Gastro Intestinal Pathology

Front 1

Thin, noncanalized cord replaces segment of esophagus causing mechanical obstruction

Back 1

Esophageal atresia

Front 2

Most common location of esopahgeal atresia

Back 2

At or near tracheal bifurcation

Front 3

Incomplete formation of the diaphragm allows the abdominal viscera to herniate into the thoracic cavity

Back 3

Diaphragmatic hernia

Front 4

closure of the abdominal musculature is incomplete, Presence of ventral membranous sac

Back 4

Omphalocele

Front 5

ventral wall defect including all layers of the gut including peritoneum, no membranous sac

Back 5

Gastrochisis

Front 6

Failed involution of the vitelline duct

Back 6

meckels diverticulum

Front 7

Connects the lumen of the developing gut to the yolk sac

Back 7

vitelline duct

Front 8

Present in 2nd or 3rd week of life as new onset of regurgitation and persitent, projectile, non billous vomiting

Back 8

hypertrophic pyloric stenosis

Front 9

abdominal PE finding in Hypertrophic pyloric stenosi

Back 9

Olive sized abdominal mass

Front 10

Hypertrophic pyloric stenosis is associated with

Back 10

Turner syndrome and edward's

Front 11

migration of Neural crest cells from cecum to rectum is arrested prematurely or when ganlion cell undergo premature death results in

Back 11

Hirshsprung disease

Front 12

lacks both meissners submucosal and aurbach myenteric plexus (aganglionosis)

Back 12

Hirshsrprung

Front 13

Normal segment in hirshprung

Back 13

Proximal dilated segment

Front 14

clinical manifestation of Hirshprung

Back 14

failure to pass meconium

obstructive constipation

Explosive passage of flatus and feces

Front 15

Most frequent cause of esophagitis

Back 15

Reflux esophagitis

Front 16

Cause of reflux esophagitis

Back 16

Transient LES relaxation

hypotensive LES

Anatomic disruption of gastroesophageal junction

Front 17

Morphology of GERD

Back 17

simple hyperemia

eosinophilic infiltration

basal zone hyperplasia

- >20 % of the total epithelial thickness

elongation of lamina propia papillae

Front 18

Punched out esophageal ulcer, nuclear viral incllusion within rim of degenerating epi cells

Back 18

HSV (viral esophagitis)

Front 19

Shallow esophageal ulceration, nuclear and cytoplasmic inclusion withing capillary endothelium and stromal cells

Back 19

CMV esophagitis

Front 20

Intestinal metaplasia within the esophageal squamous mucosa

Back 20

Barrett esophagus

Front 21

Columnar to squamous metaplasia predispose to adenocarcinoma of esophagus

Back 21

barrett esophagus

Front 22

Usual location of esophageal adenoca

Back 22

distal third

Front 23

Usual location of esophageal SSC carcinoma

Back 23

Middle third

Front 24

Morphology of esophageal adeno ca

Back 24

Intestinal morphology, with mucin production, back to back glands

Front 25

Defense forces in Stomach (protection)

Back 25

Surface mucus Secretion

Bicarbonate secretion

Mucosal blood flow

Apical surface membrane transport

Epithelial regen capacity

Prostaglandin

Front 26

Acute gastritis Morphology

Back 26

Intact surface epithelium

Active inflamation ( Neutro in BM)

Erosion

- lost of the superficial epi

- limited to lamina propia

Front 27

Focal, acutely developing gastric mucosal defects, well known complication of therapy with NSAIDs

Back 27

Acute gastric ulceration

Front 28

Proximal duodenal ulcers associated with severe burns

Back 28

Curling ulcer

Front 29

gastric, duodenal and esophageal ulcer in persons with Intracranial disease

Back 29

Cushing ulcer

Front 30

Morphology of Acute Gastric ulcerarion

Back 30

Found anywhere on the stomach

Multiple ulcer

Absence of scarring and thickening of BV

Healing with complete re-epithelialization

Front 31

Most common cause of chronic gastritis

Back 31

H. pylori

Front 32

Morphology of gastritis

Back 32

1. antral gastritis

- hight acid production despite hypogastrinemia

2. Pit Abscess

- intraepithelial neutrophils that accumulate in gastric pits

3. MALT Lymphoma

- Lymphoid aggregates with germinal centers (subepithelial plasma cells)

