GI Pathology I

Question 1

When does a hiatal hernia occur?

Answer 1

When the upper part of stomach protrudes through diaphragm into the chest

Question 2

What is the etiology of GERd

Answer 2

CNS depressants
Hypothyroidism
Pregnancy
Alcohol
Tobacco
NG intubation

Question 3

GERD has an increased risk of what?

Answer 3

Barrett’s esophagus and adenocarcinoma

Question 4

What are clinical manifestations of GERD?

Answer 4

• Dyspepsia
• Burning sensation
• Symptoms increase after lying down after large meal
• Nocturnal cough

Question 5

What are some complications from GERD?

Answer 5

• Bleeding
• Stricture formation
• Aspiration pneumonia

Question 6

What are oral manifestations of GERD?

Answer 6

Enamel erosion, dry mouth, burning sensations, irritation of inflammation of oral mucosa

Question 7

What is Barrett’s esophagus?

Answer 7

Esophageal mucosa is replaced by metaplastic columnar intestinalized epithelium due to prolonged injury (chronic reflux)

Question 8

What does mucosa loo like in Barrett’s esophagus endoscopy?

Answer 8

Salmon colored

Question 9

Are Barrett’s esophagus patients at higher risk of adenocarcinoma?

Answer 9

Yes 10-55 fold

Question 10

What are the 3Ms of herpetic esophagitis?

Answer 10

Multinucleation, molding and margination

Question 11

What are etiological factors of esophageal papillomas?

Answer 11

• Irritation (alcohol, smoking, reflux, chronic food impaction)
• Infection

Question 12

Oral cavity papillomas are associated with

Answer 12

low risk HPV 6 and 11

Question 13

Oral cavity papillomas commonly involve

Answer 13

soft palate, tongue, lips, tonsils

Question 14

Describe oral cavity papillomas

Answer 14

Common, small, benign intraoral squamous proliferation

Question 15

What color do parietal cells appear as?

Answer 15

Redish

Question 16

What do parietal celsl secrete?

Answer 16

HCl and IF

Question 17

What color do chief cells appear as?

Answer 17

Darker blue nuclei

Question 18

What do chief cells produce?

Answer 18

Pepsinogen I and II

Question 19

What is chronic gastritis?

Answer 19

Chronic mucosal inflammatory changes leading eventually to mucosal atrophy and/or epithelial metaplasia

Question 20

What are etiologies of Chronic Gastritis?

Answer 20

• Chronic infection w H. pylori
• Immunologic
• Alcohol and smoking
• Post surgical
• radiation
• Granulomatous conditiona

Question 21

H. pylori can lead to uncontrolled proliferation of B cells which can cause

Answer 21

lymphoma

Question 22

H. pylori can damage mucosa and lead to

Answer 22

Chronic gastritis, antrum atrophy and peptic ulcers

Question 23

How does Chronic H. pylori gastritis appear histologically?

Answer 23

• Inflam infiltrate in lamina propria
• Neutrophils in surface epi and glandular lumen
• Lymphoid aggregates intestinal metaplasia and glandular atrophy

Question 24

What is a peptic ulcer?

Answer 24

Breach in mucosa that extends through muscularis mucosae

Question 25

What are complications of peptic ulcers?

Answer 25

- Bleeding - Perforation - Gastric outlet obstruction - Increased acid production can lead to oral ulcers or acid induced irritation

Question 26

What are the clinical features of peptic ulcers?

Answer 26

- Burning epigastric pain after meals - Releived by food and alkali - Worse at night - Associated weight loss

Question 27

How does autoimmune gastritis appear histologically?

Answer 27

Antralized mucosa with IM, ECL hyperplasia and atrophy

Question 28

How does diffuse adenocarcinoma appear histologically?

Answer 28

Signet ring cells