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112 Cards in this Set
- Front
- Back
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most common location of ectopic thyroid tissue
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foramen cecum
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most common branchial remnant
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from the second branchial cleft (>90%)
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found in the anterior-lateral neck, lined with nonkeratinizing squamous epithelium, respiratory epithelium, and lymphoid tissue in wall
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branchial cleft cyst
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found in the midline neck, lined with nonkeratinizing squamous epithelium, respiratory epithelium, and ectopic thyroid tissue
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thryoglossal duct cyst
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is thryoid tissue found in branchial cleft cyst
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No
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results from traumatic disruption of minor salivary gland duct with escape of mucus into the CT stroma
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mucocele
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DDX of gingival hyperplasia
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dilantin
AML gingivitis |
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most common benign tumor or oral cavity, associated with HPV infection
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squamous papilloma
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red/purple, lobulated, polypoid mass of capillaries and inflammed granulation tissue involving the oral cavity found in pregnant women
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pyogenic granuloma
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most common benign oral salivary gland tumor
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pleomorphic adenoma (mixed tumor)
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causes of leukoplakia
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tobacco
alcohol local irritation - dentures |
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most common malignant tumor of oral mucosa
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squamous cell carcinoma
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two most common places for SCC in the oral cavity
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1. tongue
2. floor of mouth |
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describe a well-differentiated SCC
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atypical squamous cells with prominent keratin formation in the form of keratin pearls and whorls
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which site of SCC in the oral cavity has the worst prognosis
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tongue: most common and worst
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unilateral nasal polyp
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ominous sign: most likely malignancy
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nasal cavity mucosal erosion accompanied by necrosis, vasculitis, and multinucleated giant cells. Elevated ANCA
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Wegener's granulomatosis
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causes of nasal/paranasal malignant neoplasms
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industrial chemicals: nickel, chromium, aramatic hydrocarbons
woodworking in furniture industry |
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necrotizing, ulcerated mucosal lesions of the upper respiratory tract with overlying black crust that is associated with EBV
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nasal-type angiocentric NK/T cell lymphoma
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where does a SCC tend to be less differentiated and more biologically aggressive metastasizing early due to rich regional lymphatics
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nasopharynx
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undifferentiated SCC associated with EBV and southeast asia
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nasopharyngeal carcinoma
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squamous papillomatosis
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multiple papillomas found in children and adolescents and may extend inferiorly to trachea and bronchi. caused by HPV 6/11
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caused by HPV 6/11 and may cause life-threatening respiratory obstruction in children
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squamous papillomatosis
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almost all laryngeal cancers are of what type
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SCC - male smoker
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differentiate glottic and supraglottic carcinoma
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glottic - true vocal cords, slow to metastasize
supraglottic - false cords or epiglottis, metastasize much earlier |
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chronic inflammation of the salivary and lacrimal glands
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Sjogren syndrome
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benign neoplasm of the salivary gland characterized by admixture of epithelial and stromal elements
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pleomorphic adenoma (mixed tumor)
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most common site of a pleomorphic adenoma (mixed tumor)
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superficial lobe of parotid
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benign parotid gland neoplasm composed of cystic glandular spaces embedded in dense lymphoid stroma
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warthin's tumor (adenolymphoma)
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malignant salivary gland neoplasm composed of a mixture of neoplastic epidermoid/squamoid cells, mucus cells, and glandular cells
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mucoepidermoid carcinoma
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what makes a mucoepidermoid carcinoma higher grade
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more squamoid cells with less mucus cells and cystic spaces
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salivary gland malignancy notorious for its tendency to invade locally, especially infiltrating nerves
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adenoid cystic carcinoma
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epithelium of the esophagus
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non-keratinizing stratified squamous epithelium
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distinguish muscle in proximal vs. distal esophagus
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proximal (2/3) - smooth and skeletal muscle
distal (1/3) - only smooth muscle |
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hamatemesis
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vomiting blood
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Sliding hiatal hernia
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most common type of hiatal hernia in which the gastric cardia follows the esophagus up into the thorax
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most common cause of esophagitis
