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GIT Flashcards

1
Q

MC form of congenital intestinal atresia

A

Imperforate anus

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2
Q

MC congenital anomaly of the GIT

Failed involution of vitelline/omphalomesenteric duct

A

Meckel Diverticulum

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3
Q

Associations of Pyloric Stenosis

A

Turner syndrome
Trisomy 18
Erythromycin, Azithromycin exposure in 1st 2 weeks of life

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4
Q

Absence of Myenteric (Auerbach) and Submucosal (Meissner) d.t. ABNORMAL MIGRATION of neural crest cells or premature death

failure to pass meconium
abdominal distention

A

Hirschsprung disease

RET mutations

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5
Q

Complications of Hirschsprung disease

A

enterocolitis
fluid and electrolyte imbalance

perforation –> peritonitis

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6
Q

MC functional esophageal obstruction

A

Nutcracker esophagus

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7
Q

Triad of Achalasia

A

incomplete LES relaxation
increased LES tone
esophageal aperistalsis

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8
Q

MCC of esophageal varices

A

liver cirrhosis

2nd MCC - hepatic schistosomiasis

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9
Q

Complication of chronic GERD characterized by intestinal metaplasia within squamous epithelium

GOBLET CELLS - HALLMARK

increased risk of esophageal ADENOCARCINOMA

A

Barrett’s esophagus

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10
Q

More common

MIDDLE 3rd

squamous dysplasia

tobacco and alcohol
previous radiation
diet low in fresh fruits and vegetables
hot drink ingestion
achalasia
Plummer Vinson syndrome

A

Squamous Cell Ca (Esophagus)

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11
Q

DISTAL 3rd

Barrett’s esophagus

chronic GERD
tobacco
radiation exposure

PROTECTIVE - H. pylori

A

Adenocarcinoma (Esophagus)

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12
Q

MCC of chronic gastritis

A

H.pylori gastritis

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13
Q

Morphology of Ulcers

A

solitary (80%)
sharply punched out defects
mucosal margin level with surrounding mucosa

heaped up margins - MALIGNANCY

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14
Q

Abnormal SUBMUCOSAL arteriole

w/n LESSER curvature near GEJ

A

DIEULAFOY LESIONS

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15
Q

Longitudinal stripes of edematous, erythematous, mucosa

A

Gastric Antral Vascular Ectasia (GAVE)

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16
Q

Diffuse foveolar hyperplasia + protein losing enteropathy

d.t. excessive TGF-a secretion

A

Menetrier Disease

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16
Q

Diffuse foveolar hyperplasia + protein losing enteropathy

d.t. excessive TGF-a secretion

A

Menetrier Disease

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17
Q

Caused by gastrin-secreting neuroendocrine tumors

A

Zollinger Ellison Syndrome

TRIAD:
pancreatic islet tumors
gastric hypersecretion
PUD

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18
Q

MC gastric polyp

A

Inflammatory/Hyperplastic polyps

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19
Q

Polyp associated with PPI use

A

Fundic gland polyps

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20
Q

Associated with chronic gastritis with atrophy and intestinal metaplasia

A

Gastric adenoma

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21
Q

MC malignancy of the STOMACH

A

Adenocarcinoma

ANTRUM - MC site

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22
Q

MC site of extranodal lymphomas

23
Q

MC mesenchymal tumors of the abdomen

24
Risk Factors of Gastric Adenocarcinoma
Chronic Atrophic Gastritis Ingestion of N-nitrosocompounds and benzo(a)pyrene
25
Most important prognostic factors in Gastric Adenocarcinoma
depth of invasion nodal/distal metastases LIVER - MC sites of metastasis
26
Tumors of neuroendocrine origin intense desmoplasia (+) synaptophysin (+) chromogranin
NEUROENDOCRINE NEOPLASMS SI - MC site
27
Cytogenetic origin of GIST CD117 - immunohistological marker
interstitial cells of Cajal
28
Carney's Triad
GIST paraganglioma pulmonary chondroma
29
MCC of intestinal obstruction
Adhesion
30
MCC of intestinal obstruction in children <2
Intussusception
31
MC site of ischemic bowel disease
COLON
32
WATERSHED AREAS (termination of the blood supply)
splenic flexure colon rectum
33
Seen in Lactase Deficiency
Osmotic Diarrhea
34
Seen in Celiac disease - cell mediated immune enteropathy
Malabsorptive Diarrhea
35
Isotonic stools seen in Cholera
Secretory Diarrhea
36
Purulent, bloody stools seen in amebic dysentery
Exudative Diarrhea
37
Common extraintestinal manifestations of IBD
migratory polyarthritis ankylosing spondylitis uveitis skin lesions
38
Most feared long term complication of UC and colonic CD
colitis associated neoplasia
39
Common Histologic Changes in IBD
inflammatory infiltrates crypt abscesses crypt distortion pseudopyloric epithelial metaplasia
40
Hallmark of CD
Noncaseating granulomas
41
transmural ileum + colon rectal sparing SKIP lesions deep, knife like ulcers marked lymphoid reaction, fibrosis, serositis granulomas fistula fat/vitamin malabsorption malignant potential - if with colonic involvement recurrence after surgery - common
CROHNS DISEASE
42
mural colon superficial broad based ulcer marked pseudopolyps (+) malignant potential smoking and appendectomy protective toxic megacolon
ULCERATIVE COLITIS
43
Familial Adenomatous Polyposis (FAP) adenocarcinoma develops in 100% of untreated patients often before age 30 and nearly always by age 50
adenomatous polyposis coli (APC) gene Ch5 at least 100 polyps
44
MC site of juvenile polyps
RECTUM
45
Multiple (+) risk of malignant transformation pulmonary AVMs - extraintestinal lesions
JUVENILE POLPYS mixed inflammatory infiltrate with cystically dilated glands
46
AD SI - MC site multiple GI hamartomatous polyps and mucocutaneous hyperpigmentation increased risk of malignancy
PEUTZ JEGHERS POLYP arborizing network and normal looking glands
47
Guardian/Gatekeeper of Colonic Neoplasia
APC
48
Hereditary Non-Polyposis Colon Cancer (HNPCC) MSH2, MLH1
AMSTERDAM CRITERIA (3-2-1) 3 members (at least 1 should be a 1st degree relative of the other 2 and FAP should be ruled out already) 2 generations 1 diagnosed under age 50
49
The most important characteristic that correlates with malignancy in neoplastic polyps
SIZE >4 cm - w/ foci of invasive cancer
50
MC malignancy of the GIT
Colorectal adenocarcinoma LIVER - MC site of metastasis
51
Prognostic factors for colorectal adenocarcinoma
depth of invasion LN metastasis
52
Proximal (Right) Sided Colon Cancers BULKY, EXOPHYTIC masses
IDA weakness fatigues
53
Distal (Left) Sided Colon Cancers ANNULAR "napkin ring" morphology
CHANGE IN BOWEL HABITS Bowel obstruction
54
MC tumor in the APPENDIX
Well differentiated NET (carcinoid) TIP; benign Pseudomyxoma peritonei (MUCINOUS ASCITES) - occurs when appendix is ruptured

Pathology (24 decks)

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