Flashcards in GI Pathology Deck (313)
What is the main reason of a cleft palate to form?
failure of facial prominences to fold
What is an aphthous ulcer?
painful, ulceration of oral mucosa
What causes Behcet Syndorme?
immune complex vasculitis
Begcet Syndrome is seen after what type of infection?
What are the three areas are effected by Behcet Syndrome?
aphthous ulcer, genital ulcers, uveitis
Which HSV isotype causes oral herpes?
Where does oral herpes remaini dormant?
ganglia of trigeminal nerve
What are the two precursor lesions for squamous cell carcinoma (squamous cell dysplasia)?
leukoplakia and erythroplakia
What are the two common risk factors for developing a squamous cell carcinoma?
tobacco and alcohol
Does squamous cell carcinoma effect the floor or the roof of the mouth?
Oral hairy leukoplakia is indicative of what type of cancer?
squamous cell carcinoma
Where on the tongue does oral hairy leukoplakia arise?
lateral side of the tongue
In immunocompromised patients, what virus can drive oral hairy leukoplakia? What type of cellular change is this?
hyperplasia of squamous cells
What gland does mumps infect?
What are three other presentations that may accompany a mumps infection?
orchitis, pancreatitis, aseptic meningitis
What enzyme can be elevated due to mumps? What two glands could be responsible for this?
parotid or pancreas
What is inflammation of the salivary gland caused?
What bacteria can often infect an obstructed salivary gland?
What is the most common tumor of the salivary gland?
Is a pleomorphic adenoma benign or malignant?
What two types of tissue makes up a pleomorphic adenoma?
stromal and epithelial
In what gland does a pleomorphic adenoma most often arise?
How would one know that a pleomorphic adenoma is transforming into a carcinoma?
facial nerve damage
What gland does a warthin tumor arise?
Are Warthins tumors benign or cystic?
Warthins tumors are filled with what two constituents?
What is the most common malignant tumor of the salivary glands?
What gland does a mucoepidermoid tumor most often arise?
What is the most common type of tracheoesophageal fistula?
atresia of proximal esophagus
distal esopagus arising from trachea
What constellation of symptoms does a tracheoesophageal fistula present with?
Does an esophageal web arise in the upper of lower part of the esophagus?
Does an esophageal web carry an increased risk of squamous cell carcinoma or adenocarcinoma?
squamous cell carcinoma
What is a Zenker Diverticulum? Acquired or congenital?
outpouching of pharyngeal mucosa
Is a Zenker DIverticulum a true or false diverticulum?
What exact location does a Zenker Diverticulum arise?
junction of esophagus and pharynx
What are the two common presentations with a Zenker-Diverticulum?
dysphagia and halitosis
What is Mallory-Weiss Synrome?
What causes Mallory-Weiss Synrome? Why?
alcoholism or bulimia
Does Mallory-Weiss Syndrome present with painful or painless hematemesis?
What condition does Mallory-Weiss Syndrome have an increased risk of presenting with?
What is Boerhaave Syndrome? What can Boerhaave Syndrome result in?
esophageal rupture leading to air trapped in the mediastinum
What vein normally drains the distal esophagus?
How does esophageal varices clasically present?
What is the most common cause of death in liver cirrhosis?
esophageal varices rupture
What type of cell is damaged during achalasia? Which plexus?
What specific parasite can damage the myenteric plexus? What disease? What cells?
Does achalasia present with dysphagia for solids, liquid or both?
What is the characteristic sign of achalasia?
Does achalasia cause an increased risk of developing from squamous cell or adenocarcinoma?
New onset asthma as an adult is indicative of what disease?
What is the exact metaplasia of Barrett's esoophagus?
stratified squamous epithelium to nonciliated columnar with goblet cells
What type of cancer can Barrett's esophagus progress to?
Does esophageal cancer present late or early? What does this mean?
What type of dysphagia does esophageal cancer present with?
progressive (liquids to solids)
Which lymph nodes would cancer from the upper 1/3 of the esophagus drain into?
Which lymph nodes would cancer from the middle 1/3 of the esophagus drain into?
mediastinal or tracheobronchial
Which lymph nodes would cancer from the upper 1/3 of the esophagus drain into?
celiac and gastric
What is gastroschisis?
congenital malformation leading to exposure of abdominal contents
Is gastroschisis covered by peritoneum?
