Patho Week 1 Flashcards by María Siller Rodríguez

How are esophageal congenital abnormalities discovered?

Regurgitation during feeding

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Incomplete development of esophagus

Esophageal atresia

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Difference between omphalocele and gastroschisis

Extraembryonic gut fails to return to abdominal cavity
Omphalocele: abdominal musculature (associated with birth defects)
Gastroschisis: all layers (not associated with birth defects)

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Most common site for Meckel diverticulum

Ileum

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Rule of 2s in Meckel diverticulum

2% population
2 ft from ileocecal valve
2 in long
2x more in males

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Most common cause of esophagitis

Reflux esophagitis

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Cause of reflux esophagitis

Increased lower esophageal sphincter relaxations

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Intestinal metaplasia that increases risk of adenocarcinoma

Barrett esophagus

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Morphologic characteristic of Barrett esophagus

GOBLET CELLS

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Morphologic characteristics of dysplasia (4)

Atypical mitosis
Nuclear hyperchromasia
Irregular chromatin
Increased nuclear-to-cytoplasmic ratio

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Difference between esophageal adenocarcinoma and squamous cell carcinoma

Adenocarcinoma: distal third; glandular differentiation, caucasians
Squamous carcinoma: middle third; squamous cell differentiation; african americans

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Risk factor for squamous cell carcinoma

Mursik (hot teas)
Amplification SOX2

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Difference between acute gastritis and gastropathy

Acute gastritis: neutrophils
Gastropathy: no inflammatory cells

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Morphologic characteristic of gastropathy

Foveolar cell hyperplasia: corkscrew

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Transmission of H pylori

Fecal-oral

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Most common site of H pylori gastritis

Antrum

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Risk of a gastric adenoma turning into adenocarcinoma

> 2 cm

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Types and characteristics of gastric adenocarcinoma

Intestinal: bulky mases
- has precursors, predomiates in males
Diffuse: infiltrates and thickens wall
- no precursors, equal sexes

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Morphologic characteristic of diffuse type adenocarcinoma

Signet cells (parecen círculos blancos)

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Sites of metastases in gastric adenocarcinoma

Virchow node → supraclavicular sentinel
Sister Mary Joseph’s nodule → periumbilical
Krukenberg tumor → ovaries
Left axillary lymph node
Pouch of Douglas

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Pathogenesis of gastric adenocarcinoma

CDH1: E-cadherin loss

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Markers for neuroendocrine neoplasms

Neuroendocrine: CD56, sinaptofisina, cromogranina, INSM-1

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Morphologic characteritic of neuroendocrine neoplasms

Salt and pepper nucleus

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Most common site of neuroendocrine neoplasm

Ileum

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Cell of origin of GIST

Cajal cell

4 types of intestinal obstruction

Hernias: most common Volvulus: sigmoid colon Adhesions Intussusception: <2, viral infection

Causes of ischemic bowel disease

Thrombosis (atherosclerosis) and embolism

Site of ischemic bowel disease

Colon

Pathogenesis of ischemic bowel disease

Initial hypoxic injury → at onset of vascular compromise Reperfusion injury → more damage and initiated by restoration of blood supply

Morphologic characteristic of celiac disease

Exaggerated intraepithelial lymphocytosis

Characteristics of Crohn disease

Ileum Skip lesions Aphthous ulcer: earliest lesion Granulomas: hallmark of disease Transmural damage

Characteristics of ulcerative colitis

Colon and rectum: retrograde Pancolitis: disease of entire colon Pseudopolups Limited to mucosa

Non malignant intestine polyps found in left colon that present many mature goblet cells

Hyperplastic polyps

Clinical triad of intestinal inflammatory polyps

Rectal bleeding Mucus discharge Inflammatory lesion of anterior rectal wall

Characteristics of Peutz-Jeghers syndrome

Autosomic dominant 11 years old STK11 mutation Histology: arborizing network

Most common site of intestinal adenomas

Colon

Surveillance of intestinal adenomas

At 45-50 years old but with family history 10 years before earliest family diagnosis

Classification of intestinal adenomas

Tubular: small and rounded tubular glands Villaus: larger, covered with slender villi and more common for cancer

Common site of sessile serrated adenomas

Right colon

Characteristics of familial adenomatous polyposis

Autosomic dominant +100 polyps APC mutation

Mutations in Lynch syndrome

MSH1 and MSH2

2 pathways for pathogenesis of colon adenocarcinoma

APC/B catenin: classic pathway MSI: mismatch repair genes in microsatellite regions

Most common site of metastasis in colon adenocarcinoma

Liver

Most common site of diverticulosis

Sigmoid colon

Characteristics of appendicitis

In young adults Positive McBurney sign Neutrophilic infiltrate in muscularis propria

Difference between acute and chronic pancreatitis

Acute: reversible damage, associated with alcohol and obstruction, shows saponification Chronic: irreversible damage, associated with long term alcohol consumption, presents parenchymal fibrosis

What is high on acute pancreatitis

Lipase and amylase

Environmental and genetic influence of pancreatic carcinoma

Environmental: smoking Genetic: KRAS mutation

Precursors of pancreatic carcinoma

PanIN

Most common site of pancreatic carcinoma

Head of pancreas

Reversible patterns of liver damage

Steatosis Cholestasis Ballooning Mallory denk bodies

Irreversible patterns of liver damage

Necrosis Apoptosis Cirrhosis

Hallmark of fatty liver

Balloning

Difference between alcohol liver disease and NASH

Alcohol: associated with alcohol consumption NASH: associated with metabolic sx

Amount of alcohol associated with alcohol liver disease

80g (6 beers) → mild, reversible >80 g/day → risk of severe hepatic injury >160 g/10-20 years → severe liver injury

Labs in alcohol liver disease

Serum AST higher than serum ALT levels by 2:1 ratio

Risk factors of hepatocellular adenoma

Young women, oral contraceptives, anabolic steroids, obesity & metabolic sx

Pathogenesis of hepatocellular adenoma (3)

HNF1-a-inactivated hepatocellular adenoma: mutation HNF1a gene Inflammatory hepatocellular adenoma: mutations gp130 (JAK-STAT) B-catenin activated hepatocellular adenoma: CTNNB1

Morphological characteristics of hepatocellular adenoma

Many hepatocytes without portal triads

Most common liver tumor in early childhood

Hepatoblastoma

Characteristics of hepatocellular carcinoma

Associated with HBV and HCV infection B catenin mutations Elevated serum a-fetoprotein

Types of gallstones in cholelithiasis

Cholesterol: >50% crystalline cholesterol monohydrate (yellow) Pigment stones: bilirubin and Ca salts (brown/black)

Inflammation of gallbladder

Cholecystitis

Clinical triad of inflammatory polyps

Rectal bleeding Mucus discharge Inflammatory lesion of anterior rectal wall

Associated with reflux esophagitis

GERD

Markers for GIST

CD117 (c kit) and PDGFRA

Portion of gluten that causes disease in celiac disease

Gliadin

Genetic predisposition to celiac disease

HLA-DQ2 and HLA-DQ8

Dysplastic epithelial cells breach basement membrane and invade lamina propria

Intramucosal carcinoma

Toxin used in fertilizers of Africa and Asia related to hepatocellular carcinoma

Aflatoxin

Treatment for adenocarcinoma and squamous cell carcinoma

Adenocarcinoma: Chemotherapy Squamous cell: Radiotherapy

Immunohistochemistry to differentiate adenocarcinoma from squamous cell carcinoma

P40 and P63

Immunohistochemistry to identify Mallory denk bodies

K 8/18

Patho Week 1 Flashcards

(73 cards)