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Maddy - GI II Exam I - some pharm > Path - Esophagus > Flashcards

Path - Esophagus Flashcards

(59 cards)

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1
Q

insidious (gradual) onset of dysphagia, odynophagia, or obstruction

A

esophageal squamous cell carcinoma

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2
Q

most common cause of esophagitis

A

GERD

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3
Q

where do most esophageal adenocarcinomas occur

A

distal 1/3 esophagus

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4
Q

loss of coordination of smooth muscle of inner circular layer and outer longitudinal layer

A

nutcracker esophagus

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5
Q

common causes of infectious esophagitis

A
  • Herpes simplex
  • Cytomegalovirus
  • candida/aspergillosis
  • mucormycosis (immunocompromised)
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6
Q

systemic diseases that cause secondary achalasia

A
  • chaga’s dz
  • diabetic autonomic neuropathy
  • lesions of dorsal motor nuclei
  • down’s
  • allgrove syndrome
  • HSV1
  • Sjogren’s
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7
Q

pt presents with dysphagia, pain with swallowing, progressive weight loss, hematemesis, chest pain, and vomiting

A

esophageal adenocarcinoma

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8
Q

histo: patches of red, velvety mucosa extending cephalad from the GE junction

A

barrett esophagus

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9
Q

early mutations in TP53, CDKN2A (p16/INK4a)

A

esophageal adenocarcinoma

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10
Q

SOX2 amplification

A

esophageal squamous cell carcinoma

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11
Q

repetitive, simultaneous contractions of distal esophageal smooth m. causing chest pain when swallowing cold food

A

diffuse esophageal spasm

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12
Q

what can decrease your risk fo esophageal adenocarcinoma

A
  • diet rich in fruits and vegetables

- some serotypes of H. pylori (they cause gastric atrophy leading to reduced acid secretion and reflux)

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13
Q

demographic for esophageal adenocarcinoma

A

caucasian, males (7x more than females)

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14
Q

achalasia due to destruction of esophagus myenteric plexus due to systemic dz

A

secondary achalasia

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15
Q

sx of barrett esophagus

A

heartburn, regurg, dysphagia

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16
Q

compare spread in the lymphatic network between cancers in upper esophagus, middle esophagus, and lower esophagus

A

upper 1/3: cervical LNs

middle 1/3: mediastinal, paratracheal, and tracheobrochial LNs

lower 2/3: gastric and celiac LNs

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17
Q

histo: punched out ulcers w/ viral inclusinos and rim of epithelial cells

A

HSV

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18
Q

salmon colored mucosa

A

barrett esophagus

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19
Q

high amplitude contractions of distal esophagus

A

nutcracker esophagus

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20
Q

greatest concern for barrett esophagus

A

increased risk of esophageal adenocarcinoma

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21
Q

histo: large numbers of intraepithlial eosinophils superficially

A

eosinophilic esophagitis

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22
Q

intestinal metaplasia within the esophageal squamous mucosa

A

barrett esophagus

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23
Q

decreased LES tone and increased abd pressure can cause _____

A

GERD

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24
Q

narrowing of esophageal lumen from fibrous thickening of the submucosa

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A

benign esophageal stenosis

25
compare A and B esophageal rings
A: present in distal esophagus above GE junction, covered w/ squamous mucosa B: located at the squamocolumnar junction of lower esophagus, covered w/ gastric cardia mucosa
26
will PPIs help with eosinophilic esophagitis?
nope - acid reflux is not a prominent sx
27
demographic for esophageal squamous cell carcinoma
pts older than 45, males 4:1, 8x increase in african americans - increased incidence in iran, central china, hong kong, brazil, south africa
28
transmural tearing and rupture of distal esophagus leading to mediastinitis, tachypnea, and shock
boerhaave syndrome
29
sphincter abnormality in the absence of altered contraction patterns
hypertensive lower esophageal sphincter
30
histo: basal epithelial apoptosis with mucosal atrophy and submucosal fibrosis
graft vs host disease
31
pts where diet is subconsciously altered to soft food and liquid which attributes to nutritional deficiency and weight loss
esophageal squamous cell carcinoma
32
describe venous blood flow from the GI tract
venous blood from GI tract --> portal vein in liver --> returns to the heart
33
in situ gray-white plaque in esophagus
esophageal squamous cell carcinoma
34
esophagitis associated w/ atopic dermatitis, allergic rhinitis, asthma
eosinophilic esophagitis
35
idiopathic ledge-like protrusions of mucosa that may cause obstruction
esophageal mucosal webs
36
pathogenesis of esophageal varices
portal hypertension --> development of collateral channels at sites where portal and caval systems communicate --> develops congested subepithelial and submucosal venous plexi in distal esophagus and proximal stomach (varices)
37
prognosis of esophageal varices
- 30% w/ variceal hemorrhage due | - >50% who survive first variceal bleed have recurrent hemorrhage within 1 year --> 30% mortality
38
sx of achalasia
- dysphagia - difficulty belching - chest pain
39
incomplete lower esophageal sphincter relaxation, increased lower esophageal sphincter tone, aperistalsis of esophagus
achalasia
40
achalasia due to distal esophageal ganglion cell degeneration
primary achalasia
41
normal esophageal stratified squamous epithelium that becomes columnar epithelium
barrett esophagus
42
clinical presentation of esophageal varices
clinically silent until rupture w/ catastrophic hematemesis
43
risk factors for esophageal squamous cell carcinoma
- alcohol and tobacco synergy - esophageal injury - achalasia - plummer-vinson syndrome - scalding hot beverages - tylosis
44
stratified squamous epithelium damage leading to dysphagia and pain +/- hemorrhage leading to odynophagia
chemical and infectious esophagitis
45
diverticulum immediately above upper esophageal sphincter that develops after age 50
Zenker diverticulum
46
mucosal injury due to reflux of gastric juices
GERD
47
where do most esophageal squamous cell carcinomas occur
middle 3rd of esophagus
48
histo: shallow ulceration with nuclear and cytoplasmic inclusions
CMV
49
TP53, E-cadherin, NOTCH1 loss of function
esophageal squamous cell carcinoma
50
histo: grey-white psudomembranes of hyphae and inflammatory cells
candidiasis
51
metaplastic mucosa alternating b/w smooth, pale, squamous mucosa and light-brown columnar mucosa
barrett esophagus
52
risk factors for esophageal adenocarcinoma
- tobacco use | - radiation
53
crunching sound upon auscultation of heart
boerhaave syndrome
54
most esophageal adenocarcinomas arise from _____
barrett esophagus or obesity related GERD
55
late mutatinos in EGFR, ERBB2, MET, cyclin D1, cyclin E
esophageal adenocarcinoma
56
distention of venous vessels in the esophagus
esophageal varices
57
circumferential, thick protrusions of mucosa and submucosa in the esophagus
esophageal rings (Schatzki rings)
58
budding, irregular shapes, and cellular crowding gland architecture
barrett esophagus
59
longitudinal laceration of mucosa near GE junction associated with severe vomiting secondary to alcohol intoxication
mallory-weiss tears

Maddy - GI II Exam I - some pharm (23 decks)

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