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 (247):
1

Small, painful, rounded superficial erosions of the mouth, covered with a gray-white exudate and having an erythematous rim.

Aphthous ulcers (canker sores)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

2

Extremely common infection caused by herpes simplex virus type 1.

Herpetic stomatitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

3

Test used to identify HSV infection.

Tzanck test(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

4

Glassy, intranuclear acidophilic inclusion bodies. SEE SLIDE 15.1.

Herpes simplex virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580

5

Adherent white, curd-like, circumscribed plaque within the oral cavity. The pseudomembrane can be scraped off revealing an underlying granular erythematous inflammatory base.

Oral candidiasis /"thrush"(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

6

An oral lesion seen in patients with HIV. White confluent patches with "hairy" or corrugated surface with marked epithelial thickening.

Hairy leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

7

Hairy leukoplakia is caused by what infectious agent?

Epstein-Barr virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

8

A whitish, well-defined mucosal patch or plaque caused by epidermal thickening or hyperkeratosis, commonly seen in the vermillion border of the lower lip, buccal mucosa, hard and soft palates.

Leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581

9

Oral lesion showing a corrugated surface caused by excessive hyperkeratosis. Recurring and spreads insiduously, resulting in a warty-type lesion.

Verrucous leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

10

Red, velvety, granular, circumscribed lesions of the mouth with poorly defined, irregular boundaries. High malignant transformation rate.

Erythroplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

11

Most frequent site of oral cavity carcinomas.

Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

12

Pearly white to gray, circumscribed thickenings of the oral mucosa, which grows in exophytic pattern to produce a visible and palpable nodular, eventually fungating lesions.

Oral cavity carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

13

Most common lesion of the salivary glands resulting from blockage or rupture of a salivary gland duct.

Mucocele(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

14

Inflammation of the salivary glands.

Sialadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

15

Salivary and lacrimal gland inflammatory enlargement presenting as painless lesions, and dry mouth. Can be caused by sarcoidosis, leukemia, and lymphoma.

Mikulicz syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583

16

Incomplete relaxation of lower esophageal sphincter in response to swallowing.

Achalasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

17

Destruction of the myenteric plexus of the esophagus, duodenum, colon and ureter caused by a flagellate protozoa.

Chagas disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

18

Causative agent for Chagas disease.

Trypanosoma cruzi(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

19

Adult with progressive dysphagia to solids and eventually to all foods, caused by a narrowing of the lower esophagus, usually as a result of chronic inflammatory disease.

Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

20

A congenital defect which causes the esophagus to end in a blind-ended pouch.

Esophageal atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

21

Most common type of esophageal atresia.

Esophageal atresia with distal tracheoesophageal fistula(Type C)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

22

Thin membranes of normal esophageal tissue consisting of mucosa and submucosa that can partially obstruct the esophagus.

Esophageal web(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

23

Congenital esophageal webs commonly appear in which segment of the esophagus?

Middle and inferior third of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585

24

A diverticulum of the mucosa of the pharynx just above the cricopharyngeal muscle.

Zenker's diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

25

A triangular area in the pharyngeal wall where a Zenker's diverticulum may develop.

Killian's triangle(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

26

Protrusion of the stomach above the diaphragm, creating a bell-shaped dilation, bounded below by the diaphragmatic narrowing.

Sliding hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

27

Hernia wherein a portion of the stomach, usually along the greater curvature, enters the thorax through the widened space between the muscular crura.

Paraesophgeal (rolling) hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

28

Longitudinal tears along the gastroesophageal junction seen in chronic alcoholics after a bout of retching or vomiting.

Mallory-Weiss tears(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586

29

Tortuous dilated veins lying within the submucosa of the distal esophagus and proximal stomach due to increased portal pressure, usually due to cirrhosis. May cause massive hemorrhage if ruptured.

Esophageal varices(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587

30

Presence of eosinophils in the epithelial layer, basal zone hyperplasia and elongation of lamina propria papillae are histologic findings in this condition.

Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588

31

Defined as the replacement of the normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells. A complication of long-standing GERD. SEE SLIDE 15.2.

Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

32

Esophageal lesion at risk of developing adenocarcinoma:Reflux esophagitis or Barrett esophagus?

Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 589

33

Squamous cell carcinoma of the esophagus commonly occur at which segment of the esophagus?

Proximal 2/3 of the esophagusAdenocarcinoma- distal 1/3(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

34

Most common symptoms of esophageal cancer.