What is omphalocele covered by?
by peritoneum and amnion
Is pyloric stenosis more common in males or females?
Clasically, how long after birth does pyloric stenosis present?
What type of vomiting does pyloric stenosis present with?
What type of cells produce mucin in the stomach?
What type of gastric ulcer will develop after a severe burn?
What type of ulcer arises due to increased intracranial pressure? Why?
increased vagal tone leads to increased acid secretion
What is Cushing's Triad?
wide pulse pressure
What two parts of the stomach are parietal cells located?
fundus and body
What type of gastric adenocarcinoma does H. pylori cause?
Achlorhydria due to gastric chronic gastric inflammation present with what two symtoms?
increased gastrin levels
What is the most common site of H. pylori infection in the stomach?
What two types of cancer does chronic H. pylori infection present with?
What is the reason for almost all duodenal ulcers? What else is a less common but possible cause?
What is the classic presentation for a duodenal ulcer?
epigastric pain that improves with meals
What gland hypertrophies during a duodenal ulcer?
Are duodenal ulcer more common in the anterior or posterior portion of the duodenum?
What two things can happen if a duodenal ulcer is in the posterior portion of the duodenum?
eat away at gastroduodenal artery
What is the classic presentation for a gastric ulcer?
pain the worsens with meals
Where are gastric ulcers most commonly located?
lesser curvature of the antrum
Rupture of an ulcer in the lesser curvature of the antrum can lead to increased bleeding from what vessel?
Are duodenal ulcer commonly malignant or benign?
almost never malignant
What type of cancer is gastric cancer most commonly?
What type of gastric carcinoma is more common, intestinal or mucosal type?
Where does the intestinal type of gastric carcinoma normally arise?
lesser curvature of antrum
What type of cell is found in a diffuse gastric carcinoma?
signet ring cells
What do signet ring cell do to the gastric wall? What two things is this called?
linitis plastica and desmoplasia
Which form of gastric carcinoma is associated with nitrosamines? Where are nitrosamines found? What country?
Which form of gastric carcinoma is associated with H. pylori infection?
Which blood type is associated with Intestinal Gastric Carcinoma?
Which lymph nodes does gastric carcinoma spread to?
What is a Sister Mary Joseph Nodule?
gastric carcinoma invading periumbilical region
Which type of gastric carcinoma can produce a Sister Mary Joseph Nodule?
Where does gastric carcinoma most commonly metastisize?
Where does a Krukenberg tumor metastisize? Is this associated with intestinal or diffuse type of gastric carcinoma?
What type of intestinal carcinoma metastisizes to the ovaries?
What condition is duodenal atresia associated with?
What feature would suggest duodenal atresia in utero?
What sign does duodenal atresia produce on Xray?
Is Meckel's a true or false diverticulum? What makes it this way?
outpouching of all three layers
Meckel's diverticulum results in a failure of what duct to retract fully? What is another name for this duct?
What are the four 'twos' of Meckels Diverticulum?
two years old
two inches long
two percent of population
two feet from ileocecal valve
What is a volvulus?
twisting of bowel along the mesentery
What does a volvulus result in?
Where does a volvulus commonly arise in the elderly?
Where does a volvulus commonly arise in the young?
What is intussusception?
when a proximal portion of the bowel telescopes into a forward part
What pulls the telescoped section forward during intussusception? What does this result in?
In children what is the most common cause of intussusception? What cause this?
What section of the GI tract are involved with the most common cause of intussesception?
ileum into cecum
What is the most common cause of intussesception in adults?
What does the stool look like in intussusception?
red currant jelly
What two HLA haplotypes are associated with Celiac Disease?
HLA-DQ2 and HLA-DQ8
What is the most potent component of gluten?
What sort of enzymatic processing happens to gliadin? What enzyme?
Which MHC molecule presents gliadin?
What skin lesion can form from celiac disease?
What specific structure of the skin is involved in dermatitis herpetiformis? Which immunogloulin?
What three proteins have antibodies against them in celiac disease? Which immunoglobulin?
gliadin, endomysium and tTP
What section of the GI tract is most severly effected by celiac disease?
