XV - The Oral Cavity and the GI Tract Flashcards Preview

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Flashcards in XV - The Oral Cavity and the GI Tract Deck (224)
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211

A 33 year old man with a 10 year history of intermittent heartburn undergoes endoscopy, where his lower esophagus appears salmon-pink and velvety. Biopsy of the velvety area shows an epithelium composed of columnar cells with dark basal nuclei, and interspersed goblet cells. Compared to the normal population, this man has a 30- to 100-fold greater risk of developing (A) lymphoma (B) squamous cell carcinoma (C) adenocarcinoma (D) carcinoid

adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

212

Which is the most common site of esophageal squamous cell carcinoma? (A) cervical (B) upper thoracic (C) middle third (D) distal third

middle third (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 590

213

What is the most important etiologic association of chronic gastritis? (A) Helicobacter pylori (B) Smoking (C) Alcohol abuse (D) NSAIDS

Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

214

The histologic changes in chronic gastritis may predispose to the development of (A) squamous cell carcinoma and adenocarcinoma (B) adenocarcinoma and lymphoma (C) lymphoma and gastrointestinal stromal tumour (D) gastroinstestinal stromal tumor and squamous cell carcinoma

adenocarcinoma and lymphoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.592

215

A 34 year old triathlete on chronic NSAIDs consults for chronic epigastric pain. An endoscopy showed a punched out, 2cm diameter ulcer in the duodenum, with perpendicular margins, extending into the submucosa. If a biopsy is performed, arrange the following layers from internal to external: (A) inflammation (B) necrosis (C) scar (D) granulation tissue

necrosis, inflammation, granulation tissue, scar (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

216

A 25 year old man who suffered from a scalding burn, 80% of his body surface area, is admitted. In the burn unit, coffee ground material is observed in his NGT. Which of the following describes the type of gastric ulcer expected? (A) multiple,

multiple,

217

Which of the following gastric polyps is a true neoplasm? (A) hyperplastic polyp (B) hypoplastic polyp (C) fundic gland polyp (D) adenoma

adenoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597-598

218

Which of the following is a known risk factor for the diffuse type of gastric adenocarcinoma? (A) intestinal metaplasia (B) dietary nitrites (C) E-cadherin mutation (D) Her2-neu amplification

E cadherin mutation (all other choices are risk factors for intestinal type) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598

219

Why do infants and children with Meckel diverticulum often present with melena? (A) the mucosa of the diverticulum is highly vascular (B) the diverticulum may have functioning gastric mucosa (C) patients with Meckel diverticulum have an increased likelihood of developing adenomas that can bleed (D) Meckel diverticulum is susceptible to Entamoeba histolytica infection

the diverticulum may have functioning gastric mucosa (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

220

A 3 month old female with a perinatal history of delayed passage of meconium presents with alternating diarrhea and constipation. Imaging studies show a dilated cecum, ascending and transverse colon. The remaining distal colon is not dilated. Which of the following biopsy findings confirms Hirschprung disease? (A) absence of ganglion cells in the sigmoid (B) presence of ganglion cells in the transverse colon (C) presence of ganglion cells in the cecum (D) presence of ganglion cells in the descending colon

absence of ganglion cells in the sigmoid (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

221

A 65 year old diabetic suffers an acute MI and is admitted at the ICU. The next day, he develops severe abdominal pain and melena, and dies a few hours later. Autopsy showed a dark red jejunum and ileum. Examination of one of the mesenteric artery branches shows 95% narrowing by atherosclerosis. Which of the following is the expected histologic finding of the affected bowel? (A) increased mitotic rate in mucosal crypts, decreased maturation of surface epithelial cells, variable neutrophilic infiltration (B) hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (C) tortuous mucosal and submucosal vessels (D) flask like submucosal ulcers filled with necrotic debris

hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

222

Which of the following features of intestinal adenomas is the main determinant of risk of harboring an adenocarcinoma? (A) size (B) histologic architecture (C) severity of dysplasia (D) degreee of inflammation

size (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

223

Which of the following is most likely affected by Familial Adenomatous Polyposis? (A) 44 year old female with 150-160 tubular adenomas in the colon (B) 65 year old male with 20-30 tubulovillous adenomas in the colon (C) 54 year old female with 120-130 hyperplastic polyps in the colon (D) 13 year old male with 30-40 hamartomatous polyps in the colon

44 year old female with 150-160 tubular adenomas in the colon (minimum of 100 colonic adenomas) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619

224

Carcinoids in which of the following location is least likely to have metastasized at the time of diagnosis? (A) appendix (B) ileum (C) stomach (D) colon

appendix (also, rectum) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.626