Dysphagia and odynophagia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

35

Mucin-producing glandular tumors of the distal esophagus showing intestinal-type features. SEE SLIDE 15.3.

Adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591

36

Presence of chronic inflammatory changes in the mucosa of the stomach eventually leading to mucosal atrophy and epithelial metaplasia.

Chronic gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

37

Most important etiologic association with chronic gastritis. A non-invasive, non-spore forming S-shaped gram negative rod.

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

38

Gastritis resulting from production of autoantibodies to the gastric gland parietal cells, leading to gland destruction and mucosal atrophy with loss of acid and intrinsic factor.

Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

39

Refers to the replacement of gastric epithelium with columnar and goblet cells of intestinal variety.

Intestinal metaplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592

40

A acute mucosal inflammatory process of the stomach, marked by mucosal edema and inflammatory infiltrate of neutrophils and chronic inflammatory cells. Regenerative replication of cells in the gastric pit is prominent.

Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

41

One of the major causes of hematemesis, especially in alcoholics.

Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

42

A breach in the mucosa that extends through the muscularis mucosae into the submucosa or deeper.

Ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

43

Breach in the epithelium of the gastrointestinal mucosa only.

Erosions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593

44

Chronic, solitary lesions that occur in any portion of the GIT exposed to the aggressive action of acidic peptic juices.

Peptic ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 594

45

Major cause of peptic ulcer disease in patients without H. pylori disease.

NSAID use(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 595

46

Histologic layers in a chronic, nonperforated, open ulcer.

From luminal surface:NecrosisInflammationGranulation tissueScar(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

47

Chief complication of peptic ulcer.

Bleeding(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

48

Increases risk of developing gastric adenocarcinoma:Acute gastritis vs. peptic ulcer disease?

Acute gastritisPUD is NOT a premalignant lesion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

49

Acute gastric ulceration which occurs in the presence of extensive burns.

Curling ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

50

Acute gastric ulceration which occurs in the presence of injury to the CNS.

Cushing ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596

51

Composed of hyperplastic gastric mucosal epithelium and an inflamed edematous stroma. A mass lesion arising from the mucosa.

Gastric polyp(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597

52

Most common site of gastric carcinoma within the stomach.

Pylorus and antrum (50-60%), along the lesser curvatureCardia (25%)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598

53

What are the two most important factors in the genesis of colonic diverticula?

Focal weakness in the colonic wall and increased intraluminal pressure(TOPNOTCH)

54

Morphologic feature of gastric carcinomas with greatest impact on prognosis.

Depth of invasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

55

Gastric carcinoma confined to the mucosa and submucosa, regardless of the presence or absence of perigastric LN metastasis.

Early gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

56

Gastric carcinoma which has extended below the submucosa into the muscular wall.

Advanced gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

57

Three macroscopic growth patterns of gastric carcinoma.

Exophytic - protrusion of mass into lumenFlat or depressed - no obvious tumor mass within the mucosaExcavated - a shallow or deeply eroded crater(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

58

Rigid and thickened stomach, secondary to extensive malignant infiltration.

Linitis plastica(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

59

Histologic classification of gastric carcinoma composed of malignant cells forming neoplastic intestinal glands resembling colonic adenocarcinoma. Associated with H. pylori induced chronic gastritis. SEE SLIDE 15.4.

Intestinal variant gastric adenocarcinoma (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 570

60

Histologic classification of gastric carcinoma composed of gastric-type mucous cells that do not form glands but permeate the mucosa and wall as "signet-ring" cells in an infiltrative growth pattern. Often evoke a desmoplastic reaction that may cause leather bottle appearance (linitis plastica). SEE SLIDE 15.5.

Diffuse variant gastric adenocarcinoma (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 570

61

A malignancy in the ovary that metastasized from a gastric adenocarcinoma.

Krukenberg tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599

62

Complete failure of development of the intestinal lumen.

Atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

63

Narrowing of the intestinal lumen with incomplete obstruction.

Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

64

Most common intestinal anomaly which results from the failure of involution of the omphalomesenteric duct, leaving a persistent blind-ended tubular protrusion as long as 5-6cm.

Meckel diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

65

A congenital defect of the periumbillical abdominal musculature that creates a membranous sac, into which intestines herniate.

Omphalocoele. SEE SLIDE 15.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

66

Extrusion of the intestines caused by lack of formation of a portion of the abdominal wall.