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chronic regurgitation of gastric contents into the lower esophagus
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what is GERD associated with
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alcohol
smoking CNS depressants pregnancy |
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what type of inflammatory cells are seen in GERD
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eosinophils
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complications of GERD
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ulceration - with potential perforation
strictures - due to contraction of healed ulcers Barrett's esophagus |
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replacement of squamous mucosa of esophagus by columnar, goblet cells
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Barrett's esophagus
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what does Barrett's esophagus have increased risk of
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the intestinal metaplasia turning to dysplasia and adenocarcinoma
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associated with patches of glandular mucosa in lower 1/3 of esophagus
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Barrett's esophagus
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type of esophageal cancer associated with alcohol, cigarettes, nitrosamines, iron deficiency anemia (Plummer-Vinson syndrome), and achalasia
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Squamous cell carcinoma
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most common of esophageal cancers
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Adenocarcinoma
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What are basically all esophageal adenocarcinomas associated with
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Barrett's esophagus - but only few Barrett's become adenocarcinoma
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Plummer Vinson syndrome triad
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cervical esophageal web
oral mucosal lesions iron deficiency |
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associated with increased risk of cervical esophageal carcinoma
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Plummer Vinson syndrome
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Mucosal ring at the squamo-columnar GastroEsophageal junction associated with hiatal hernia
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Schatzki Ring - very common
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most common type of tracheoesophageal fistula
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atrea with the upper segment of esophagus with lower segment communicating with the trachea
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complication of most common TE fistula
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aspiration of food
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failure of lower esophageal sphincter to relax due to absent ganglion cells
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Achalasia
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causes of achalasia
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autoantibodies against ganglion cells of myenteric plexus
Chaga's Disease - trypanosoma cruzi peripheral neuropathy associated with another disease |
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complication of achalasia
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nocturnal regurgitation and aspiration
increased risk of SCC of esophagus |
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causes of laceration/perforation of esophagus
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prolonged vomiting
-alcoholism - Mallory-Weiss Syndrome -after excessive meals - Boerhaave Syndrome Trauma Medical instrumentation |
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Mallory-Weiss Syndrome
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Laceration at GastroEsophageal junction due to excessive vomiting associated with alcoholism
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false esophageal diverticulum in which the mucosa herniates through a weak spot in the muscles of the hypopharynx,
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Zenkers Diverticulum
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true diverticulum of the esophagus occurring in the mid-esophagus, does not retain food
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Traction Diverticulum
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two organism associated causes of esophagitis without reflux
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Candida - yeast with pseudohyphae
Herpes (simplex, CMV) - intranuclear inclusion in epithelial cells **both are immunocompromised |
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esophagitis associated with allergies, especially asthma
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eosinophilic esophagitis
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dilated submucosal esophageal veins in the lower third of the esophagus associated with cirrhosis of the liver
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Esophageal varices
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cells associated with gastric glands
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chief and parietal cells
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where are gastric and mucous glands located in the stomach
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gastric - body and fundus
mucous - antrum |
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focal necrosis of gastric mucosa in an otherwise normal stomach
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Acute erosive gastropathy
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Causes of acute erosive gastropathy
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aspirin and other NSAIDS
severe burns - Curling ulcers CNS trauma - Cushing ulcers |
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Pathogenesis of acute erosive gastropathy
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loss of protective mechanism: decreased mucus production and prostaglandin deficiency via NSAIDS
ischemia in shock or trauma |
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complication of acute erosive gastropathy
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massive bleeding
iron deficiency anemia |
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Type A chronic gastritis - autoimmune
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Antibodies to parietal cells and intrinsic factor
superficial inflammation - lymphocytes Loss of gastric glands (body and fundus) leads to atrophy increased G-cell hyperplasia - increased serum gastrin levels intestinal metaplasia - goblet cells |
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associated with pernicious anemia, goblet cells, and increased serum gastrin levels
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type A chronic gastritis
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most common type of chronic gastritis
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Helicobacter assocaited - type B chronic gastritis
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involves inflammation of the antrum of the stomach via neutrophils and lymphocytes
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Helicobacter associated gastritis
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type A and B chronic gastritis
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type B progresses from the antrum to involving the body as well