What two cancers can arise due to long-term celiac disease?
small bowel carcinoma
What two sections of the GI tract are most affected by tropical sprue?
jejunum and ileum
When does tropical sprue arise? What does tropical sprue respond to?
What species causes Whipple Disease?
What cell gets infected during Whipple disease?
Where is the classic layer of involvement of Whipple Disease?
small bowel lamina propria
Why does Whipple Disease present with Steatorrhea?
swollen macrophages compress lacteals and fat cant be absorbed through lymphatics
What occupation type most often presents with Whipple Disease?
Abetalipoproteinemia presents with deficiency in what two proteins?
B48 and B100
What type of cells give rise to a carcinoid tumor?
Since a carcinoid tumor arise from neuroendocrine cells. what would be the IHC stain?
Where is the most common site for a carcinoid tumor?
What hormone is often released by carcinoid tumors?
In a carcinoid tumor, what metabolite will be found in the urine?
Where does a carcinoid tumor have to metastisize to in order to produce symptoms?
What are the three symptoms of carcinoid syndrome?
What two factors often precipitate carcinoid syndrome?
alcohol and emotional stress
What is carcinoid syndrome causing heart disease characterized by? What is deposited?
right sided valvular fibrosis
What two valvular issues does carcinoid heart lead to?
pulmonary valve stenosis
Why does carcinoid syndrome not cause left heart failure?
presence of MAO in lung
What obstructs the appendix in children?
What obstructs the appendix in adults?
What two populations have the highest incidence of IBS?
eastern european jews
What two parts of the GI tract are most affected by Hirschsprung Disease?
rectum and distal sigmoid
What other disease is Hirschprung disease highly associated with?
What two plexuses are most affected by Hirschsprung Disease?
What type of cells fail to migrate in Hirschprung disease? What structure are these cells derived from?
Which layers of the GI tract are involved in UC?
mucosal and submucosal
Which layers of the GI tract are involved in Chrons?
Where does UC always begin? Where can UC progress to?
Where is the most common site for Crohns to arise?
Would UC or crohns present with LLQ pain?
Would UC or crohns present with RLQ pain?
What is the key inflammatory structure of UC? What cell type?
What is the inflammatory structure of Crohns? What cell type?
What is lost during UC? What radiological sign would this present with?
lead pipe sign
What does the bowel mucosa look like during Crohns? How would this appear on radiology?
What are the two complications of Ulcerative Colitis?
Which IBS disease can present with kidney stones? What type of stone? Why?
Crohns increases oxalate absorption
What is p-ANCA?
perinuclear Anti-Neutrophil Cytoplasmic Antibody
What two layers of the GI tract out pouch during a colonic diverticula?
mucosa and submucosa
What specific location do colonic diverticula arise?
where vasa recta traverse muscularis propria
Which form of IBS does smoking protect against?
What two locations does angiodysplasia often arise?
cecum and ascending colon
What is the mode of inheritance for hereditary telangiectasia?
Where are the two most common locations for hereditary telangiectasia?
mouth and GI tract
What is the most common location for Ischemic Colitis? Why?
watershed of SMA/IMA
What is the most classic presentation of Ischemic Colitis? Why?
increased energy require of colon exacerbates oxygen deficiency
What layer of the GI tract is raised in a polyp?
What structure undergoes hyperplasia to give rise to a hyperplastic polyp?
hyperplasia of glands
At what junction do colonic polyps most commonly arise?
What gives rise to a adenomatous polyp?
neoplastic proliferation of glands
What chromosome is APC on?
What mutation (not APC) is implicated in the formation of a polyp?
A mutation in what gene and increased expression of what gene contribute to the adenoma-carcinoma cycle?
p53 = mutated
COX = over-expressed
What drug can impede the progression from a colonic adenoma to a carcinoma?
What are the three risks of polyps that can contribute to their pathogenicity?
greater than 2cm
What does sessile growth mean?
grows off colonic wall w/o a stalk
What is the mode of inheritance for FAP?
What is Gardner Syndrome?
FAP with fibromatosis and osteomas
Where does the fibromatosis of Gardner Syndrome arise?
