82
FAP IS associated with
Gardner's syndrome | Turcot syndrome
83
Colonic carcinoma gross in caecum nd asc. colon
Polypoid fungating masses
84
Distal colorectum gross morphology carrcinoma
Annular masses
85
type of carcinoma seen in anorectal
squamous cell carcinoma | basal cell carcinoma

lymphoreticular pathology (7 decks)

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