Front 33

Gastritis that typically spares

Back 33

Autoimmune

Front 34

Autoimmune gastritis cause

Back 34

- AB against Parietal cells and intrinsic factor

- Reduced serum pepsinogen

- antral endocrine cell hyperplasia

- Vitamin B12 deficiency

- Defective gastric acid secretion (Achlorhydia)

Front 35

Sequale of H. Pylori gastritis

Back 35

Peptic ulcer, AdenoCA

Front 36

Sequale of Autoimmune gastritis

Back 36

Atrophy, Pernicious Anemia, Adenocarcinoma, Carcinoid tumor

Front 37

LOCATION of:

H. pylori gastritis

Autoimmune gastritis

Back 37

antrum

Body

Front 38

Infiltrate of:

H pylori gastritis

Autoimmune

Back 38

Neutrophils, Subepithelial Plasma cells

Lymphocytes, macrophages

Front 39

Autoimmune gastritis morphology

Back 39

Diffuse mucosal damge and glandular atrophy of oxyntic mucosa

Megaloblastic changes

Intestinal metaplasia

Antral endocrine Hyperplasia

Front 40

Most often associated with H. Pylori induced hyperchlorhydic chronic gastritis

Back 40

PUD

Front 41

Most common location of PUD

Back 41

Gastric antrum and first portion of duodenum

Front 42

PUD morphology

Back 42

4 x more common in proximal duodenum than stomach

Sharply punched out defects with clean edges

necrotic ulcer base

Front 43

Location of duodenal ulcer

Back 43

Near pyloric valve (duodenal bulb) anterior duodenal wall

Front 44

Location of gastric ulcers

Back 44

Occur along lesser curvature ( Interface of body and antrum)

Front 45

Most common malignancy of the stomach

Back 45

Gastric adenocarcinoma

Front 46

Clinical manifestation of gastric adenoCA

Back 46

Early: Dyspepsia, dysphagia, nausea

Advanced: weight loss, anorexia, altered bowel habits, anemia, hemorrhage

Front 47

Types of gastric adenoma

Back 47

1. intestinal type: Bulky tumors composed of glandular structure, abundant mucin in gland lumens

2. Diffuse infiltrative: Signet ring cells, mucin lakes, Linitis plastica

Front 48

Diffuse rugal flattening, rigid, thickened wall (Leather bottle appearance)

Back 48

Linitis plastica

Front 49

Gold standard in detecting H. Pylori infection

Back 49

BIOPSY

Front 50

Types of chronic gastritis

Back 50

a. Type A: fundic type atoimmune gastritis

b. Type B: Antral type H pylori gastritis

Front 51

Differentiate PUD vs gastric AdenoCA ulcer

Back 51

PUD- Small, < 3 cm, Sharply demarcated (Punched out") solitary ulcers, round or oval, overhanging margins, radiating mucosal folds

AdenoCA- Large, > 3 cm, irregular with heaped-up margins and necrotic base

Front 52

Metatastasis of Gastric CA on the left supraclavicular sentinel lymph node

Back 52

Virchow node

Front 53

Metastasis of AdenoCa to bilateral OVaries (+ signet ring)

Back 53

krukenburg tumor

Front 54

Palpable nodules in the pelvic cul de sac in Gastric AdenoCA

Back 54

Blumer shelf

Front 55

Metastasis to periumbilical nodule

Back 55

Sister mary and joseph

Front 56

Gastric lymphoma is also known as

Back 56

Mucosa-associated lymphoid tissue (MALTomas)

Front 57

Most common site of extranodal lymphoma

Back 57

GI esp. stomach

Front 58

Most common site of EBV-positive B-cell lymphoma in BMT/organ transplant recepient

