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26 Cards in this Set
- Front
- Back
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Gastroschisis
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Congenital abnormality in which there is a ventral wall defect similar to omphalocele (incomplete closure of abdominal musculature) except that it involves all the layers of the abdominal wall, from the peritoneum to the skin.
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Meckel Diverticulum
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Diverticulum in the ileum due to failed involution of vitelline duct.
Rule of 2's - 2% of population, w/in 2 ft of ileocecal valve, 2 inches long, 2x m>f. |
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Pyloric stenosis
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Associated with Turner syndrome (45X) and trisomy 18.
Presents in 2nd or 3rd week of life as new-onset regurgitation and persistent, projectile, nonbilious vomiting. |
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Associated with down syndrome
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Hirschprung's disease and Duodenal atresia.
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Esophageal Obstruction - Diverticulum and Motility disorders.
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Zenker (pharyngoesophageal) - immediately above the UES.
Traction - near the middle. Epiphrenic - immediately above the LES. Nutcracker - longitudinal layer contracts before circular layer; periodic short-lived esophageal obstruction. Diffuse esophageal spasm - causes diverticulae to form with increased esophageal wall stress. |
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Plummer-Vinson Syndrome
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1) Due to chronic iron deficiency
2) leukoplakia in oral mucosa and esophagus 3) mucosal esophageal webs - intermittent dysphagia for solids. |
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Esophageal rings, or Schatzki rings
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Like webs, but circumferential and thicker. Include mucosa, submusoca, and sometimes hypertrophic muscularis propria.
A rings - in distal esophagus above gastroesophageal junction; covered by squamous mucosa. B rings - located at squamocolumnar junciton of lower esophagus. |
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Lacerations - Esophagitis
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Mallory-Weiss tears: mucosal tears of distal esophagus due to severe retching in alcoholics or bulimia.
Boerhaave's syndrome: rupture of distal esophagus. |
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Chemical and Infectious esophagitis
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Dense infiltrates of neutrophils.
Candidiasis: adherent gray-white pseudomembranes. Herpesviruses - typically causes punched out ulcers. CMV - shallow ulcerations and CHARACTERISTIC nuclear and cytoplasmic inclusions within capillary endothelium and stromal cells. Graft vs. Host Disease: basal cell apoptosis, mucosal atrophy, and submucosal fibrosis without significant acute inflammatory infiltrates. |
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VATER syndrome
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1) Verterbral abnormality
2) Anal atresia 3) Tracheoesophageal fistula 4) Renal disease and absent r radius |
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GERD
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Due to relaxation to LES.
80% of pregnant women and 70% of ppl wil GERD have hiatal hernia. Hyperemia and eosinophils recruited with more significant disease. Basal zone hyperplasia may also be present. |
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Hiatal Hernia
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1) sliding type
most common; proximal stomach in thoracic cavity. 2) Paraesophageal (rolling) hernia gastroesophageal junc. remains at level of diaphragm and part of stomach bulges into thoracic cavity. |
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Barrett Esophagus
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Increased risk of esophageal adenocarcinoma.
Red, velvety musoca. Goblet cells define intestinal metaplasia and are necessary for diagnosis of Barrett esophagus. |
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Leiomyoma
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Most common benign tumor of esophagus. Tumor of smooth muscle origin.
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Esophageal Adenocarcinoma
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Most common primary cancer of esophagus in US.
Long standing GERD and Barrett's esophagus are most common predisposing cause. |
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Squamous cell carcinoma (esophagus)
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Most common primary cancer in developing countries. More often in women and blacks.
Risk factors include alcohol, tobacco, and achalasia. 50% occur in middle third. Symptoms relate to local invasion (hoarseness, enlargement of supraclavicular nodes). Alteration of diet from solid to liquid; weight loss. |
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Acute Erosive Hemorrhagic Gastritis
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Erosion of superficial epithelium accompanied by pronounced neutrophilic infiltrate within the mucosa and a fibrin-containing purluent exudate in the lumen. May progress to ulcers.
NSAID is most common cause; alcohol second. H. Pylori. |
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Acute Gastric Ulcerations
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Stress ulcers - w/ shock, sepsis, or severe trauma.
Curling ulcers - proximal duodenum, and associated with severe burns or trauma. Cushing ulcerrs - gastric, duodenal, and esophageal, arising in persons with intracranial disease. No scarring or thickening of blood vessels - signs of chronic peptic ulcers. |
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Chronic Gastritis
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Complications - PUD, Mucosal atrophy and intestinal metaplasia, Dysplasia, and Gastritis Cystica.
Type A - body and fundus; most often due to pernicious anemia. Type B - antrum and pylorus; most common cause is H. Pylori. Usually increased acid production with despite hypogastrinemia. Intraepithelial neutrophils and subepithelial plasma cells. Autoimmune gastritis - most common cause of atrophic gastritis. Damage of the oxyntic mucosa. Intestinal metaplasia. Lymphocytes and macrophages, most often deep and centered in gastric glands. Decreased acid production with increased gastrin. Pernicious anemia, atrophic glossitis (B12 def). |
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Uncommon forms of gastritis
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Reactive Gastropathy - foveolar hyperplasia, glandular regenerative changes, and mucosal edema. Antrum. "watermelon stomach"
Eosinophilic - allergies. Increased IgE. In mucosa and muscularis, usually in the antral or pyloric region. Lymphocytic (varioliform) gastritis - idiopathic; women. Thickened folds covered by small nodules with central aphthous ulceration. CD8. Associated with celiac disease. Granulomatous gastritis - any gastritis which contain granulomas, or aggregates of epitheloid histiocytes (tissue macrophages). Associated with Crohn's or sarcoidosis. |
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Hypertrophic Gastropathies
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1) Menetrier Disease - excessive secretion of TGF-alpha. Diffuse hyperplasia of foveolar epithelium (body and fundus) + hypoproteinemia. Increasd risk of adenocarcinoma.
2) Zollinger-Ellison syndrome - gastrinomas; majority are malignant pancreatic islet cell tumors. PUD + diarrhea. Associaed with MEN type I. |
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Inflammatory and Hyperplastic Polyps
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Usually develop in association with chronic gastritis, which initiates the injury and reactive hyperplasia that leads to polyp growth.
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Fundic Gland Polyps
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Occurs sporadically and in individuals with FAP.
Prevalence increased as a result of proton pump inhibitory therapy; reflects increased gastrin secretion, in response to reduced gastric acidity, and the resulting glandular hyperplasia. |
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Gastric Adenoma
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Almost always occur on a background of chronic gastritis with atrophy and intestinal metaplasia.
By definition, there is epithelial dysplasia (intestinal type columnar cells). |
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Gastric Adenocarcinoma
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Most common malignancy of stomach. Increased incidence in blood group A.
Intestinal type - Associated with H. Pylori. Risk factors: Increased incidence in Japan (smoked products), Nitrosamines. Diffuse Type - Incidence unchanged. Not associated with H. Pylori. SIGNET-RING CELLS. Rugal flattening and a rigid, thickened wall imparts a "leather bottle" appearance termed LINITIS PLASTICA. May metastasize to Virchow's node (supraclavicular), Sister Mary Joseph nodule (periumbilical), ovaries (Krukenberg tumors). |
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Gastric Malignant Lymphoma
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Stomach is most common site for extranodal malignant lymphoma.
Low grade B-cell lymphoma - H-Pylori related. MALToma. Can transform into more high grade B or T cell lymphomas. |
