Pathology Flashcards
(174 cards)
1
Q
Facial pain or paralysis with a salivary gland tumor usually indicates what?
A
Malignant involvement of CN VII
2
Q
Which salivary gland is most commonly affected by benign tumors?
A
Parotid gland
3
Q
Malignant tumors of salivary glands are most commonly found in what size glands?
A
Small glands
4
Q
Typical presentation of salivary gland tumors
A
Painless mass or swelling
5
Q
Most common salivary gland tumor
A
Pleomorphic adenoma
6
Q
Where are pleomorphic adenoma tumors most commonly located?
A
At angle of jaw
7
Q
What happens if pleomorphic adenoma tumor is not completely excised or ruptures?
A
Recurs
8
Q
A benign mixed tumor composed of chondromyxoid stroma and epithelium
A
Pleomorphic adenoma
9
Q
Most common malignant salivary gland tumor
A
Mucoepidermoid carcinoma
10
Q
Malignant salivary tumor that can present with facial nerve damage and has mucinous squamous components
A
Mucoepidermoid carcinoma
11
Q
Benign cystic tumor with germinal centers and lymphoid tissue that is the 2nd most common tumor of salivary glands typically found in smokers
A
Warthin tumor
12
Q
What population group is commonly affected by Warthin tumors?
A
Smokers
13
Q
Infection in someone from South America that causes achalasia
A
T cruzi infection causing Chagas disease
14
Q
What is the cause of achalasia
A
Destruction of Auerbach plexus causing esophageal dysmotility
15
Q
Presents with “bird’s beak” on barium swallow and progressive dysphagia to solids and liquids
A
Achalasia
16
Q
What neurons are affected in achalasia
A
Postganglionic inhibitory neurons
17
Q
Loss of what regulatory substances can cause achalasia
A
NO and VIP
18
Q
Transmural esophageal rupture, usually in the distal esophagus, with pneumomediastinum due to violent retching that is considered a surgical emergency
A
Boerhaave syndrome
19
Q
Typical sign of Boerhaave syndrome
A
Crepitus in neck or chest region
20
Q
Type of infiltrates seen in esophagus with esophageal rings and linear furrows on endoscopy caused by food allergens and common in atopic patients
A
Eosinophils
21
Q
Esophageal pathology caused by food allergens leading to dysphagia and food impaction and unresponsive to GERD therapy
A
Eosinophilic esophagitis
22
Q
Individual with caustic ingestion or acid reflux is at risk for what esophageal pathology
A
Esophageal strictures
23
Q
Painless dilated submucosal veins that are 2ndary to portal HTN and commonly seen in cirrhotics which may cause life-threatening hemorrhage
A
Esophageal varices
24
Q
Pill esophagitis is associated with what drugs?
A
PINT Bis: Potassium chloride Iron NSAIDs Tetracycline Bisphosphonates
25
Esophagitis caused by Candida infection will have what type of gross finding?
White pseudomembrane
26
Esophagitis caused by HSV-1 infection will have what type of gross finding?
Punched-out ulcers
27
Esophagitis caused by CMV infection will have what type of gross finding?
Linear ulcers
28
Esophagitis is commonly associated with what?
Reflux
29
Commonly presents with heartburn, regurgitation, dysphagia, cough or hoarseness
GERD
30
GERD is associated with what atopic condition?
Asthma
31
What is considered the cause of GERD
Transient decrease in LES tone
32
Partial thickness mucosal laceration at GE junction due to severe vomiting
Mallory-Weiss tear
33
Clinical presentation of Mallory-Weiss tear
Painful hematemesis in alcoholics or bulimics
34
Mallory-Weiss tear can lead to what more serious condition
Boerhaave syndrome
35
Mallory-Weiss tear is commonly misdiagnosed with what other condition
Ruptured esophageal varices
36
Presents with Dysphagia, Iron deficiency anemia, and Esophageal webs with associated glossitis and beefy red tongue
Plumber-Vinson syndrome
37
Classic triad of Plumber-Vinson syndrome
Dysphagia, Iron deficiency anemia, Esophageal webs
| Plumbers DIE
38
Part of CREST syndrome caused by esophageal smooth muscle atrophy leading to decreased LES pressure and dysmotility and acid reflux
Sclerodermal esophageal dysmotility
39
Complication of sclerodermal esophageal dysmotility
Barret esophagus, Aspiration, Strictures (BAS)
40
CREST syndrome
Calcinosis, Raynaud's, Esophageal dysmotility, Telangiectasias
41
Replacement of Nonkeratinized stratified squamous epithelium with intestinal epithelium in distal esophagus
Barret esophagus
42
Type of epithelium seen on pathology in Barret esophagus
Non-ciliated columnar intestinal epithelium with goblet cells
43
What is Barret esophagus associated with?