Back 58

BOWEL

Front 59

Salt and Peeper chromatin

Back 59

Carcinoid tumor

Small cell lung cancer

Front 60

Immunohistochemistry of Carcinoid tumor

Back 60

Positive for synaptophysin and Chromogranin A

Front 61

Well differentiated neuroendocrine carcinoma

Back 61

Carcinoid tumor

Front 62

Most common location of carcinoid tumor

Back 62

APPENDIX then Terminal ileum in the terminal ileum

Front 63

Carcinoid syndrome manifestation and cause:

Back 63

Cutaneous flushing, bronchospasm, wheezing, and fibrosis

due to the release of serotonin

Front 64

serotonin is converted to 5 HIAA by

Back 64

MAO

Front 65

Most common mesenchymal tumor of the abdomen

Back 65

GIST

Front 66

Diagnostic marker for GIST

Back 66

C-KIT

Front 67

Carney triad

Back 67

GIST, Paranglioma and pulmonary chondroma

Front 68

Common location of volvulus;

Associated congenital anomalies:

Back 68

Sigmoid colon and small bowel

Malrotation

Front 69

Types of infarction in ischemic bowel disease

Back 69

Mucosal infarction: Muscularis mucosa

Mural infarction: Mucosa and submucosa

Transmural: all walll layers

Front 70

Characterized by malformed submocosal and mucosal blood vessels, accounting for 20 % major episodes of lower intestinal bleeding

Back 70

Angiodysplasia

Front 71

Angiodysplasia occurs most commonly in

Back 71

the cecum or right colon

Front 72

Hypersentsitivity to Gluten (Gliadin)

Back 72

Celiac sprue ( not tropical sprue, Celiac disease, Gluten sensitive enteropathy)

Front 73

Most common Bacterial enteric pathogen associated with improperly cooked chickened, unpasturized milk or contaminated water

Back 73

Campylobacter jejuni

Front 74

serum antibodies to C. jejuni lipopolysacharide can cross react with gangliosides causing

Back 74

Guillain-Barre syndrome

Front 75

Campylobacter enterocolits Morphology

Back 75

Cryptitis

Crypt abscess

Crypt architecture is preserve

Front 76

Enteric fever or typhoid fever is caused by

Back 76

Salmonella typhi

Front 77

DOC for typhoid fever

Back 77

Ceftriaxone

Front 78

Transmission of Typhoid

Back 78

Person to person contact

contaminated food or water

Front 79

Chronic carriage of salmonella occurs in what organ?

Back 79

Gallbladder

Front 80

Chronic carrier of salmonell is best treated with

Back 80

Ampicillin/ Amoxicillin

(+) entero hepatic recirculation

Front 81

Also known as antibiotic assoicated colitis

Back 81

Pseudomembrenous colitis

Front 82

Whipple's disease is caused by:

Manifestation:

Back 82

Gram Postitive Actinomycete named tropherma whippelii

Malabsorptive diarrhea due to impaired lymphatic transport

Front 83

Inappropriate mucosal immune activation

Back 83

Inflammatory disease

Front 84

Includes distended foamy macrophages in SI lamina propia with PAS-positive diastase resistant granules

Back 84

Whipples diseas

Front 85

Most common site of involvement in Chron's disease

Back 85

Terminal ileum

Ileocecal valve

Cecum

Front 86

IBD which extends only to the mucosa?

Extends transmural?

Back 86

Ulcerative colitis

Chron's disease

Front 87

Skip Lesion, with thicked wall appearance, and stricture

Back 87

chron's disease

Front 88

Diffuse distribution, with rare stricture, and thin wall appearance

Back 88

UC

Front 89

Deep knife ulcer?

Superficial Broad base ulcer?

Back 89

Chron's

UC

Front 90

IBD associated with toxic megacolon

Back 90

UC

Front 91

IBD which is associated with lymphoid reaction, fibrosis, serositis and granuloma?

