Pathology: Oral Cavity, Stomach Liver and Pancreas Flashcards
(26 cards)
What are Malabsorption Syndromes and how do they present?
Defective absorption of fats, vitamins, proteins, carbohydrates, electrolytes, and water
- chronic diarrhea
- fatty feces (steatorrhea)
What is Gluten-Sensitive Enteropathy (GSE) - Celiac Disease or Non-Tropical Sprue?
autoimmune enteropathy triggered when a genetically predisposed person ingests gluten-containing foods
- leads to flattened intestinal villi
What are the serologic tests for Celiac Disease
- Anti-tTG (Tissue Transglutaminase): Most sensitive/specific.
- Anti-EMA (Endomysial Antibodies)
- Anti-Gliadin Antibodies (AGA)
How is Celiac Disease multisystemic?
it affects many organs through genetic markers: HLA-DQ2, sometimes HLA-DQ8
What is the main symptom of the oral cavity in Celiacs Disease?
apthous stomatitis
What is Colitis and what are the main causes?
an inflammatory reaction causing lesions in the digestive tract
- Antibiotic associated colitis (Pseudo
membranous colitis)
- Ischemic colitis
- Idiopathic-Inflammatory bowel disease (IBD)
What is Pseudomembranous Colitis (PMC)?
toxins caused by C. difficile (usually after antibiotics) damage the mucosa, forming pseudomembranes
- layers of necrotic debris and pus on the colon lining
- “mushroom cloud”
What can long term atibiotic use cause?
Long antibiotic use → gut microbiome disrupted → overgrowth of yeast → oral candidiasis (thrush): white patches on the tongue or cheeks
What is Inflammatory Bowel Disease (IBD) and what are types of IBD?
chronic relapsing, inflammatory disorders of obscure origin
- Crohn’s Disease (CD)
- Ulcerative Colitis (UC)
What are the main causes of IBD?
- Unknown triggers (genetics, infections)
- Leads to abnormal immune reaction
- PMNs (neutrophils), cytokines cause inflammation and tissue damage
What is Ulcerative Colitis?
non-granulomatous ulcero-inflammatory disease limited to colon and affecting mucosa and sub mucosa
- extends in continuous fashion
- Starts in rectum and then extends proximally to involve whole of the colon
What is Ulcerative Colitis usually associated with?
Primary Sclerosing Cholangitis (PSC)
What are the features of Ulcerative Colitis?
Bowel appears red, friable with broad ulcers and pseudopolyps
What is Crohn’s Disease and what are its features?
Granulomatous inflammation which can affect any part of GIT from mouth to anus characterized by
- presence of non caseating granulomas
- mucosal fissuring with formation of fistulas
- thickened segments of small intestine radiographically- String sign
What are the extraintestinal manifestations of IBD?
- polyarthritis
- Ankylosing spondylitis
- Sclerosing cholangitis (UC)
What are the oral manifestations associated with IBD?
- Apthous ulcers
- Swollen gums
- Cobblestone-like lesions in the inner cheeks and lips
***more common in CD
What is the correlation between neoplasia and IBD?
- Risk of neoplasia is greater in IBD
- Dysplasia & carcinoma are positively correlated with duration of disease and amount of colonic involvement
**Neoplasia more common in UC than CD
What are Small Bowl Tumors and what is an example?
- benign tumors slightly more common than malignant, accounting for 3-6% of all GI tumors
- Hamartomatous polyps
What is Peutz-Jegher syndrome?
inherited cancer syndrome characterized by mucocutaneous melanin pigmentation and hamartomatous intestinal polyposis
- autosomal dominant germline mutation in STK11
Are Peutz-Jeghers Polyp (hamartomatous polyp) malignant?
Non-malignant per se but moderate to high lifetime (up to 93%) cumulative risk of malignancies in Peutz-Jeghers syndrome
What are the diagnostic criteria for Peutz-Jegher Syndrome?
- ≥3 PJ polyps and/or
- Any number of PJ polyps in pt with family h/o PJS
- Any number of polyps in a pt with mucocutaneous melanin pigmentation
What are Large Bowel tumors: Adenomas?
low grade benign gland-forming tumors that show dysplasia (premalignant change) and an increased risk of malignancy in large polyps (most important)
What are the three types of Large Bowel tumors: Adenomas?
- Tubular – most common, lowest cancer risk
- Villous – highest cancer risk
- Tubulovillous – mixed
What is Familial Adenomatous Polyposis (FAP)?
Autosomal dominant mutation in APC gene that predisposes to adenomatous polyps and thus invariably results in colorectal cancer
