Pathoma GI

Question 1

aphatous oral ulcers, genital ulcers, uveitis

Answer 1

Becet’s

Question 2

Hairy leukoplakia

Answer 2

EBV and immunocompromised state. Not premalignant, because only hyperplastic.

Question 3

Erythroplakia

Answer 3

Vascular leukoplakia and more suggestive of dysplasia and risk of squamous cell carcinoma of oral cavity.

Question 4

What is the most common benign cancer of mouth?

Answer 4

pleomorphic adenoma

Question 5

Warthin tumor

Answer 5

Benign cystic tumor with lymph node tissue (lymphocytes and follicles)

Question 6

What are the portal caval anastomoses?

Answer 6

1) lower esophagus: L gastric to azygous.
2) rectal venous plexus: superior rectal v (IMA) to inferior rectal and anal veins (internal iliac)
3) Caput: paraumbilical veins and inferior epigastric vein.

Question 7

Where is the myenteric plexus?

Answer 7

In the muscularis propria?

Question 8

Layers of gut wall?

Answer 8

Mucosa, submucosa, muscularis propria, serosa

Question 9

Risk factors for SCC:

Answer 9

alcohol, tobacco, hot tea, Achalasia, plummer-vinson syndrome

Question 10

Lymph node spread of upper, middle, and lower thirds of esophageal SCC?

Answer 10

upper: cervical nodes.
middle: mediastinal and trancheobronchial nodes
lower: celiac and gastric nodes

Question 11

Curling ulcer?

Answer 11

Stomach ulcers caused by burns (decreased mucosa blood flow causes mucosa damage)

Question 12

Cushing ulcer?

Answer 12

Increased vagal stimulation causes increased ACh and parietal cell stimulation

Question 13

Chronic Autoimmune Gastritis?

Answer 13

Type 4 hypersensitivity reaction against parietal cells. Mostly attacks fundus and body and as a consequence there are Ab against parietal cells or intrinsic factor. Hypochloridia and G-cell hyperplasia.

Question 14

Where does Chronic H Pylori like to infect?

Answer 14

Antrum of the stomach

Question 15

What are the 3 consequences of H Pylori Gastritis?

Answer 15

1) ulceration, 2) gastric adenocarcinoma, 3) MALT lymphoma

Question 16

How should you think about gastric adenocarcinoma?

Answer 16

There are two types; Intestinal and Diffuse.

Question 17

Acanthosis nigricans

Answer 17

Gastric Adenocarcinoma, Insulin resistance

Question 18

Leser-Trelat Sign

Answer 18

(seborrheic keratosis)

Gastric Adenocarcinoma

Question 19

Sister Mary Joseph nodule

Answer 19

Metastasis of intestinal type gastric adenocarcinoma to the supraclavicular lymph node

Question 20

Krukenberg Tumor

Answer 20

Metastasis of diffuse type gastric adenocarcinoma to the bilateral ovaries

Question 21

linitis plastica

Answer 21

the desmoplastic response to diffuse type gastric adenocarcinoma

Question 22

Signet Ring cells

Answer 22

caused by the overproduction of mucous in the diffuse type of gastric adenocarcinoma

Question 23

HLA DQ2, 8

Answer 23

Celiac disease

Question 24

Dermatitis Herpetiformis

Answer 24

Celiac disease

Question 25

What should you think of if a patient with celiac is refractory to diet change?

Answer 25

small bowl carcinoma or t cell lymphoma (EATL)

Question 26

Tropical Sprue

Answer 26

Sx similar to celiac. Damage is in jejunum and ileum. Causes folic acid deficiency.

Question 27

Whipple Disease

Answer 27

Caused by tropheryma whippeli which infects MO and builds up in lamina propia of bowl (foamy MO). PAS +. Compresses lacteals so chylomicrons cannot be absorbed into the lymphatics. Fat malapsorption and steatorrhea occur. Involves arthritis, cardiac valves, and CNS.

Question 28

Carcinoid tumor marker

Answer 28

+ chromogranin

Question 29

Carcinoid heart syndrome

Answer 29

will see R sided valve fibrosis that causes TR and PS. Don't left sided because the lung has MAOIs.

Question 30

5HT and Metastasis to liver-->

Answer 30

Carcinoid syndrome.

Question 31

SAD PUCKER

Answer 31

Retroperitoneal organs: Suprarenal, Aorta (and IVC), Duodenum (2-4th parts), Pancreas (except tail), Ureters, Colon (Ascending and descending), Kidneys, Esophagus, Rectum