Gastroschisis. SEE SLIDE 15.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

67

Condition that prevents the intestines from assuming their normal intra-abdominal positions.

Malrotation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600

68

Critical lesion in the development of Hirschprung disease.

Lack of ganglion cells in the muscle wall and submucosa of the affected segment.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

69

Ischemic lesion of the intestines which extends only up to the muscularis mucosae.

Mucosal infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

70

Ischemic lesion of the intestines involving the mucosa and submucosa, sparing the muscular wall.

Mural infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

71

Ischemic lesion of the intestines involving all of the visceral layers.

Transmural infarct(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601

72

Most common cause of transmural infarction of the intestines.

Acute occlusion of a major mesenteric artery(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

73

Development of sudden abdominal pain out of proportion to the physical signs. Sometimes accomplanied by bloody diarrhea. May progress to shock and vascular collapse within hours.

Ischemic bowel injury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

74

A weakness or defect in the wall of the peritoneal cavity, which permits protrusion of a pouch-like serosa lined sac of peritoneum.

Hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 603

75

A blind pouch that communicates with the lumen of the gut. Histologically describes as small, flask-like or spherical outpouchings, usually 0.5 to 1 cm diameter.

Diverticula(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602

76

Telescoping of a proximal segment of a bowel into the immediately distal segment

Intussusception(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604

77

Refers to twisting of a loop of bowel or other structure about its base of attachment, constricting venous outflow and sometimes the arterial supply.

Volvulus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604

78

Characterized by transmural inflammation of the bowel, associated with noncaseating granulomas and fistula formation. Intestinal walls are rubbery and thick. SEE SLIDE 15.7. (+) skip lesions, creeping fat mesentery

Crohn's disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 613

79

An ulceroinflammatory disease of the colon which is limited to the mucosa and submucosa. No granulomas, no skip lesions. High risk of carcinoma development. SEE SLIDE 15.8.

Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 614

80

Small, nipple-like, hemispherical, smooth protrusions of the intestinal mucosa. Contains abundant crypts lined by well-differentiated goblet or epithelial cells, giving a SERRATED surface architecture. SEE SLIDE 15.9.

Hyperplastic polyps(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 593

81

Hamartomatous proliferations mainly of lamina propria, enclosing widely spaced, dilated cystic glands. Occur most frequently in children younger than 5 years old. SEE SLIDE 15.10.

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

82

Most common type of intestinal adenoma, which are tubular glands with slender stalks and raspberry-like heads composed pf neoplastic epithelium forming branching glands lined by tall, hyperchromatic cells.

Tubular adenomas. SEE SLIDE 15.11. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

83

Larger, more ominous intestinal epithelial polyp. Tends to occur in older persons at the rectum or rectosigmoid. Sessile, velvety and cauliflower-like mass projecting 1-3cm above the surrounding mucosa. Frondlike villiform extensions covered by dysplastic columnar epithelium.

Villous adenomas. SEE SLIDE 15.11. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618

84

Composed of broad mix of tubular and villous areas, an intermediate between tubular and villous lesions.

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

85

Uncommon autosomal dominant disorder with propensity for malignant transformation. Patients with this disease typically develop 500 to 2500 colonic adenomas that carpet the mucosal surface.

Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619

86

Uncommon hamartomatous polyps associated with melanotic mucosal and cutaneous pigmentation. SEE SLIDE 15.12. Caused by germ-line mutations in LKB1 gene.

Peutz-Jeghers syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619

87

Polypoid, exophytic masses that extend along the wall of capacious cecum and ascending colon. Symptoms of fatigue, weakness and iron deficiency anemia.

Right sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623

88

Annular, encircling lesions, "napkin-ring" constrictions of the bowel and narrowing of the lumen. Symptoms pf occult bleeding, changes in bowel habit or crampy left lower quadrant discomfort.

Left-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623

89

Tumor of the small intestines, showing spindle cells with elongated nuclei with fine chromatin and eosinophilic fibrillar cytoplasm. (+) c-KIT gene mutation. SEE SLIDE 15.13.

Gastrointestinal stromal tumors (GIST)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 628

90

Most common site of carcinoid tumors.

Small intestine(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774

91

Tumors arising from endocrine cells along the GIT. Solid, yellow-tan appearance on transection. Nmay also cause a desmoplastic reaction that may cause kinking of bowel and obstruction. Histology shows islands, trabeculae, strands, or sheets of uniform cells with scant, pink granular cytoplasm, with a stippled nucleus. SEE SLIDE 15.14.

