Pathoma 10.1-10.3: Gastrointestinal Pathology Flashcards Preview

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Flashcards in Pathoma 10.1-10.3: Gastrointestinal Pathology Deck (23):
1

Name the diagnosis: Full-thickness defect of lip or palate; Failure of facial prominences to close.

Cleft lip and palate They usually occur together

2

What is the diagnosis? Painful, superficial ulceration of the oral mucosa Stress-related Grayish blue base surrounded by erythema

Aphthous ulcer

3

Name the diagnosis: Recurrent aphthous ulcers Genital ulcers Uveitis Immune complex vasculitis involving small vessels

Behcet's Syndrome

4

Name the diagnosis: Primary infection usually occurs in childhood; Dormancy in trigeminal ganglia; vesicles in oral mucosa rupture and leave shallow ulcerations

HSV-1 (usually) - oral herpes Stress and sunlight can reactivate the virus

5

Name the diagnosis: Oral leukoplakia and erythroplakia are precursor lesions; Floor of mouth is common location;

Squamous cell carcinoma - malignant neoplasm of squamous cells lining oral mucosa

6

What is the difference between oral candidiasis and leukoplakia?

Oral candidiases can be scraped away easily. Leukoplakia cannot. The latter represents squamous cell dysplasia

7

What is erythroplakia?

Vascularized leukoplakia Red plaque

8

Name the disease: Bilateral inflamed parotid glands; Orchitis, pancreatitis, aseptic meningitis may also be present

Mumps *Serum amylase is increased due to salivary gland or pancreatic involvement

9

What is sialadenitis?

Inflammation of the salivary gland; Most commonly due to an obstructing stone --> staph aureus Usually unilateral

10

What is the diagnosis? Benign tumor composed of stromal (cartilage) and epithelial tissue; Most common tumor of the salivary gland; Arises in parotid; Mobile, painless, well-circumscribed mass at the angle of the jaw.

Pleomorphic adenoma rarely turns into carcinoma; high rate of recurrence (prob due to no excising enough)

11

What is the diagnosis? Benign cystic tumor with abundant lymphocytes and germinal centers; Almost always arises in the parotid

Warthin tumor 2nd most common tumor of the salivary gland

12

What is the diagnosis? Malignant tumor composed of mucinous and squamous cells; Most common malignancy of the salivary gland; Involves facial nerve; Usually arises in parotid

Mucoepidermoid Carcinoma

13

What is the diagnosis? Vomiting, polyhydraminos, abdominal distention and aspiration

Tracheoesophageal fistula Congenital defect resulting in connection between trachea and esophagues; Proximal esophageal atresia with the distal esophagus arising from the trachea - common form

14

What is the diagnosis? Thin protrusion of esophageal mucosa; Most often the upper esophagus; Dysphagia for poorly chewed food

Esophageal web Increased risk for esophageal squamous cell carcinoma

15

What is the diagnosis? Esophageal web; Beefy red tongue due to atrophic glossitis; iron-deficiency anemia

Plummer-Vinson syndrome

16

What is the most common cause of death in cirrhotics?

Rupture of esophageal varices Arise secondary to portal HTN; Left gastric vein backs up into the esophageal vein, resulting in dilation Asymptomatic until/unless rupture Presents with *painless* hematemesis

17

What is a Zenker Diverticulum?

Outpouching of pharyngeal mucosa through an acquired defect in the muscular wall; Arises above the upper esophageal sphincter (at the junction of the esophagus and the pharynx; Presents with dysphagia, obstruction, halitosis

18

What is the diagnosis? Longitudinal laceration of mucosa at the GE junction; Caused by severe vomiting (alcoholism, bulimia implicated here); *Painful* hematemesis

Mallory-Weiss syndrome risk of Boerhaave syndrome due to laceration: rupture of esophagus leading to air in the mediastinum and subcutaneous emphysema

19

Inability to relax the lower esophageal sphincter (LES) is called:

Achalasia Damaged ganglion cells in myenteric plexus; Can be idiopathic or due to Chagas disease (Trypanosoma cruzi) "Bird-beak" sign - narrowing of esophagus at sphincter, can see on barium swallow study; Presents with dysphagia, putrid breath, high LES pressure on esophageal manometry Increases risk for esophageal squamous cell carcinoma

20

Reduced lower esophageal sphincter tone is due to:

GERD Heartburn, asthma and cough, damage to enamel of teeth Late complications are Barrett esophagus and ulceration with stricture

21

What is the diagnosis? Metaplasia of lower esophageal mucosa from stratified squamous to nonciliated columnar with goblet cells

Barrett esophagus May progress to dysplasia and adenocarcinoma

22

What is the diagnosis? Arising from pre-existing Barrett esophagus; usually involves lower 1/3 of esophagus lymph node spread commonly celiac and gastric; Malignant proliferation of glands

Adenocarcinoma of the esophagus Most common esophageal carcinoma of the West

23

What is the diagnosis? Malignant proliferation of squamous cells; Usually in middle or upper third of the esophagus; Lymph node spread is cervical if upper, Mediastinal or tracheobronchial if middle; Risk factors - very hot tea, alcohol, tobacco, Plummer-Vinson syndrome, esophageal web and esophageal injury ie ingesting lye

Squamous cell carcinoma of the esophagus Most common esophageal carcinoma worldwide Presents late, poor prognosis, progressive dysphagia, weight loss, hematemesis, hoarse voice and cough

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