Midterm Ch.14 Part 2

Question 1

What is the MC cause of esophagitis

Answer 1

Reflux aka GERD

25-40% of U.S. adults

Idiopathic LES dysfunction

Question 2

What is associated with a “sour brash”

Answer 2

GERD

Thx. Antacids, dietary modification

MC G.I. Compliant

Question 3

Infectious esophagitis MC develops following an

Answer 3

Ulcer

Also microbes
Fungal= Candida esophagitis
Viral- HSV, CMV

Question 4

What is Mallory Weiss tear

Answer 4

Longitudinal esophageal tear

From forceful vomiting

Hematemesis

1/2 of all upper G.I. Bleeds

Question 5

What is the MC hiatal hernia

Answer 5

Axial 95%

” bell shaped” dilation

AKA sliding

Question 6

What is Non axial hiatal hernia

Answer 6

AKA rolling

Separate potion of stomach protrudes

Prone to strangulation or obstruction

Question 7

Who’s is most at risk for hiatal hernia

Answer 7

70% occur in adults 70+

90% are asymptomatic

MC with non axial type

Question 8

What is Barrett esophagus

Answer 8

Esophageal metaplasia at distal end

Pre-neoplastic lesion

10% of symptomatic GERD patients

Risks White ppl 30-100x, males 4x

Age 40-60

Question 9

What are found in Barrett esophagus

Answer 9

Goblet cells

Get red velvety mucosa aka “tongues”

Question 10

What is a leiomyoma

Answer 10

Benign smooth muscle tumor in the esophagus

Question 11

Adenocarcinoma in the esophagus is

Answer 11

50% of esophageal cancers

Risks GERD, white, male, fat, tobacco

Question 12

What is the MC esophageal tumor

Answer 12

Squamous cell carcinoma

MC world wide 90%

Question 13

Adenocarcinoma with ealrly lymphatic invasion results in

Answer 13

Poor prognosis <25% 5 yr survival

Question 14

Esophageal adenocarcinoma may have

Answer 14

Exophytic (raised lesion)

Flat or raised patches

Distal 1/3

Question 15

Risks for squamous cell carcinoma

Answer 15

> 45yr old, males, black, HPV

Question 16

Esophageal squamous epithelium cell carcinoma MC affects

Answer 16

Middle 1/3

Question 17

What is melena

Answer 17

black “tarry” feces

Question 18

What is MC infxn. Of stomach

Answer 18

Helicobacter pylori

Question 19

What is acute gastritis

Answer 19

Neutrophils will be present

Acute erosive hemorrhagic gastritis

Pathogensis is multipfactorial

May be asymptomatic

Question 20

Acute peptic ulceration occurs from

Answer 20

Severe PHYSIOLOGICAL stress

High douses of NSAIDs

Intracranial disease

“Coffee ground” throw up

Question 21

Chronic gastritis involves

Answer 21

Upper abdominal discomfort

Hematemesis is RARE

H. Pylori, old age, stressors

Risk for producing peptic ulcer disease
Gastric adenocarcinoma

Question 22

Chronic gastritis results in

Answer 22

H. Pylori

Increased acid production

Epithelial metaplasia

Question 23

Autoimmune gastritis is

Answer 23

mc in elderly

Pernicious anemia= antibodies against parietal cells

Question 24

What is a “punched out” lesion

Answer 24

Peptic ulcer disease

Question 25

Where is peptic ulcer disease MC located

Answer 25

Proximal duodenum Gastric antrum MC in men

Question 26

When is peptic ulcer disease MC

Answer 26

At night 1-3 hours after eating If perforation or hemorrhage happens MEDICAL emergency

Question 27

Presentation of duodenal and gastric Peptic ulcer disease

Answer 27

Duodenal= postprandial relief Gastric= worse postprandial Eating does influence pain

Question 28

What is the MC gastric polyp

Answer 28

Inflammatory Hyperplastic polyps 75% 1cm age 50-60 H. Pylori

Question 29

Funding gland polyp

Answer 29

15% of cases PPI use or FAP

Question 30

Gastric adenomas

Answer 30

10% of gastric polyps Males 3x, age 50-60 30% are adenocarcinoma

Question 31

Dysplasia adenomas are

Answer 31

90% of all stomach cancers MC in males around 55 Japan 20X risk 5yr survival early 90% vs. advanced 20%

Question 32

What is pyloric stenosis

Answer 32

Hypertrophy/ narrowing of pyloric sphincter Dx. Shortly after birth 1 per 400 births Projectile vomiting

Question 33

Vomiting from pyloric stenosis is

Answer 33

Fluid is NOT bile stained Males, whites at risk, Turner syndrome

Question 34

Where is MC intestinal obstructions

Answer 34

Small intestine

Question 35

What is intussusception

Answer 35

A proximal segment telescopes into a distal segment

Question 36

What is a volvulus

Answer 36

Twisting a loop of bowel Possible infarction

Question 37

What is Hirshsprung disease

Answer 37

Forms from defective neural crest cell migration Lack of neurologic ganglia in rectum Dx. Failure to pass meconium (48hrs) Sever dilation of proximal bowels

Question 38

Hirschsprung disease MC in

Answer 38

Males, but MORE SEVERE when in females

Question 39

Chronic ischemic bowel disease

Answer 39

Mimics IBD, insidious, episodic bloody diarrhea

Question 40

Acute ishemic bowel disease has

Answer 40

Severe abdominal pain, nausea, vomiting, frank blood in stool 50% mortality Risk for septic or hypocalcemia shock Risks= elderly, cardiovascular disease

Question 41

What is angiodysplasia

Answer 41

Vascular lesion MC in cecum or ascending colon 20% of lower GI bleeds melena Risk increases with age Hypothesized development following constipation

Question 42

What is the MC G.I. vascular disorder

Answer 42

Hemorrhoids

Question 43

What is pruritus

Answer 43

Perinatal itching