Where does the Osteoma arise during Gardner Syndrome?
What are the two characteristics of Turcot Syndrome?
FAP with CNS tumors
What are the two types of CNS tumors found in Turcot Syndrome?
What is the mode of inheritance for Peutz-Jeghers Syndrome?
What does Peutz-Jeghers syndrome produce in the GI tract?
What three locations does Peutz-Jeghers produce hyperpigmentation?
lips, oral mucosa and genitals
What three cancers does a patient with Peutz-Jeghers have a higher risk of developing?
colorectal, breast and gynecological
What does microsatellite instability indicate?
defective DNA repair mechanisms
What are microsatellites?
repeating sequences of non-coding DNA
HNPCC is a result in a defect in what type of enzymes?
DNA mismatch repair enzymes
Patients with HNPCC have an increased risk for what three types of cancer?
colorectal, ovarian and endometrial
How does colorectal cancer arise in patients with HNPCC? From a polyp?
What are two ways to describe the appearance of a left sided carcinoma?
apple core sign
How does the stool look in a left sided carcinoma?
blood streaked stool
How does a right sided colon cancer usually present?
iron deficiency anemia
How does a right sided colonic carcinoma grow?
Colon cancer carries a risk to develop endocarditis of what strain?
Gastric cancer most oftenly invades what organ?
What is the most common cause of Aphthous Ulcer?
What does an Aphthous ulcer look like?
gray base surrouned by ring of erythema
What is the gray base of an Aphthous ulcer composed of?
What is more suggestive of dysplasia, erythroplakia or leukoplakia?
Where does a pleomorphic adenoma often arise?
angle of mandible
Lets say a parotid tumor was removed but kept coming back, what type of tumor could it by? Why?
What two cell types are found in a mucoepidermoid carcinoma?
mucinous and squamous
What salivary gland tumor most often involves the facial nerve?
Esophageal webs are a protrusion of what part of the GI tract?
What two esophageal issues arise during achalasia?
loss of esophageal motility
inability to relax LES
Does achalasia present with dysphagia for solids, liquids or both?
What type of hernia can produce bowel sounds in the lower lung fields?
What are the two long-term complications of GERD?
ulceration with stricture
What type of cancer could develop from Barretts esophagus?
What type of esophageal cancer would arise in the lower third of the esophagus?
What type of esophageal cancer would arise in the upper two thirds of the esophagus?
What type of dysphagia does esophageal carcinoma present with? What does this mean?
liquids to solids
Does esophageal carcinoma present early or late?
Which type of esophageal carcinoma can irritate the recurrent laryngeal nerve?
Is pyloric stenosis present at birth?
Which GI disease can present with visible peristalsis?
What is acute gastritis?
acidic damage to stomach
Why does a Curling ulcer happen?
poor blood flow doesnt remove enough acid
Why are most patients in ICU placed on PPIs?
shock can cause an ulcer
What are the two types of chronic gastritis?
What two parts of the stomach are parietal cells found?
Where in the stomach are the majority of G-cells located?
Chronic autoimmune gastritis features antibodies against what two antigens?
Chronic gastritis can drive which type of cancer? Which type?
Which form of gastric adenocarcinoma can H. pylori present with?
Is diffuse type gastric carcinoma associated with H. pylori?
Is diffuse type gastric carcinoma associated with metaplasia?
Is diffuse type gastric carcinoma associated with nitrosamines?
Does gastric carcinoma present early or late ?
Though somewhat rare, where on the body can acanthosis nigricans present during gastric carcinoma?
Would duodenal atresia has bilious or non-bilious vomiting?
What two sections of the GI tract become distended during duodenal atresia?
duodenum and stomach
What are the four ways that Meckels Diverticulum can present?
obstructio (mimmics appendicitis)
What type of metaplastic cell can be found in Meckels Diverticulum? What can this lead to? Why?
production of acid
Which layer of the GI tract is most susceptible to infarction during severe hypotension?
What specific structure is destroyed during celiac disease?
What type of immune reaction is celiac disease?
What is THE MOST affected portion of the GI tract during celiac disease?
What specific structure is destroyed during tropical sprue?
What stain can be used to identify f Disease?
