Path-Esophagitis Flashcards Preview

Gastrointestinal > Path-Esophagitis > Flashcards

Flashcards in Path-Esophagitis Deck (44):
1

what are the histology layers of the digestive tract?

epithelium, lamina propria, muscularis mucosa, submucosa, muscularis propria (with auerbach's plexus), serosa/adventitia

2

what components of the digestive tract epithelium are stratified squamous?

esophagus, anus

3

which components of the digestive tract are connective tissue?

lamina propria, mubmucosa, serosa/adventitia

4

describe the muscle layers inside the digestive tract

two layers of muscularis propria are perpendicular to one another; skeletal muscle in top of esophagus and anus, smooth mm in between

5

auerbach's plexus is made up of _____ ganglia

parasympathetic

6

where are blood vessels found within the wall of the GI tract?

inside the connective tissue always (lamina propria, submucosa)

7

where are immune cells found within the GI tract?

scattered immune cells within the mucosa (epithelium+lamina propria) (GALT) where they can respond to antigen in the lumen

8

neoplastic disorders of the gut usually affect this layer of the GI tract

epithelium

9

infectious and inflammatory conditions of the gut start in what later of the GI tract

mucosa (epithelium + lamina propria + muscularis mucosa) because this is where inflammatory cells are

10

most bleeding comes from the ____ layer of the GI tract

submucosa

11

motility disorders are pathologic processes of the ____ layer

muscularis propria

12

pathogenesis of GI erosion

surperficial necrosis involving mucosa only; heals by regeneration without fibrosis or scar

13

pathogenesis of GI ulcer

deeper necrosis involving mucosa + deeper layers; heals with granulation tissue leading to fibrosis and scar formation

14

causes of GI stenosis

congenital, stricture (necrosis = circumferential fibrosis/scar which contracts), neoplasms

15

presentation with GI stenosis

causes obstruction of movement of lumen contents; dysphagia if esophagus

16

what nerves surround the esophagus?

vagus and recurrent laryngeal nerves

17

___ are found within the mucosa of the esophagus

mucous glands

18

the vast majority of hiatal hernias are (sliding/paraesophageal)

sliding (95%)

19

hiatal hernias are usually (congenital/acquired)

acquired

20

hiatal hernias increase likelihood of GERD due to?

development of an incompetent lower esophageal sphincter

21

name 5 categories of etiology for esophagitis

1. infectious, 2. drug/pill, 3. corrosive/chemical, 4. eosinophilic, 5. GERD

22

what is the pathogenesis of esophagitis?

etiology -> mucosal necrosis -> erosion or ulceration (+/- stricture)

23

three common sources of infectious esophagitis; who is at risk for it?

candida, CMV, herpes; immunocompromised, DM, EtOH, increased age, systemic ABX

24

esophageal candidiasis is an overgrwoth of (normal/abnormal) GI flora, which looks like?

normal; superficial white plaques "pseudomembranes" on roof of mouth and esophagus

25

esophageal candidiasis can be seen histologically with a ____ stain and looks like?

PAS stain; "spaghetti with meatballs" -- spaghetti is pseudohyphae and meatballs are budding yeast (?PMNs)

26

what is seen on gross pathology of HSV I (herpetic esophagitis)?

superficial vesicles, erosions/ulcers, plaques

27

what type of cell does HSV infect?

keratinocytes in the epithelium

28

describe the histopath of HSV

ground glass (viral material), chromatin margination, multinucleation with nuclear molding

29

gross pathology of CMV esophagitis

erosions/ulcers only

30

what cell types are infected by CMV?

lamina propria (endothelial + fibroblasts)

31

histopath of CMV

nuclear- and cyto-megaly; nuclear inclusions (classic owl eye effect)

32

histopath of pill esophagitis

localized inflammation +/- erosion/ulceration

33

chemical esophagitis is usually due to ____ in adults, and ____ in children

suicide; accidental ingestion

34

what agents can cause chemical/corrosive esophagitis?

strong alkaline agents or strong acids (cleaning products) -- lye, sulfuric acid or HCl

35

what chemical agent causes the worst chemical esophagitis?

alkaline solutions (liquid)

36

alkali cause ____ necrosis, and acids cause _____ necrosis

liquefactive; coagulative (protective eschar)

37

chemical esophagitis can be 1st, 2nd, or 3rd degree -- how deep and what are the consequences of 2nd degree?

injury to submucosa/muscularis propria leading to ulceration, granulation tissue, and fibrosis (can cause stricture)

38

what is the pathogenesis of eosinophilic esophagitis?

chronic allergic rxn -> infiltration of eosinophils in epithelium (can see on histo)

39

the gross pathology of eosinophilic esophagitis?

varies (normal, microabscesses, strictures)

40

pathogenesis of GERD

reflux of gastric contents (acid, pepsin, +/- bile) into esophagus -> chemical injury to mucosa

41

gross pathology of GERD

distal esophagus shows erythema +/- erosions/ulcers; ulcers can cause strictures

42

histopath of GERD

intraepithelial inflammation with neutrophils and eosinophils

43

long-term acid exposure from GERD causes the normal _____ epithelium of the esophagus to turn into _____ epithelium like that seen in the _____

stratified squamous; simple columnar epithelium with crypts and villi; stomach/intestine

44

eventually, Barrett's esophagus could cause?

adenocarcinoma of the esophagus