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Year2 GI Exam I > Path III > Flashcards

Flashcards in Path III Deck (54)
1

esophageal varices are assoc with

portal HTN
alcoholics- cirrhosis
schistosomiasis mansoni or japonicum

2

presentation esophageal varices

asymptomatic then rupture and massive hematemesis
>30% fatality

3

what do esophageal varices look like on endoscopy

varices polypoid grape-like with cherry red spots

4

lye strictures

esophagitis

5

what infectious agents can cause esophagitis

candidiadis
herpesviruses
bacterial is uncommon

6

what is reflux esoophagitis

GERD

7

what does herpes esophagitis look like

punched out leasions, ulcers
intranuclear inclusions

8

clinical features GERD

>40 y.o M>F obese>non-obese
mild and transient
heartburn, regurg, dysphagia
cough, chest pain

9

complications of GERD

esophageal ulceration
Barrett mucosa
stricture with stenosis
long-term risk of adenoca

10

most common cause gERD

loos tone of LES

11

histo of GERD

esosinophilia within squamous epithelium
elongation propria papillae and basal zone hyperplasia

12

What is NERD

non-erosive reflux disease,
no evidence of erosion
do not respond to PPIs

13

eosiniphilic esophagitis

failure high does PPI Tx in absence of acid reflux
atopic individuals

14

most important ADCA risk factor

barret esophagus, 30-40x increase if >3cm long

15

what reduces incidence ADCA in barrets esophagus

statins

16

what is a good stain for barrets esophagus

alcian blue stains the goblet cells

17

what are the benign tumors of esophagus

mesenchymal
squamous papillomas (HPV related)
inflammatory "pseudotumor"

18

malignant tumors of esophagus

adenocarcinoma, SCC
leiomyosarcoma and GI stromal tumor are less common

19

distribution of ADCA of esophagus

7M:1F
white>hispanic

20

prognosis of ADCA esophagus

<25% 5 yr survival from time of Dx

21

common place ADCA esophagus

distal third of esophagus

22

signs of ADCA esophagus

pain, dysphagia, progressive weight loss, hematemesis, chest pain, vomiting

23

histo ADCA esophagus? what stain?

holes with mucin in middle sometimes
mucicarmine stain

24

90% malignant esophageal tumors are what

SCC

25

risk factors SCC esophagus

heavy smoking and ethanol intake
>50 y.o
diet, achlasia, HPV, plummer vinson
M4:1F
blacks 8:1caucasians
fermented milk- kenya

26

prognosis SCC esophagus

5 yr survival is <10%

27

most common place SCC esophagus

mid-esophagus
strictures, dysphagia, odynophagia, obstruction

28

what does histo SCC esophagus look like

keratin pearls
no mucin

29

what are the parts of stomach and cells in each area
superior to inferior

cardia- mucous cells
fundus- parietal cells, chief cells
body
antrum- mucous cells, G cells
pylorus

30

enterochromafin like cells in stomach secrete what

histamine

31

G cells secrete?
D cells secrete?

G cells- gastrin
D cells- somatostatin

32

chief cells secrete

pepsinogen and gastric lipase

33

functions of gastrin

stimulate parietal cells and chief cells
contract LES
increase stomach motility
relax pyloric sphincter

34

describe mucosa of stomach

superficial has specialized columnar cells
deeper has gastric puts with chief and parietal cells

35

where are blood vessels, lymph and nerves in stomach

submucosa

36

describe muscularis of stomach

outer zone for peristalsis: has outer longitudinal layer and internal circular layer
3rd layer of smooth muscle that is internal and oblique to the other layers

37

describe serosa of stomach

thin zone CT
single layer mesothelial cells

38

what is acute gastritis

acute mucosal inflammatory process of transient nature, Neutrophils present with or without ulceration

39

acute hemorrhagic gastritis is assoc with what

NSAIDs like aspirin
heavy alcohol intake
heavy smoking
stress

40

Tx stress gastric ulcers

PPIs

41

stress ulcers are common in what patients

shock, burns, sepsis, severe trauma
critically ill

42

what is gastropathy

repair process assoc with chronic episodes of acute gastritis
usually chemically induced

43

how do Dx gastropathy

clinical
no signs.. sometimes pain vomtiing, maybe blood

44

what cells are numerous in histo of acute gastritis

PMNs

45

what do stress uclers look like on gross structure

black because there is digested blood (Hb) on surface

46

what is chronic gastritis

presence of chronic mucosal inflammatory changes leading to atrophy and metaplasia usually in absence of erosions

47

chronic gastritis is usually secondary to what

H pylori

48

autoimmune gastritis is at increased risk for what

gastric cancer

49

transmission H pylor

oral-fecal route

50

gastritis assoc with H pylor attacks what part of stomach and patients at increase risk for what?

antrum
increased risk duodenal ulcer

51

4 features H pylor virulence

flagella
urease- generates ammonia to elevate gastric pH
adhesins
toxins like cytotoxin assoc gene A

52

What is hallmark of ongoign ifnection with H pylor

PMNs

53

what does chronic inflammation from H pylori look like on histo

diffuse lymphocytic infiltrate and plasma cells in lamina propria
presence of lymphoid follicles= severe

54

test for H pylor

swallow urea tagged with carbon 14 and then to breath test for C14
+ means H pylori present