GERD
44
Complication of Barret esophagus
Esophageal adenocarcinoma
45
Typical presentation of esophageal cancer
Progressive dysphagia (first solids then liquids) and weight loss
46
Adenocarcinoma is seen in what part of the esophagus?
Lower 1/3
47
Risk factors for adenocarcinoma of the esophagus
GERD, Barrett esophagus, obesity, smoking, achalasia
48
Adenocarcinoma of the esophagus is more prevalent in what part of the world?
America (west)
49
Squamous cell carcinoma is seen in what part of the esophagus
Upper 2/3
50
Risk factors for squamous cell carcinoma of the esophagus
Alcohol, hot liquids, caustic strictures, smoking, achalasia
51
Plumber-Vinson syndrome is associated with what risk factor?
Alcohol
52
Type of intestinal metaplasia caused by GERD or irritation to lower esophagus
Barret esophagus
53
Lymph nodes that drain the lower 1/3 of the esophagus
Celiac and gastric nodes
54
Lymph nodes that drain the middle 1/3 of the esophagus
Mediastinal or tracheobronchial nodes
55
Lymph nodes that drain the upper 1/3 of the esophagus
Cervical lymph nodes
56
How do NSAIDs cause acute gastritis?
NSAIDs decrease PGE2 decreasing gastric mucosa protection
57
How doe burns cause acute gastritis?
Hypovolemia causes intestinal ischemia
58
Type of ulcers caused by burns in acute gastritis
Curling ulcers
59
How does brain injury cause acute gastritis?
Increased vagal stimulation increases ACh which increases acid production
60
Type of ulcers caused by brain injury in acute gastritis
Cushing ulcers
61
Complication of chronic gastritis
Gastric cancers
62
H pylori infection affects what part of the stomach
Affects antrum first then spreads to body
63
Complications seen in H pylori infection
Peptic ulcer disease and MALT lymphoma
64
Treatment for H pylori infection
PPIs, Clarithromycin, Amoxicillin or Metronidazole
65
Most common cause of chronic gastritis
H pylori infection
66
Autoantibodies to parietal cells and intrinsic factor with increased risk of pernicious anemia is seen in what type of chronic gastritis
Autoimmune gastritis
67
What causes pernicious anemia in autoimmune gastritis
Parietal cells destroyed, cannot make intrinsic factor, vitamin B12 cannot be absorbed
68
What type of lymphocytes are involved in autoimmune gastritis?
T-cell mediated damage (type IV)
69
Precancerous condition caused by hyperplasia of the gastric mucosa leading to hypertrophied rugae that look like brain gyri, excess mucus production with resultant protein loss and parietal cell atrophy with decreased acid production
Ménétrier's disease
70
Bilateral metastases to ovaries with abundant mucin-secreting, signet ring cells
Krukenberg tumor
71
Krukenberg tumor is associated with which type of cancer?
Diffuse type gastric cancer
72
Virchow node is associated with what condition?
Metastasis from stomach
73
Left supraventricular node by metastasis from stomach cancer
Virchow node
74
Subcutaneous periumbilical metastasis
Sister-Mary-Joseph nodule
75
Sister-Mary-Joseph nodule is associated with which type of cancer?
Intestinal type gastric cancer
76
Type of stomach cancer not associated with H. pylori infection
Diffuse type
77
Stomach cancer with signet ring cells and stomach wall that is grossly thickened and leathery
Diffuse type
78
Mucin-filled cells with peripheral nuclei seen in diffuse type gastric cancer and Krukenberg tumor
Signet ring cells
79
Gastric cancer associated with H. pylori infection, dietary nitrosamines, tobacco, achlorhydria and chronic gastritis
Intestinal type
80
Most common type of gastric cancer
Adenocarcinoma
81
Acute onset of multiple eruptive seborrheic keratoses common in gastric cancer
Leser-Trelat sign
82
Which type of peptic ulcer is seen most commonly with H. pylori infections?