Other than GI symptoms, what other four symptoms can Whipple Disease produce?
arthritis, cardiac valve issues, lymph nodes and CNS
Is IBS more common in men or women?
What is produces continuous lesions, UC or Crohns?
What involves the entire radius of the tube, UC or Crohns?
What type of mucosa is seen during UC?
What are the two associated risks of UC developing into carcinoma?
length of colon involved
duration of involvement
What is the main complication of Crohns Disease?
What are the two extraintestinal complications of UC?
primary sclerosing cholangitis
What layer of the GI tract are affected by Crohns?
What do the fissures look like in Crohns?
Where is the least likely location of Crohns?
Which form of IBS can produce fistulas? Why?
full thickness inflammation of wall
Which form of IBS presents with skeletal issues?
Does smoking increase or decrease liklihood of Crohns?
Which form of IBS can produce a stricture?
What biopsy is used to Dx Hirschsprung disease?
What is the definition of a colonic diverticulum?
outpouching of mucosa and submucosa through muscularis propria
What is believed to be the cause of colonic diverticula?
What part of the GI tract is where colonic diverticula most commonly arise?
What are the three most common consequences of developing a colonic diverticula?
What is the definition for Colonic Angiodysplasia?
acquired defects in the capillary beds of the mucosal and submmucosal layers
How does angiodysplasia present?
WHat does high stress in the right colon produce?
What does high stress in the left colon produce?
What change may improve the symptoms of IBS?
increased fiber in diet
What GI diseases improves with defecation?
What is fibromatosis? Where usually?
non-neoplastic proliferation of fibroblasts
What type of growth is a juvenile polyp?
In what two locations does juvenile polypsosis usually present?
stomach and colon
What is the prototypic disease involving microsatellite instability? What process is hereditarily defective?
DNA repair mechanisms
Does HNPCC give rise to tumors on the left side or right side?
Is the adenoma-carcinoma cycle more prevalent on left side or right side?
Is the right or left side associated with microsatellite instability?
What is the T-stage based on?
depth of invasion
What is the N-stage based on?
regional lymph node spread
What tumor marker does colonic carcinoma present with?
What is CEA useful for?
What is CEA not useful for?
Mumps can lead to sterility in what patient group?
At the lower esophageal sphincter, where specific layer are the ganglion cells located?
between IC and OL
What two tests confirm eradication of H. pylori infection?
negative urea breath test
negative stool antigen
What two signs of gastric carcinoma may be evident on physical examination?
If a patient doesnt have IgA against gliadin does this mean they dont have celiac disease? Why?
might be IgG. IgA deficiency is more common in celiac patients
What are the three histological findings of celiac disease?
flattening of villi
hyperplasia of crypts
What layer of the GI tract does a carcinoid tumor grow in?
Which IBS can present with skin issues? What are the two issues?
Erythema nodosum and proderma gangrenosum
Can one tell the difference between an adenomatous polyp and hyperplastic polyp on colonoscopy?
During FAP, are the polyps hyperplastic of adenomatous?
What kind of dysplasia is oral Leukoplakia?
Between which two layers of the GI tract are the ganglion cells located?
inner circular and outer longitudinal
Which type of Hypersensitivity is Chronic Autoimmune Gastritis?
B48 is required for which lipid carrying molecule?
B100 is required for which two lipid carrying molecules?
VLDL and LDL
In a carcinoid heart, what molecule is present in the areas of fibrosis?
Does UC have bloody or non-bloody diarrhea?
Does Crohns have bloody or non-bloody diarrhea?
What is more suggestive of squamous cell dysplasia, leukoplakia or erythroplakia?
Is pyloric stenosis present at birth?
Which prostaglandin promotes mucus secretion in the stomach?
Ulcerative colitis progressing into carcinoma depends on what two factors?
extent of colon involved
length of disease
Is p-ANCA associated with UC or Crohns?
Does Smoking protect or contribute to UC?
Does Smoking protect or contribute to Crohns?
What is the only way Crohns can cause carcinoma?
What disease is PUEA associated with?
What does PUEA stand for?
How does Angiodysplasia present?
What dietary modification can improve Irritable Bowel Syndrome?
increased fiber intake
What is the appearance of a Hyperplastic Colonic Polyp on microscopy?