Carcinoid tumors(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 571

92

What is the most common ectopic tissue rests seen in the esophagus?

Ectopic Gastric Mucosa seen in the upper third of the esophagus (TOPNOTCH)

93

What is the most common location of Mallory Weiss Tears?

Esophagogastric junction or in the proximal gastric (TOPNOTCH)

94

Definitive diagnosis of Barret Esophagus is made when what type of cells is seen in the columnar mucosa?

Intestinal Goblet Cells(TOPNOTCH)

95

What type of esophagitis presents with linear ulcerations of the esophageal mucosa with histologic findings of intranuclear and cytoplasmic inclusions?

CMV esophagitis. SEE SLIDE 15.15. (TOPNOTCH)

96

98% of Peptic Ulcers are located in what part of the GIT?

First portion of the anterior part of the duodenum(TOPNOTCH)

97

What is the most common location of gastric ulcer?

Lesser curvature (TOPNOTCH)

98

What is the most common location of gastric carcinoma is?

Pylorus and antrum > Cardia > body and fundus(TOPNOTCH)

99

What is the morphologic feature of gastric carcinoma that has the greatest impact on the clinical outcome?

Depth of invasion(TOPNOTCH)

100

What is the most common primary source of gastric metastasis?

Systemic lymphoma(TOPNOTCH)

101

What is the usual organism that cause spontaneous bacterial peritonitis in patients with nephrotic syndrome?

E. coli(TOPNOTCH)

102

In bacterial peritonitis, approximately how many hours from the time of initiation before there is loss of the gray, glistening quality of the peritoneal surface and it becomes dull and lusterless?

2-4 hours(TOPNOTCH)

103

What is the histologic criterion for the diagnosis of acute appendicitis?

Presence of neutrophilic infiltration of the muscularis propria.(TOPNOTCH)

104

What is the most important prognostic indicator of colorectal carcinoma?

The extent of the tumor at the time of diagnosis or the stage(TOPNOTCH)

105

These structures represent islands of inflamed regenerating mucosa surrounded by ulceration

Inflammatory or pseudopolyps(TOPNOTCH)

106

Most adenomas are seen in what part of the GIT?

Ampulla of Vater(TOPNOTCH)

107

Most tubular adenomas are found in what part of the GIT?

Colon(TOPNOTCH)

108

Morphology: thin wall composed of flattened or atrophic mucosa, compressed submucosa, and attenuated or totally absent muscularis propria.

Colonic diverticula(TOPNOTCH)

109

What is the most common site of angiodysplasia?

Cecum(TOPNOTCH)

110

Morphology: these are tortuous dilations of submucosal and mucosal blood vessels

Angiodysplasia(TOPNOTCH)

111

What area of the GIT is at greatest risk of ischemic injury?

Splenic flexure(TOPNOTCH)

112

Morphology: diffuse active inflammation with crypt abscess and glandular architectural distortion

Ulcerative Colitis(TOPNOTCH)

113

What is the earliest lesion seen in Crohn Disease?

Focal neutrophilic infiltration into the epithelial layer, particularly overlying mucosal lymphoid aggregates(TOPNOTCH)

114

What is the hallmark of inflammatory bowel disease, both CD and UC?

Chronic mucosal damage(TOPNOTCH)

115

Gross morphology: narrowing of lumen, bowel wall thickening, serosal extension of mesenteric fat, and linear ulceration of the mucosal surface

Crohn disease(TOPNOTCH)

116

What are the two key pathogenic abnormalities seen in Idiopathic Inflammatory Bowel disease?

Strong immune response against normal flora and defects in epithelial barrier function(TOPNOTCH)

117

Gross morphology: intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis and hypertrophy of the muscularis propria

Crohn disease(TOPNOTCH)

118

Morphology: Small intestinal mucosa laden with distended macrophages in the lamina propria which are PAS positive and contains numerous bacilli and diastase resistant granules. SEE SLIDE 15.16.

Whipple disease(TOPNOTCH)

119

Intestinal lipodystrophy is associated with what disease entity?

Whipple disase(TOPNOTCH)

120

Disease associated with GLUTEN intake, often affects second portion of duodenum or proximal jejunum. There is increased lymphocytosis and diffuse severe atrophy and blunting of villi.

Celiac disease. SEE SLIDE 15.17. (TOPNOTCH) Robbins Basic Pathology, 9th ed. P 578.