Duodenal > Gastric ulcer
83
Which type of peptic ulcer has pain that is greater with meals and weight gain is seen?
Gastric ulcer
84
What are common causes of gastric ulcers?
H. pylori, NSAIDs
85
What are common causes of duodenal ulcers
Zollinger-Ellison syndrome
86
Which type of peptic ulcer has a greater risk of carcinoma?
Gastric ulcer
87
Type of peptic ulcer that has hypertrophy of Brunner glands on biopsy?
Duodenal ulcer
88
Type of peptic ulcer in which biopsy of margins needs to be done to rule out malignancy?
Gastric ulcer
89
Type of peptic ulcer in which weight loss is seen and pain is increased with meals?
Gastric ulcer
90
Which artery is at risk of bleeding from a ruptured gastric ulcer on the lesser curvature of the stomach?
Left gastric artery
91
What is the most common complication of peptic ulcers
Posterior hemorrhage
92
Which artery is at risk of bleeding from an ulcer on the posterior wall of duodenum?
Gastroduodenal artery
93
Which area, anterior or posterior duodenal, when ruptured, will cause free air under diaphragm with referred pain to the shoulder?
Anterior > posterior
94
What nerve, when irritated, will have referred pain to the shoulder?
Phrenic nerve
95
Celiac disease is an autoimmune-mediated intolerance to what product found in wheat products
Gliadin
96
What HLA subtypes are associated with Celiac disease?
HLA-DQ2 and HLA-DQ8
97
Which group of people are commonly affected by Celiac disease?
Northern Europeans
98
Disease seen in Celiac disease that is caused by IgA deposits on dermal papillae?
Dermatitis herpetiformis
99
What will a biopsy in Celiac disease show?
Villi atrophy and crypt hyperplasia
100
What section of the GI tract is mostly affected by Celiac disease?
Mostly distal duodenum and/or proximal jejunum
101
What is the treatment for Celiac disease?
Gluten-free diet
102
A d-xylose test that shows decreased blood and urine levels is indicative of what type of disease?
Mucosal defects or bacterial overgrowth
103
In what disease is a d-xylose test normal
Pancreatic insufficiency
104
What type of immune cells mediate Celiac disease?
T-cell mediated
105
What antibodies are seen in Celiac disease?
IgA anti-tissue transglutimase, anti-endomysial, and anti-deaminated gliadin peptide antibodies
106
What test is done to test for lactose intolerance?
Lactose hydrogen breath test
107
What level is necessary to diagnose lactose intolerance in a lactose hydrogen breath test?
> 20 ppm compared with baseline
108
What is a common finding in lactose intolerance?
Osmotic diarrhea with decreased stool pH
109
What are biopsy findings in lactose intolerance?
Normal-appearing villi
110
What vitamins are commonly deficient in pancreatic insufficiency?
Fat-soluble vitamins and vitamin B12
111
What are common findings in pancreatic insufficiency?
Decreased pH and fecal elastase
112
Type of malabsorption syndrome that is responsive to antibiotics and seen in recent visitors to tropics?
Tropical sprue
113
What vitamin deficiencies are seen in tropical sprue?
Vitamin B9 and B12
114
What area of the GI tract is commonly affected in tropical sprue?
Jejunum and ileum > duodenum
115
What is the cause of Whipple disease?
Tropheryma whipplei
116
Disease more commonly seen in older man and causes cardiac symptoms, arthralgias, and neurologic symptoms that is PAS positive and has foamy macrophages in intestinal lamina propria?
Whipple disease
117
Refractory cases of Celiac disease can lead to what complication?
Small bowel carcinoma and T-cell lymphoma
118
Which group of individuals are commonly affected with IBS?
Middle-aged women
119
What are the symptoms in IBS?
Diarrhea predominant, Constipation predominant or Mixed
120
Symptoms in change in stool frequency with increased diarrhea in middle-aged women points to what disease?
IBS
121
What is the most common cause of appendicitis in children?
Lymphoid hyperplasia
122
What is the most common cause of appendicitis in adults
Fecalith obstruction
123
What is the treatment for appendicitis
Appendectomy
124
Abdominal pain with psoas, obturator and Rovsing sings with guarding and rebound tenderness indicated what disease?
Appendicitis
125
Where is the initial pain in appendicitis usually felt?