Back 91

Chron's

Front 92

IBD with Marked pseudopolyp

Back 92

UC

Front 93

IBD associated with cobblestone appearance and apthous ulcer

Back 93

Chron's disease

Front 94

Earliest lesion of chron's described as elongated serpentine ulcers

Back 94

Apthous ulcer

Front 95

Morphology of Chron's

Back 95

Paneth cell metaplasia

Non-caseating granuloma

Crypt abscess

Front 96

Morphology of UC

Back 96

broad base ulcer

Pseudopoly

Mucosal atrophy

Toxic megacolon

Front 97

IBD associated with increased risk of colon CA

Back 97

UC

Front 98

UC flare up can be triggered by what microorganism

Back 98

C. defficile

Front 99

associated with back wash ileitis

Back 99

UC

Front 100

Acquired pseudo-diverticular outpoutchings of the colonic mucosa and submucosa

Back 100

Sigmoid diverticulitis

Front 101

Associated with small flask-like outpoutching alongside the taeniae coli

Back 101

Sigmoid diverticulitis

Front 102

Focal malformations of mucosal ephitelium and lamina propia with associated rectal bleeding

Back 102

Juvenile polyp

Front 103

Pedunculated, smooth sufaced reddish lesion with cystic lesions, mostly benign, which is composed of dilated gland filled with mucin and inflammatory debris

Back 103

Juvenile polyp

Front 104

Multiple GI hamartomatous polyps and mucocutaneous hyperpigmentation with arborizing neworks

Back 104

peuts jeghers syndrome

Front 105

Polyp due to decreased epithelial cell turnover and delayed shedding of surface epithelial cells leads to pilling up of goblet cells and absorptive cells

Back 105

Hyperplastic polyps

Front 106

True or false: Hyperplastic has malignant potential

Back 106

False

Front 107

Hyperplastic polyp is most commonly found in

Back 107

Left colon

Front 108

PJS is most commonly located in

Back 108

The small intestine

Front 109

Smooth nodular protusion of mucosa often on the crests of mucosal folds, with serrated architecture

Back 109

hyperplastic polyps

Front 110

Neoplastic polyps

Back 110

Tubular

Villous

TubuloVillous

Front 111

Non neoplastic polyp

Back 111

Juvenile

PJS

Hyperplastic polyp

Front 112

Neoplastic polyp morphology

Back 112

Pedunculated or sessile

Velvety texture

Epithelial dysplasia

Front 113

Larger and sessile polyp covered by slender villi

Back 113

Villous polyp

Front 114

HIgh malignant potential but lacks typical cytologic features of dysplasia

Back 114

Sessile serrated adenoma

Front 115

Intramucosal carcinoma treatment

Back 115

complete polypectomy, No metastatic potential

Front 116

Familial Adenomatous polyposis is associated with what gene?

How may polyp needed for dx

Back 116

APC gene

100 polyp

Front 117

How many percent of FAP will develop Colorectal Adenoca if left untreated?

Back 117

100 %

Front 118

Intestinal polyps with associated osteomas of mandible, skull and long bones, Epidermal inclusion cysts,

Back 118

Gardner syndrome

Front 119

Intestinal adenomas and tumors of the CNS

Back 119

Turcot syndrome

Front 120

HNPP is AKA

Back 120

Lynch syndrome

Front 121

Common location of HNPP

Back 121

Often in the right colon

Front 122

Most common malignancy of the GI Tract

Closely related with

Back 122

Colorectal adenocarcinoma

Dietary factors

Front 123

Characteristic of colon adnoca associated with poor prognosis

Back 123

Mucin accumulation

Front 124

Location characteristic of Colon Adenoca

Back 124

Proximal: Polypoid, exophytic masses that rarely obstruct

Distal: annular lesions that produce napkin ring constrictions and luminal narrowing

Front 125

Clinical aspects of Colon Adeno Ca

Back 125

Right sided colon cancer

- Often presents wiht fatigue and weakness due to iron deficiency anemia

Left sided Colon Ca

-Occult bleeding, changes in bowel habits, cramping left lower quadrant discomfort

Front 126

Most impt. prognosticating factor of COlon CA

Back 126

Depth of invasion

Presence of absence of lymph node metastasis

Front 127

MC site of metastasis

Back 127

LIVER

Front 128

left sided cancer is associated with what lesion

Back 128

Apple core lesion

Front 129

thanks

Back 129

thanks