121

Morphology: focal crypt cell necrosis or apoptosis with minimal to absent inflammatory cell response in the lamina propria

Acute GVHD(TOPNOTCH)

122

Morphology: Marked blunting of the small intestinal villi with a mixed inflammatory infiltrate resembling the atrophic stage of celiac disease

Giardiasis(TOPNOTCH)

123

Morphology: Superficial erosion of the mucosa and an adherent pseudomembrane of fibrin, mucus, and inflammatory debris. SEE SLIDE 15.18.

Pseudomembranous colitis(TOPNOTCH)

124

Morphology: Small intestinal mucosa usually exhibits modestly shortened villi and infiltration of the lamina propria by lymphocytes

Viral gastroenteritis(TOPNOTCH)

125

What virus affecting the GIT can produce a flat mucosa resembling celiac sprue?

Rotavirus(TOPNOTCH)

126

Morphology: Characterized by the absence of ganglion cells and ganglia in the muscle wall and submucosa of the affected segment

Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)

127

Stercoral ulcers are seen in what disease entity?

Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)

128

The majority of these tumors are positive for c-KIT (CD 117)

Gastrointestinal Stromal Tumor(TOPNOTCH)

129

What is the most common site of gastric carcinoma?

Pylorus and antrum 50%-60%(TOPNOTCH)

130

What is the most favored site of gastric carcinoma?

Lesser curvature of the anthropyloric region(TOPNOTCH)

131

What is the most common type of gastric polyp?

Hyperplastic polyp(TOPNOTCH)

132

In gastritis, histologically, what signifies an active inflammation?

Presence of neutrophils above the basement membrane.(TOPNOTCH)

133

H. pylori infection in duodenal ulcers is present in about how many percent of patients?

Virtually ALL (70% in patients with gastric ulcer(TOPNOTCH)

134

A 10 y/o male presented with recurrent painless rectal bleeding with no other associated symptoms. PE findings were unremarkable. The abdomen was soft, non tender, with no palpable mass. What is the clinical impression?

Meckel Diverticulum (TOPNOTCH)

135

Most common site of Meckel Diverticulum

Antimesenteric border of ileum (TOPNOTCH)

136

True or False. Meckel diverticulum is a true diverticulum

True (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

137

Most common site of acquired diverticula.

Sigmoid colon (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

138

The most common true diverticulum

Meckel Diverticulum (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

139

A 3 week old male infant presented to the ER due to vomiting. Mother denies bilious or bloody emesis. Mother states he is always hungry and vomits after nearly every bottle. PE reveals firm, ovoid, 2 cm abdominal mass. What is the most likely diagnosis?

Pyloric stenosis (TOPNTOCH)

140

Pathology of Pyloric stenosis

Hyperplasia of pyloric muscularis propria (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

141

Pyloric is more common in male or female?

3-5x more common in male (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751

142

A 3-day-old infant presented with emesis and failure to pass meconium for the first 36 hours. PE revealed a moderately distended abdomen. Bowel sound are active. No organs or abdominal masses were palpated. Anus was patent. What is the clinical impression?

Hirchsprung's Disease (TOPNOTCH)

143

Most important diagnostic test in Hirchsprung Disease

Rectal biopsy (TOPNOTCH)

144

Histologic findings in Hirchsprung Disease

Absence of ganglion cells in the submucosal and myenteric plexuses.(and hypertrophic extrinsic nerve fibers) (TOPNOTCH)

145

Typically presentes with failure to pass mecondium in the immediate postnatal period, followed by obstruction or constipation, often with visible ineffective peristalsis, progressing to abdominal distention and bilious vomiting.

Hirchsprung's Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752

146

Most frequent site of ectopic gastric mucosa

Upper third of esophagus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 750

147

Aganglionic segment of the colon presents with distention or contracted appearance?

Grossly normal or contracted appearance. Normal proximal colon-dilated. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752

148

Dysphagia, regurgitation of undigested food, aspiration, and halitosis strongly suggest diagnosis of ______.

Zenker diverticulum (TOPNOTCH)

149

It is characterized by the triad of incomplete LES relaxation, increased LES tone, and aperistalsis of the esophagus

Achalasia(TOPNOTCH) Robbins Basic Pathology, 9th ed., p.753

150

Patient presented with dysphagia for both solid and liquid, difficulty in belching, and chest pain. The esophageal obstruction is most likely caused by?