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chronic gastritis that produces atrophy and metaplasia is associated with
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increased risk of gastric carcinoma
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chronic localized loss of mucosa due to gastric secretions
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peptic ulcer disease
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most common sites of PUD
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proximal duodenum
less curvature of antrum |
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Are peptic ulcers deeply penetrating
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Yes, penetrate into muscular wall and can erode blood vessels or perforate
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clinical characteristics of peptic ulcer disease
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pain relieved by food - duodenal
pain occurring with meal - gastric nocturnal pain |
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most common location of perforation caused by peptic ulcer
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anterior wall of duodenum
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pneumoperitoneum
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air seen under the diaphragm on CXR while patient is sitting upright
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Causes of peptic ulcers
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H. pylori infection- majority
NSAIDs Smoking Hydrochloric acid secretion |
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virulence factors associated with H. pylori
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CagA damage epithelium
urease attract neutrophils enzymes break down protective mucus |
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Decrease prostaglandin production
Decrease mucus production increase HCL |
Aspirin and other NSAIDs
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gastrinoma associated with pancreatic islet cell tumor that causes hyperplasia of gastric fundic glands
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Zollinger-Ellison Syndrome
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Are most gastrinomas malignant
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Yes
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Too much mucus secretion causing giant mucosal folds and low acid production, hypoproteinemia
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Menetrier's Disease
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Trichobezoar
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bezoar composed of hair - usually distrubed or nervous women
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Phytobezoar
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bezoar composed of plant fibers - delayed gastric emptying
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associated with obstruction or bleeding ulcer due to foreign body in the stomach
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phytobezoar - persimmon eating especially associated with bleeding ulcer
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Risk factors for Gastric Cancer
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Nitrites - smoked and salted foods or nitrate-converting bacteria
H. pylori |
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most common type of gastric cancer
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adenocarcinoma
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most common places for benign or malignant adenocarcinomas of the stomach
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benign - antrum
malignant - body or fundus |
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gastric carcinoma limited to mucosa associated with Japan and good prognosis
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Early gastric carcinoma
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gastric carcinoma that invades muscularis propria
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advanced gastric carcinoma
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3 types of advanced gastric carcinomas
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polypoid/fungating
ulcerating linits plastica - wall thickening |
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Virchow's node
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enlarged supraclavicular lymph node associated with stomach cancer
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Krugenberg tumor
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metastatic gastric adenocarcinoma to ovaries
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strong association with B-cell lymphomas of MALT
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H. pylori
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GI stromal tumors
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Interstitial cells of cajal (pacemaker cells)
CD34 and CD117 prediction of behavior depends more on size |
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CD117
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growth factor receptor with tyrosine kinase activity - associated with GI stromal tumor
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expression of c-Kit (CD117) is important why
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because the tumor will respond to Gleevec
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are most parotid tumors benign or malignant
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benign (80%)
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most common malignant tumor of the parotid gland
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mucoepidermoid carcinoma
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most common malignant carcinoma of the minor salivary glands
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adenoid cystic carcinoma
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type of esophageal cancer associated with african americans
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squamous cell carcinoma
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where are gastrin secreting cells located
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antrum
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gastrin levels seen in type A chronic gastritis
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increased gastrin levels due to the loss of gastric glands
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type of carcinoma associated with achalasia
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squamous cell carcinoma
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male patient presents with benign salivary gland tumor
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Warthin's tumor
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Female patient presents with benign salivary gland tumor
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mixed tumor
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most common complication associated with PUD
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bleeding
*perforation most common cause of death |
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does PUD have increased HCl secretion
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No, but some must be present in order for the ulcer to persist
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Is there increased HCl secretion in type A chronic gastritis
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There is no HCl secretion - Achlorydia
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