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83 Cards in this Set

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  • Back
refers to any benign epi tumor of the oral mucosa. can occur anywhere in the mouth
epithelial tumor arising from precursor cells of enamel origin; usu occurs in the mandible - can lead to slow expansion of the jaw because of irregular local extension.
what type of cancer most commonly occurs in the mouth?
squamous cell carcinoma; tongue involved >50% of cases. assoc w combined used of tobacco and alcohol.
Sjogren syndrome
autoimmune destruction of minor salivary glands and lacrimal glands; karatoconjunctivitis sicca (dry eyes), xerostomia (dry mouth), dental caries, oft assoc w RA.
large mucocele of salivary gland origin, characterisitically located on the floor of the mouth
Where do the majority of salivary gland tumors occur?
Parotid gland
What is the most commonly occuring salivary gland tumor?
Pleomorphic adenoma
Describe a pleomorphic adenoma of the salivary gland. Why does it often recur after resection?
a benign tumor, myxoid and cartilage-like elements as well as epithelial cells. presents as firm, non-tender swelling - difficult to remove completely bc of its proximity to facial nerve
MC malignant salivary gland tumor
Mucoepidermoid carcinoma
Warthin tumor
papillary cystadenoma lymphomatosum. Benign parotid gld tumor. Heterotrophic salivary gland tissue trapped in a lymph node
newborn w/ copious salivation, choking, coughing, cyanosis on eating. d/o?
tracheoesophageal fistula
Zenker diverticulum
esophageal diverticulum occuring immediately above the upper esophageal sphincter
Epiphrenic diverticulum
esophageal diverticulum occuring immediately above LES
persistent contraction of the LES and absence of eso peristalsis, leading to dilation of esophagus (bird beaking on barium swallow)
What causes achalasia?
loss of gangloin cells in the myenteric plexus --> progressive dilation of eso (assoc w/ Chagas dz)
What can Achalasia lead to?
eso squamous cell carcinoma (5%)
Mallory-Weiss syndrome
mucosal tear of distal eso (oft due to severe retching)
Left gastric coronary vein drains blood from distal eso and prox stomach into portal vein
Esophageal varices: portal HTN dilates left gastric coronary veins
Barrett esophagus
columnar (intestinal)metaplasia of squamous epithelium with prom goblet cells - precursor to eso adenocarcinoma
what is the MC carcinoma of the eso?
squamous cell and adenocarcinoma are about equal in the US (squamous MCC worldwide)
Compare the most common locations of squamous and adenocarcinoma of the esophagus
Squamous, upper 2/3; adeno - lower 1/3 (arises from barrett eso)
projectile vomiting in child indication of?
congenital pyloric stenosis (hypertrophy of musc layer of pylorus)
Curling ulcer v Cushing ulcer
Curling - burn inj; Cushing - Brain injury
Antibody to _______ in autoimmune gastritis?
parietal cells (sometimes IF)
what is the most common form of chronic gastritis?
Helicobacter pylori - assoc gastritis.
Features of Helicobacter pylori gastritis
inc gastric acid sec, no assoc w pernicious anemia, urease +.
H. pylori
assoc w gastric and duodenal peptic ulcer and high suspect in the causality of carcinoma of the stomach and gastric lymphoma of the MALT type
Menetrier disease
giant hypertrophic gastritis; characterized by extreme enlargement of gastric rugae w atrophy of parietal cells-achlorhydria; inc risk of stomach cancer.
MCC hemorrhagic gastritis
Etiologic factors for gastric carcinoma
H.pylori, Nitrosamines (food preservatives) and ppl who eat large amts of smokes fish and pickled veggies; excessive salt
MC type of stomach carcinoma
almost always adenocarcinoma
Virchows node
gastric carcinoma invlovement of a supraclavicular lymph node by metastasis
Kruckenberg tumors
Bilat involvement of the ovaries by metastatic spread of carcinoma of the stomach. Signet ring cells
compare lesion of peptic ulcer vs. intestinal type stomach carcinoma
peptic ulcer: smooth base w nonelevated, punched-out margins; carcinoma forms an ulcer w irregular necrotic base and firm, raised margins.
infiltrating carcinoma of stomach
"linitis plastica"/"leather bottle stomach" not assoc w H.pylori infxn and characterized by a thickened, rigid stomach wall, caused by diffuse infiltration of tumor cells w fibrosis
Associations w/ peptic ulcer
Aspirin, smoking, sollinger-ellison, primary hyperparathyroidism, MEN I
Crohn's disease
chronic infl condition unknown etiology, any part of GI tract, MC: distal ileocecum, small intestine, colon
UC or Crohn's most commonly leads to neoplastic transformation?
Chronic infl of all layers of intestinal wall (transmural) and thickening of involved segments w narrowing lumen, what dz?