Impaired smooth muscle relaxation of LES (Case of Achalasia) (TOPNOTCH)

151

It is the result of distal esophageal inhibitory neuronal/ganglion cell degeneration.

Primary achalasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 753

152

Characterized by transmural tearing and rupture of the distal esophagus. Patients present with severe chest pain, tachypnea and shock.

Boerhaave syndrome. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 754

153

Most frequent cause of esophagitis

Reflux of gastric contents in the lower esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755

154

Most common cause of gastroesophageal reflux

Transient lower esophageal sphincter relaxation. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755

155

Severe form of this condition may have histologic finding of eosinophils recruited into the squamous mucosa followed by neutrophils. Basal zone hyperplasia and elongation of lamina propria papillae of the esophagus may be present.

GERD (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 561

156

Barrett esophagus confers an increased risk of what cancer?

Esophageal adenocarcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 757

157

A 55 y/o patient with a chronic history of heartburn and acid regurgitation underwent EGD, and revealed patches of red, velvety mucosa with interface of light-brown columnar epithelium with goblet cells. He is at risk for developing___.

Esophageal adenocarcinoma. This is a case of Barret esophagus. (TOPNOTCH)

158

Patient presented with odynophagia, dysphagia, progressive weight loss, chest pain and vomiting. A 5 cm mass was noted at the distal 3rd of the esophagus, which ulcerate and invade deeply. The most likely diagnosis is

Esophageal adenocarcinoma. It usually occurs in the distal 3rd of esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 758

159

Most common site of volvulus

Sigmoid colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778

160

Most common cause of intestinal obstruction in children younger than 2 years of age

Intussusception(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778

161

Presents with sudden onset of cramping, left lower abdominal pain, a desire to defecate, and passage of blood or bloody diarrhea.

Acute colonic ischemia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780

162

Most common acquired GI emergency of neonates, particularly those who are premature or of low birth weight.

Necrotizing enterocolitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780

163

Immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed individual

Celiac disease/Celiac sprue/Gluten-sensitive enteropathy(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 782

164

Most sensitive test for Celiac sprue

IgA antibodies against tissue transglutaminase(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 783

165

Most common bacterial enteric pathogen; an important cause of traveler's diarrhea

Campylobacter jejuni(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786

166

Watery diarrhea associated with ingestion of improperly cooked chicken, unpasteurized milk or contaminated water. It is an important bacterial cause of food poisoning.

Campylobacter enterocolitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786

167

Diagnosis of Campylobacter enterocolitis, stool culture or biopsy?

Stool culture(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 787

168

Presents with 1 week of diarrhea, fever, and abdominal pain, constitutional symptoms for about 1 month. May also present with waxing and waning diarrhea. Caused by gram-negative, facultative anaerobe.

Shigellosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 787

169

Complications of Shigella infection(Triad)

Sterile reactive arthritis, urethritis, and conjunctivitis.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 788

170

Infection by a gram-negative bacilli causing diarrhea, common in young children and older adults by ingestion of contaminated food, particularly raw or undercooked meat, poultry, eggs, and milk.

Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789

171

Patients with sickle cell disease are particularly susceptible to osteomyelitis caused by:

Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789

172

The principal cause of traveler's diarrhea

Enterotoxigenic E. Coli(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 790

173

Mechanism of diarrhea in this infection : adenylate cyclase activation, increase intracellular cAMP, opens CFTR to drive chloride secretion and diarrhea.

Cholera(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 785

174

Most common etiologic agent causing pseudomembranous colitis/antibiotic-associated colitis.

Clostridium difficile(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 791

175

Most frequent complication of Peptic ulcer disease

Bleeding(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768

176

Most frequent etiology of noninfectious chronic gastritis

Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768

177

Characterized by irregular enlargement of gastric rugae associated with excessive secretion of TFG-alpha.

Menetrier disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 768

178

Syndrome most commonly found in the small intestine or pancreas, caused by gastrin-secreting tumors; most remarkable feature is doubling of oxyntic mucosal thickness

Zollinger-Ellison Syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 769

179

Most common site of gastric adenoma in the stomach

Antrum(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 770

180

Most common malignancy of the stomach

Adenocarcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 771

181

Most common type of cancer the predominates in high-risk areas and develops from flat dysplasia and adenomas

Intestinal-type gastric cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 772

182

Most common site of extranodal lymphoma

Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773

183

Most common inducer of MALToma in the stomach

H. pylori(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773

184

GI Tumor characterized by cutaneous flushing, sweating, bronchospasm, colicky abdominal pain, diarrhea, and right-sided cardiac valvular fibrosis.

