GIT I

Question 1

CONGENITAL ABNORMALITIES
______, _____, and duplications may occur in any part of the GI tract. when present within the esophagus they are discovered shortly after birth, usually due to regurgitation during feeding

Answer 1

atresia, fistula, and duplications

Question 2

CONGENITAL ABNORMALITIES
_______, a segment of the esophagus does not develop, leaving only a thin, noncanalized cord and causing mechanical obstruction

Answer 2

atresia

Question 3

CONGENITAL ABNORMALITIES
________ is an incomplete form of atresia in which the lumen is markedly reduced in caliber as a result of fibrous thickening of the wall

Answer 3

stenosis

Question 4

CONGENITAL ABNORMALITIES
_______ tissues (developmental rests) are common in the GI tract. The most frequent site of ectopic gastric mucosa is the upper 3rd of the esophagus where it is referred to as an inlet patch.

Answer 4

ectopic tissue

Question 5

CONGENITAL ABNORMALITIES
__________ is a blind outpouching of the alimentary tract that communicates with the lumen and includes all 3 layers of the bowel wall

Answer 5

true diverticulum

Question 6

CONGENITAL ABNORMALITIES
_____________ generally presents between the 3rd and 6th weeks of life as new-onset regurgitation, projectile nonbilious vomiting after feeding, and frequent demands of refeeding

Answer 6

congenital hypertrophic pyloric stenosis

Question 7

CONGENITAL ABNORMALITIES
________ diseases causes functional obstruction of the colon due to failure of ganglion cells to migrate to the wall of the colon resulting from mutation in the receptor tyrosine kinase

Answer 7

Hirschsprung disease

Question 8

CONGENITAL ABNORMALITIES
Hirschsprung disease
Heterozygous loss-of-function mutations in the receptor tyrosine kinase ______ account for the majority of familial and approximately 15% of sporadic Hirschsprung diseases.

Answer 8

receptor tyrosine kinase RET

Question 9

CONGENITAL ABNORMALITIES
HIRSCHSPRUNG
diagnosis of Hirschsprung disease requires histologic confirmation that _________ are absent within the affected segment

disease limited to the rectosigmoid is termed _________
proximal extension are termed as ______________

Answer 9

ganglion cells
short-segment Hirschsprung disease
long-segment Hirschsprung disease

Question 10

ESOPHAGUS
Esophageal obstruction
________- describes functional obstruction of the esophagus by intense, high amplitude, uncoordinated contractions of inner circular, and outer longitudinal smooth muscle

Answer 10

nutcracker esophagus

Question 11

ESOPHAGUS
Esophageal obstruction

_________- also known as corkscrew esophagus is due to the appearance on barium swallow, is characterized by repetitive simultaneous contractions of the distal esophageal smooth muscle

Answer 11

diffuse esophageal spasm

Question 12

ESOPHAGUS
Esophageal obstruction
__________ including high resting pressure or incomplete relaxation may be presented as an isolated anomaly or accompany nutcracker esophagus or diffuse esophageal spasm

Answer 12

lower esophageal dysfunction

Question 13

ESOPHAGUS
Esophageal obstruction

in the upper-esophagus, webs may be accompanied by iron-deficiency anemia, glossitis, and cheilosis, as part of ___________

Answer 13

plummer-vinson syndrome

Question 14

ESOPHAGUS
_______ is characterized by the triad of incomplete lower esophageal sphincter relaxation, increased lower esophageal sphincter tone, and aperistalsis of the esophagus

Answer 14

achalasia

Question 15

ESOPHAGUS
_______ achalasia may arise in Chagas disease, in which trypanosoma cruzi infection causes destruction of the myenteric plexus, failure of peristalsis, and esophageal dilation

Answer 15

secondary achalasia

Question 16

ESOPHAGUS
logitudinal mucosal tears near the gastroesophageal junction called _________ are most often associated with severe retching or vomiting secondary to alcohol intoxication

Answer 16

mallory-weiss tears

Question 17

ESOPHAGUS
chemical and infectious esophagitis

Symptoms range from self-limited pain, particularly on swallowing called __________, hemorrhage, structure, or perforation in severe cases

less severe chemical injury to the esophageal mucosa can occur when medicinal pills lodge and dissolve in the esophagus, a condition termed ____________

Answer 17

odynophagia
pill-induced esophagitis

Question 18

ESOPHAGUS
chemical and infectious esophagitis (Morphology)

candidiasis is characterized by adherent, gray white _______ composed of densely matted fungal hyphae, and inflammatory cells covering the esophageal mucosa

Answer 18

pseudomembranes

Question 19

ESOPHAGUS
chemical and infectious esophagitis (Morphology)

histologic features of esophageal ____________ are similar to those of skin and include basal epithelial cell apoptosis, mucosal atrophy, and submucosal fibrosis without significant acute inflammatory infiltrates

Answer 19

graft vs host disease

Question 20

ESOPHAGUS

reflux of gastric contents into the lower esophagus is the frequent cause of esophagitis and the most common outpatient GI diagnosis in the US

Answer 20

reflux esophagitis

Question 21

ESOPHAGUS
reflux esophagitis

transient lower esophageal sphincter relaxation is thought to be a major cause of _________

Answer 21

GERD

Question 22

ESOPHAGUS
________ is a form of acute eosinophilic dominated esophageal inflammation associated with atopic disease

in addition to GERD like symptoms, patients experience food impaction, dysphagia, and vomiting

Answer 22

eosinophilic esophagitis

Question 23

ESOPHAGUS
______________ are caused by portal hypertension which is due to impaired blood flow, through the portal venous system and liver

Morphology:
torturous dilated veins within the mucosa and submucosa of the distal esophagus and proximal stomach

