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56 Cards in this Set

  • Front
  • Back
Causes of esophageal stenosis?
Caustic injury
2 types of esophageal rings
A: above EG jxn
B: AT EG jxn
What can GERD cause?
Barrett esophagus
Pathogenesis of Mallory-Weiss Syndrome?
Excess vomiting with failure to relax LES
3 types of tracheoesophageal fistulas?
(Most common): Lower esophagus is connected to trachea, upper esophagus ends in a blind pouch
(Next common): Upper esophagus is connected to trachea, lower esophagus is not connected to upper esophagus
Completely patent esophagus, with a fistula between trachea and patent esophagus
Etiology of most common variant of tracheoesophageal fistula?
Maternal polyhydramnios (increased amniotic fluid)
2 types of esophageal diverticuli?
Traction: complete outpouching involving serosa, mucosa, submucosa

Pulsion: herniation of mucosa through defects in muscular wall
What do traction diverticuli result from?
Periesophageal inflammation and scarring
What are the 3 characteristic locations of esophageal diverticuli?
Immediately above UES (Zenker diverticulum)
Near midpoint of esoph (likely to be traction)
Above LES (Epiphrenic diverticuli)
Plummer-Vinson Syndrome?
WEbs and Fe deficiency, glossitis, chelosis
What are mucosal webs?
Ledgelike mucosal protrusions in upper esoph
Causes of acute gastritis
Heavy EtOH
Burn/Brain injury
Menetrier's disease
Extreme enlargement of gastric rugae
Severe loss of plasma proteins
Increased risk of gastric ca
How does HP --> injury
Secreates urease, protease, phospholipase (all toxic to mucosa)
Bacterial LPS stimulates cytokines --> inflammation
Bacterial PAF --> thrombosis
Mucosal damage --> nutrient leakage onto surface environment, sustaining HP in mucus
Which ulcer is made worse by eating? Better?
What role does partial gastrectomy play in the development of carcinoma of the stomach
Favors reflux of bilious, alkeline intestinal fluid
Decreaed Cl secretion (favors HP colonization)
Krukenberg tumors?
Bilateral involvement fo ovaries by metastatic carcinoma of stomach
Have signet ring cells
Which type of esophageal CA has signet rings?
Which layers of stomach are involved in early gastric ca?
mucosa and submucosa
Extends beyond submucosa
Linitis plastica?
VAriation of stomach carcinoma that is not associated with HP
Thickened rigid stomach wall with fibrosis
This type of CA is HEREDITARY!
Cells are epithelioid or spindle
cKIT mutation common
Responds to Gleevac (has altered tyrosine kinase activity)
AD syndrome
Pituitary, thyroid, parathyroid, adrenal cortical, and pancreatic islet cell adenoma or hyperplasia
Hypergastrenemia and peptic ulcer
Which is neoplastic transformation more common in: Crohn's disease or UC?
UC, although can happen in both
Which IBD has granulomas?
Crohn's disease
Meckel diverticulum
most common congenital anomaly of SI
Remnant of vitelline duct in distal small bowel
Can contain ectopic gastric, duo, colonic, or panc tissue
Usually asymptomatic, but can --> ulceration in ectopic tissue
Invagination of proximal blwel into more distal area
Often seen in infants and children
Usually no pre-existing bowel path
Twisting of GI tract around itself
Which part of the immune system mediates Celiac sprue?
T cells (AB mediated)
What malignancy is celiac sprue related to?
T cell lymphoma in proximal small bowel (poor prognosis)
10-15% of cases
Tropical sprue
Looks similar to celiac sprue
Probably from E. coli, responds to AB
Whipple disease
Macrophages in intestinal mucosa
affects SI most often
Arthralgias, cardiac, and neuro sx
No histologic changes
See circulating acanthocytes (RBC with spiny projections)
See neuro and liver d/o
Intestinal lymphangiectasia
Generalized dilation of SI lymphatics
Marked GI protein loss
What is the most common primary malig of SI?
Pt presentation?
Where does it met to?
Cramping, pain, N/V
Mesentary, regional LN, liver
Most common site of diverticuli?
sigmoid colon
Sx of diverticulitis?
Lower abdominal pain, fever, leukocytosis
Complications of diverticulitis
Abscess formation
Causes of ischemic bowel diseaes
Atherosclerotic occlusion of 2 mesenteric BV
Areas of bowel most affected by ischemic bowel dz?
Splenic flexure
Rectosigmoid jxn
(Both are in poorly vascularized regions between SMA, IMA, and internal iliac arteries)
What is a common cause for otherwise unexplained lower bowel bleeding?
Complication of UC
Toxic megacolon
Pseudomembranous colitis
Gray mucosa, with exudate of necrotic, mucosal debris (= pseudomembrane)
C. diff causes it through excreting exotoxin (related to broad-based AB tx)
Morphology of amebic colitis
Flask-shaped ulcers
Which polyps have no clinical significance?
What are inflammatory polyps
Polyps caused by IBD
2 types of hamartomatous colonic polyps
Peutz-Jeghers polyps
What are juvenile polyps
in SI and colon
Occur in children
high risk of adenomas and adenocarcinomas
Large, pedunculated
Peutz-Jegher syndrome
hamartomatous polyps and melanotic accumulations in mouth, lips, hands, genitals
Polyps have no maignant potential, but the SYNDROME is associated wiht risk for adenocarcinoma of the colon and malig of ovaries, breast, stomach
Types of adenomatous polyps
Tubular adenomas
Tubulovillous adenomas
Villous adenomas
Which type of adenomatous polyp is most common?
Small, pedunculated
Larger = greater likelihood --> malignant
Which type of adenomatous polyp has most malignant potential?
Large, sessile
Directly involves wall of colon (mucosa and submucosa)
Gardner syndrome
Many polyps with osteomas and soft tissue tumors
Turcot syndrome?
Adenomatous polyps and CNS tumors
What marker is elevated in colon cancer?
CEA (but not specific for colon cancer, but can be used to track dz)
What role does fatty diet play in the development of colon cancer?
Cholesterol --> increased bile synth --> bile is changed to carcinogen by bacteria
Pathogenesis of acute appendicitis
obstruction of appendiceal lumen by fecalith --> baterial proliferation and invasion of mucosa