Carcinoid tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774

185

The most common mesenchymal tumor of the abdomen

GI stromal tumor(GIST) tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775

186

The most important prognostic factor for GI Carcinoid tumor

Location(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775

187

Most common site of GIST

Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777

188

Most frequent cause of intestinal obstruction

Hernias(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777

189

Most common sites of ischemic bowel disease

Splenic flexure, sigmoid colon, rectum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 784

190

Autosomal recessive disorder presenting with explosive diarrhea with watery, frothy stools, and abdominal distention.

Congenital lactase (disaccharidase) deficiency(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 784

191

IBD presenting with thick wall appearance, transmural inflammation, skip lesions, knife-like ulcer, marked fibrosis and serositis

Crohn disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., . 797

192

IBD which may presents with thin wall appearance, inflammation limited only to mucosa, marked pseudopolyps, broad-based ulcer, moderate lymphoid reaction, and toxic megacolon (complication)

Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 797

193

Most important characteristic of colorectal adenomas that correlates with risk of malignancy.

Size of the tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 808

194

An autosomal dominant disorder in which patients develop numerous colorectal adenomas as teenager caused by mutation of APC

Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 809

195

Most common syndromic form of colon cancer; colon cancers tend to occur at younger ages

HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809

196

Most common location of HNPCC

Right colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 809

197

Autosomal dominant disorder characterized by familial clustering of cancers at several sites caused by DNA mismatch repair

HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809

198

Location of colorectal cancer presenting with fatigue and weakness due to iron deficiency anemia

Right-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623

199

Most common site of metastasis of colorectal adenocarcinoma

Liver(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 813

200

Which of the following statements regarding oral plaques is TRUE? (A) leukoplakia has a strong association with tobacco use (B) among the oral leukoplakias, those on the floor of the mouth have the highest rate of transformation to squamous cell carcinoma (C) hairy leukoplakia in AIDS patients have a high risk of malignant transformation (D) erythroplakia is less likely to undergo malignant transformation than leukoplakia

leukoplakia has a strong association with tobacco use (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 581-82

201

Which of the following is the most common site of oral cavity carcinoma? (A) lateral orders of the mobile tongue (B) floor of mouth (C) vermilion border of the lateral margins of the lower lip (D) hard palate

Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582

202

A 28 year old man presents with a 5 year history of a slow growing, painless, preauricular mass. FNAB showed clusters of bland cells admixed with myxoid material. He undergoes parotidectomy, and histopathologic examination of the mass shows bland epithelial cells forming clusters, ducts, and sheets, with surrounding myxoid stroma. SEE SLIDE 15.19. There are also islands of cartilage. His tumor (A) can metastasize (B) is a chondrosarcoma (C) is the commonest tumor of the parotid gland (D) does not undergo malignant transformation

is the commonest tumor of the parotid gland (pleomorphic adenoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 584

203

A 55 year old male smoker undergoes parotidectomy for a cystic mass. Histopathology shows cystic spaces lined by abranching, two-tiered layer of epithelial cells, with well developed lymphoid tissue right beneath the lining. SEE SLIDE 15.20. This tumor is thought to arise from (A) respiratory epithelium (B) heterotopic salivary tissue trapped within a lymph node (C) myoepithelial cells (D) macrophages

Heterotopic salivary tissue in a lymph node (Warthin tumor) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585.

204

A 60 year old chronic alcoholic man suddenly has massive hematemesis and dies. At autopsy, his lower esophagus shows bluish, dilated veins in the submucosa with surrounding erythema. One of the veins is ruptured. Which of the following is expected of his liver? (A) smaller than normal, firm, with nodular external surface (B) markedly enlarged, with multiple hemorrhages on cut section (C) smaller than normal, with a nutmeg appearance on cut section (D) markedly enlarged, with a greasy yellowish cut surface

Smaller than normal, firm, with a nodular external surface (cirrhosis) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587

205

A 24 year old female complains of heartburn, usually following spicy or sour meals. She takes antacids, with partial relief. She undergoes endoscopy where her lower esophagus appears diffusely erythematous with some epithelial erosions. A biopsy showed eosinophils in the epithelial layer, with basal zone hyperplasia. This is (A) reflux esophagitis (B) Barrett esophagus (C) esophageal candidiasis (D) squamous cell carcinoma

Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588

206

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

207

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

208

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

209

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

210

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

211

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,

212

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

213

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

214

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

215

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

216

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

217

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

218

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

219

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

220

Four features liked to H. pylori virulence

1) Flagella; 2) Urease (raises pH around bacterium); 3) Adhesins; 4) Toxins (involved in ulcer or cancer development) (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.566

221

Which part of the stomach do you biopsy for evaluation of H. pylori gastritis?