C/C UC and Crohns
UC: affects only colon, infl and ulceration limited to mucosa and submuc, crypt abscesses, pseudopolyps, inc inc of colon cancer.
mucosal cobblestone appearance
skip lesions
Non-caseating granulomas in intestine
Fistulas bet intestine and bladder, vagina, skin
Remnant of embyonic vitelline duct
Meckel diverticulum
Celiac disease
sensitivity to gluten in cereal products
presentation: wgt loss, weakness, diarrhea w pale, bulky, frothy, foul smelling stool; growth retardation and general failure to thrive
Celiac disease
Dx Celiac dz
malabsorption, sm int Bx = blunting of sm int villi; clinical improvement w gluten-free diet
Carcinoid, when metastatic to the liver, can be manifest as carcinoid syndrome, which is ____
caused by elaboration of vasoactive peptides and amines, esp 5-HT: cutaneous flushing, watery diarrhea and abd cramps, bronchospasm, valvular lesions of the right side of the heart
Hirschsprung disease
congenital megacolon = dilation of the colon due to absence of ganglion cells of the submucosal and myenteric neural plexuses (dilation proximal to agang seg)
how are hirschprung disease of the colon and achalasia of the esophagus similar?
both involve aganglionic segments of the organ
MC site for diverticula
sigmoid colon
presence of multiple diverticula w/o infl; mc in low fiber diets, usu asymptomatic
infl of diverticula; bright red rectal bleeding is common; presents with lower abd pain and signs of acute infl
what are the most common areas affected by ischemic bowel disease
splenic flexure and rectosigmoid junction (watershed areas) ==> mucosal, mural, transmural infarction (like Crohns)
Is the rectum affected in ulcerative colitis?
Yes, the rectum is always affected
Crypt abscesses
infiltrates of neutrophils in teh crypts of Lieberkuhn
flask-shaped ulcers
amebic colitis caused by infection with entameoba histolytica
Peutz-Jeghers polyps
hamartomatous polyps of colon and sm intestine and melanonitc accum on mouth and on lips, hands, genitalia
which adenomatous polyp has the highest malignant potential
Villous adenoma (not tubovillous or tubular)
Familial polyposis
autosomal dom condition by the presence of numerous adenomatous polyp - the risk for malignant transformation approaches 100%
Gardner Syndrome
autosomal dom condition characterized by numerous adenomatous polyps along w osteomas and soft tissue tumors
Turcot syndrome
adenomatous polyps along w tumors of CNS
olive shaped epigastric mass
pyloric stenosis
compare S/S of left v right sided carcinoma of colon
left: (rectosigmoid) early obstruction w change in bowel habits and dec caliber stools;
Right: presents late, w iron def anemia due to chronic blood loss
what enzyme is relatively deficient in physiologic jaundice of the newborn
glucuronyl transferase
Gilbert Syndrome
extremely common; modest elevation of serum unconjugated bilirubin; no clinical consequences
Crigler-Najjar syndrome
severe familial d/o - unconj ehyperbilirubinemia caused def of glucuronyl transferase. one form -->kernicterus another responds well to phenobarbital therapy
Dubin-Johnson syndrome
autosomal recessive form of conjugated hyperbilirubinemia, defective bilirubin transport; brown to black discoloration of liver
HBV, HCV have major assn w
hepatocellular carcinoma
What marker of hepatitis infection is present during the "window period" btwn esapp of HBsAg and appearance of anti HBsAg
Which two Hepatites do not lead to chronic carrier states = chronic hepatitis?
Councilman bodies
Yellow fever, dying hepatocytes that condense into eosinophilic contracted forms - councilman bodies
Is fatty change (steatosis) of liver reversible?
Mallory bodies
Alcoholic hepatitis - characteristic, but not entirely specific
Def: Cirrhosis
descriptive term for chronic liver dz characterized by gernarlized disorganization of hepatic architecture w scarring and nodule formation
4 clinical manifestations of hepatocellular damage and liver failure (alcoholic cirrhosis)
1. jaundice
2. hypoalbuminemia
3. coag factors deficiencies
4. Hyperestrinism
4 consequences of intrahepatic scarring w inc portal venous pressure
1. eso varices
2. rectal hemorrhoids
3. periumbilical venous collaterals (caput medusa)
4. splenomegally
Alcoholic cirrhosis micro or macronodular?
Primary biliary cirrhosis
autoimmune; antimitochondrial antibodies characteristic; middle aged women, severe obst jaundice, itching, hypercholesterolemia
Kayser-Fleischer rings
wilsons disease
Bud-Chiari syndrome
caused by thombotic occlusion of the major hepatic veins - abd pain, jaundice, hepatomeg, ascites, eventual liver dz; most oft assc w polycythemia vera, hepatocellular carcinoma
serum marker of hepatocellular carcinoma
a fetoprotein