Clinical manifestations
Variceal hemorrhage

Answer 23

esophageal varices

Question 24

ESOPHAGUS
_________ esophagus is a complication of chronic GERD that is characterized by intestinal metaplasia within the esophageal squamous mucosa and is associated with an increased risk of cancer

Answer 24

Barret Esophagus

Question 25

ESOPHAGUS ____________ is classified as a low-grade or high grade. Atypical mitoses, nuclear hyperchromasia, irregularly clumped chromatin, increased nuclear-to-cytoplasmic ratio, and failure of epithelial cells to mature as they migrate to the esophageal surface are present in both grades

Answer 25

dysplasia

Question 26

ESOPHAGEAL TUMORS ___________ typically arises in the background of barret esophagus and long standing GERD

Answer 26

adenocarcinoma of the esophagus

Question 27

ESOPHAGEAL TUMORS esophageal tumors (Esophageal adenocarcinoma) chromosomal abnormalities and mutations of tumor suppressor genes _________ and _________ are detected at early stages

Answer 27

TP53 and CDK2A

Question 28

ESOPHAGEAL TUMORS Esophageal tumors (esophageal adenocarcinoma) usually happens in the ___________ of the esophagus and invade the adjacent gastric cardia

Answer 28

distal 3rd

Question 29

ESOPHAGEAL TUMORS squamous cell carcinoma begins as an in situ lesion termed ___________ (this histopathology is referred to as intraepithelial neoplasia or carcinoma in situ at sites outside the GI tract e.g. uterine and cervix

Answer 29

squamous dysplasia

Question 30

STOMACH Gastropathy and acute gastritis distruption of protective mechanisms is illustrated by the following examples: ___________ NSAIDs inhibit COX-dependent synthesis of prostaglandins E2 and i2 which contribute to nearly all the above defense mechanisms including: mucus, bicarbonate, phospholipid secretion; mucosal blood flow; and epithelial restitution

Answer 30

institution of cyclooxygenase (COX) by NSAIDS

Question 31

STOMACH Gastropathy and acute gastritis distruption of protective mechanisms is illustrated by the following examples: ______________ by ammonium ions can result in gastric injury in uremic patients and those infected with urease-secreting H. pylori

Answer 31

inhibition of bicarbonate transporters

Question 32

STOMACH Gastropathy and acute gastritis distruption of protective mechanisms is illustrated by the following examples: ___________- have been suggested as factors that explain the increased susceptibility of older adults to gastritis ___________- may account for an increased incidence of acute gastritis at high altitudes

Answer 32

reduced mucin and bicarbonate secretion decreased oxygen delivery

Question 33

STOMACH Stress related mucosal disease ________ are most common in the setting of shock, sepsis, or severe trauma ________ refer to ulcers occuring in the proximal duodenum in the context of severe burns or trauma ________ refers to gastric, duodenal, and esophageal ulcers arsing those with intracranial disease, they have an elevated risk of perforation

Answer 33

stress ulcers curling ulcers cushing's ulcers

Question 34

STOMACH Stress related mucosal disease Non-stress related causes of gastric bleeding include the following two conditions: 1. __________- consists of an abnormal submucosal arteriole that is usually found within the lesser curvature of the stomach near the gastroesophageal junction 2. ___________ is responsible for 4% of non-variceal upper GI bleeding

Answer 34

dielafoy lesion Gastric antral vascular ectasia (GAVE)

Question 35

STOMACH Chronic gastritis and its complications Chronic gastritis is most often caused by _____- infection

Answer 35

H. Pylori

Question 36

STOMACH Chronic gastritis and its complications H. PYLORI ______: allows the bacteria to be motile in viscous mucus ______: which generates ammonia from endogenous urea and thereby elevates local gastric pH and enhances bacterial survival ______: enhances bacterial adherence to surface folveolar cells ______: such as cytotoxic associated gene A (Cag A)

Answer 36

flagella urease adhesins toxins

Question 37

STOMACH Chronic gastritis and its complications Helicobacter pylori gastritis Lymphoid aggregates some with germinal centers are frequently present and represent induced _________ that has the potential to transform into lymphoma

Answer 37

mucosa-associated lymphoid tissue

Question 38

STOMACH __________ gastritis in contrast to H. Pylori associated gastritis, typically spares the antrum and is often associated with marked hypergastrinemia ___________ gastritis is associated with loss of parietal cells which is responsible for secretion of gastric acid and intrinsic factor. Leads to cobalamin (Vitamin B12) deficiency --> pernicious anemia

Answer 38

autoimmune atrophic gastritis

Question 39

STOMACH autoimmune atrophic gastritis is characterized by diffuse damage to the ______ mucosa within the body and fundus

Answer 39

oxyntic (acid producing)

Question 40

STOMACH UNCOMMON FORMS OF GASTRITIS ___________ is characterized by tissue damage associated with dense infiltrates of eosinophils in the mucosa, muscularis, usually in the antral or pyrolic region

Answer 40

eosinophilic gastritis

Question 41

STOMACH UNCOMMON FORMS OF GASTRITIS this disease preferentially affects women and produces nonspecific abdominal symptoms. It is idiopathic but approximately 40% of cases are associated with celiac disease suggesting an immune-mediated pathogenesis.

Answer 41

Lymphocytic Gastritis

Question 42

STOMACH UNCOMMON FORMS OF GASTRITIS the descriptive term _________ is applied to any gastritis that contains granulomas

Answer 42

granulomatous gastritis

Question 43

STOMACH ___________ refers to chronic mucosal ulceration affecting the duodenum or stomach and is almost always associated with H. Pylori infection, NSAIDs or cigarette smoking

Answer 43

Peptic ulcer disease