Antrum (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

222

INCREASED or DECREASED: Gastrin in H. pylori infection

Decreased (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

223

INCREASED or DECREASED: Gastrin in autoimmune gastritis

Increased (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

224

Characterized by diffuse damage of oxyntic mucosa within BODY and FUNDUS. In contrast with H. pylori gastritis, the inflammatory reaction is DEEP and centered on gastric glands. There is parietal and chief cell loss.

Autoimmune gastritis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567

225

Round to oval, sharply punched-out defect, with a smooth and clean base with rich granulation tissue.

Classic peptic ulcer(TOPNOTCH)Robbins Basic Pathology, 9th Ed p.568

226

Antibodies typically present in autoimmune gastritis

Anti-parietal cell and anti-intrinsic factor antibodies. (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.569

227

Two infectious agents linked to development of gastric cancer

H. pylori and EBV (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.570

228

Related mutation to GIST

Tyrosine kinase c-KIT (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.572

229

During embryogenesis, failure of ______ to migrate from cecum to recum causes Hirchsprung disease.

Neural crest cells (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.574

230

Mutation associated with Hirschsprung disease

Tyrosine kinase RET loss of function mutation (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.574

231

Can present as atrophy or sloughing of surface epithelium with hyperproliferative crypts. Inflammation initially absent, but neutrophils can be recruited within hours of reperfusion. Bacterial superinfection of the lesion may also lead to pseudomembrane formation that resembles C.diff colitis.

Acute intestinal ischemia (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.575

232

OSMOTIC or SECRETORY diarrhea: Cholera

Secretory (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.582

233

CROHN DISEASE or ULCERATIVE COLITIS: Skip lesion and can occur anywhere in the GI tract

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

234

CROHN DISEASE or ULCERATIVE COLITIS: Thin bowel wall appearance with broad-based ulcers, with normal parts looking like pseudopolyps. At risk to develop toxic megacolon.

Ulcerative Colitis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

235

CROHN DISEASE or ULCERATIVE COLITIS: At risk to develop fistulas, malabsorption, and recurrence after surgery

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

236

CROHN DISEASE or ULCERATIVE COLITIS: Transmural inflammation with deep, knife-like ulcers with crypt abscesses. Leads to cobblestone appearance.

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

237

CROHN DISEASE or ULCERATIVE COLITIS: Presence of NONCASEATING GRANULOMAS in 35%

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

238

CROHN DISEASE or ULCERATIVE COLITIS: Risk for colon cancer

Both, especially if with colonic involvement in CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

239

Common site of involvement in Crohn disease

Terminal ileum, ileocecal valve, cecal area (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.589

240

CROHN DISEASE or ULCERATIVE COLITIS: Metaplastic changes, such as psudopyloric metaplasia (gastric antral-appearing glands) and Paneth cell metaplasia (in the left colon where Paneth cells are normally absent)

CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.590

241

CROHN DISEASE or ULCERATIVE COLITIS: Typically just involves the colon but can involve the distal ileum (backwash ileitis)

Ulcerative Colitis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587

242

SYNDROME: Hamaromatous polyp + Facial angifibroma + renal angiomyolipoma + cortical tubers

Tuberous sclerosis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.593

243

SYNDROME: Hamaromatous polyp + Nail atrophy + Hair loss + Cachexia + Anemia + Abnormal skin pigmentation

Cronkhite-Canada Syndrome (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.593

244

How does one differentiate a hyperplastic polyp (no malignant potential) to a sessile serrated adenoma?

Both serrated, but hyperplastic polyps occur more on the left colon. Sessile serrated often on the right. Also, sessile serrated is fully serrated including the crypt base, with crypt dilation and lateral growth. (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.594

245

Initial mutation in the classic adenoma-carcinoma sequence which acounts for 80% of sporadic colon tumors

APC tumor suppressor gene inactivation (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597

246

Typical appearance of proximal colon adenocarcinoma

Polypod, exophytic (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597

247

Typical appearance of distal colon adenocarcinoma

Annular that produce napkin ring constrictions and cause obstruction (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597