Periumbilical
126
What disease in elderly can mimic appendicitis?
Diverticulitis
127
What pregnancy condition can mimic appendicitis?
Ectopic pregnancy
128
What test is done to exclude ectopic pregnancy in a women of child-bearing age?
B-hCG
129
What layers of the gut are found in a false or pseudo diverticulum?
Mucosa and submucosa
130
What type of diet is associated with diverticulosis?
Low-fiber diets
131
What is the most common location of diverticulum?
Mostly in sigmoid colon
132
Pain caused by diverticulitis is typically felt in what abdominal quadrant?
LLQ
133
What signs and symptoms are seen in diverticulitis?
LLQ pain, fever, leukocytosis
134
What are complications of diverticulitis?
Abscess, fistula, obstruction or perforation
135
What is a complication of fistulas seen in diverticulitis?
Colovesical fistula causing pneumaturia
136
What is a complication of obstruction seen in diverticulitis?
Inflammatory stenosis
137
What is a complication of perforation seen in diverticulitis?
Peritonitis
138
Obstruction, dysphagia and halitosis in an elderly male points to what disease?
Zenker's diverticulum
139
What type of diverticulum is Zenker's diverticulum, true or false diverticulum?
False diverticulum
140
Where is the common location of Zenker's diverticulum?
Killian triangle
141
Where is Killian's triangle located in the GI tract?
Between thyropharyngeal and cricopharyngeal parts of the inferior pharyngeal constrictor
142
What is the cause of Zenker's diverticulum?
Esophageal dysmotility
143
What is considered a true diverticulum?
Meckel diverticulum
144
What is the cause of Meckel diverticulum?
Persistence of vitelline duct
145
What is the most common congenital anomaly of the GI tract?
Meckel diverticulum
146
What are common findings in Meckel diverticulum?
RLQ pain, intussusception, volvulus or obstruction near terminal ileum with bleeding
147
Cystic dilation of the vitelline duct?
Omphalomesenteric cyst
148
What are the rule of 2's in Meckel diverticulum?
```
2 times as likely in males
2 inches long
2 feet from ileocecal valve
2% of the population
2 years of life
2 types of epithelia (gastric/pancreatic)
```
149
Congenital megacolon characterized by lack of ganglion cells/enteric nervous plexuses in distal segment of colon?
Hirschsprung disease
150
What gene mutation is associated with Hirschsprung disease?
RET mutation
151
What is the cause of Hirschsprung disease?
Failure of neural crest cell migration
152
What chromosomal trisomy is associated with Hirschsprung disease?
Down syndrome
153
What is a common finding in Hirschsprung disease?
Dilation of normal colon proximal to aganglionic segment
154
Patient presents with bilious emesis, abdominal distention, and failure to pass meconium within 48 hours points to what disease?
Hirschsprung disease
155
Where is Meckel diverticulum usually located?
Near terminal ileum
156
How is Hirschsprung disease diagnosed?
Absence of ganglionic cells on rectal suction biopsy
157
Squirt sign is a common finding in what disease?
Hirschsprung disease
158
What is the treatment for Hirschsprung disease?
Resection of aganglionic segment
159
Complication of malrotation of bowel
Volvulus or duodenal obstruction
160
What is the cause of malrotation?
Anomaly of midgut rotation during fetal development
161
What are common findings in malrotation?
Improper position of bowel and Ladd bands
162
Fibrous bands from liver to colon caused by malrotation
Ladd bands
163
Volvulus affects what area of gut in infants and children?
Midgut
164
What are of colon is affected most in elderly?
Sigmoid colon
165
Coffee bean sign on X-ray in an elderly person points to what disease?
Sigmoid volvulus
166
What is a complication of volvulus?
Obstruction and infarction of colon
167
Twisting of portion of bowel around its mesentery
Volvulus
168
Telescoping of proximal bowel segment into distal segment commonly at ileocecal junction
Intussusception
169
Who is mainly affected by intussusception?
Children
170
What are common causes of intussusception in children?
Recent viral infection
171
Mechanism of viral infection causing intussusception
Adenovirus causes Peyer path hypertrophy leading to a lead point for intussusception
172
What vaccine is associated with intussusception?
Rotavirus vaccine
173
What is the most common cause of intussusception in adults
Mass or tumor causing lead point
174
What is the most common pathologic lead point causing intussusception?
Meckel diverticulum
