Patho 2 Chap 10

Front 1

A 23 yo female presents with small, shallow, 5mm lesions on the inside of her cheek and lower lip. The lesions appear grayish-white and have an erythematous rim around them. You most likely suspect

Back 1

Aphthous Ulcers (Canker Sores)

Front 2

You see a patient with multiple 4mm lesions filled with clear fluid around the corner of her mouth. You suspect

Back 2

Herpes Virus Infection (cold sores)

Front 3

A 6-month old boy with a history of otitis media and treatment with antibiotics 5 days ago. His oral cavity is filled with adherent, curd-like plaques which you wipe off to reveal extremely red tissue. you suspect____

Back 3

Candida albicans

Front 4

Candida albicans infection are particularly risky for patients with

Back 4

AIDS

Front 5

Kaposi sarcoma and hairy leukoplakia

Back 5

Acquired Immunodeficiency Syndrome (AIDS) and (HIV)

Front 6

Whitish, well-defined mucosal patch or plaque caused by epidermal thickening or hyperkeratosis that cannot be removed by rubbing surface

Back 6

Leukoplakia

Front 7

is found virtually only in persons infected with HIV. (from Epstein-Barr virus)

Back 7

Hairy leukoplakia

Front 8

what are the 3 primary sites of origin for Cancers of the Oral Cavity and Tongue

Back 8

- Vermilion border of the lateral margins of lower lip
- Floor of the mouth
- Lateral borders of mobile tongue (50%)

Front 9

what is the survival rate of Cancers of the Oral Cavity and Tongue if discovered early

Back 9

survival rate can EXCEED 90%

Front 10

80% of Salivary Gland Tumors are located where

Back 10

in the parotid glands , the rest primarily in the submandibular glands.

Front 11

inflammation of the major salivary glands

Back 11

Sialadenitis

Front 12

stone formation in the salivary gland, often leads to bacterial sialadenitis

Back 12

Sialolithiasis

Front 13

where are salivary tumor neoplasms more ominous than in the parotids

Back 13

in the submandibular glands

Front 14

Chronic sialadenitis is associated with what autoimmune disorder

Back 14

Sjogren’s syndrome

Front 15

What are the two anatomic patterns of Hiatal Hernia

Back 15

Axial
Non-axial

Front 16

What type of Hiatal Hernia is associated with the stomach sliding up and down through an enlarged hiatus (hole in the diaphragm). AKA “sliding” – 95% of cases, most patients with this will NOT have reflux (but some will)

Back 16

Axial

Front 17

What type of Hiatal Hernia is associated with the – stomach slides up next to esophagus. Progressively enlarges,
AKA “paraesophageal” or “rolling”, may get trapped becoming a surgical emergency but is very rare

Back 17

Non-axial

Front 18

What are the three major abnormalities associated with
Achalasia

Back 18

aperistalsis
Partial or incomplete relaxation of LES
Increased resting tone of LES

Front 19

Achalasia in Latin America, commonly caused by what bug

Back 19

Trypanosoma cruzi
Known as Chagas Disease

Front 20

Denotes incomplete relaxation of the lower esophageal sphincter (LES) in response to swallowing

Back 20

Achalasia

Front 21

birds beak

Back 21

Achalasia

Front 22

a circumscribed pouch or sac of variable size occurring normally or created by herniation of the lining mucous membrane

Back 22

Esophageal diverticula

Front 23

midportion of esophagus diverticula seen in older patients. Caused by enlarged mediastinal nodes and / or inflammation.

Back 23

Traction

Front 24

the most common type.
upper esophagus diverticula in > 60 y/o.

Back 24

Zenker

Front 25

Esophageal diverticula immediately above diaphragm, seen in younger patients

Back 25

Epiphrenic

Front 26

Longitudinal tears in the esophagus at the esophagogastric junction
Commonly seen in severe alcoholics after severe retching or vomiting

Back 26

Mallory-Weiss Syndrome

Front 27

Result from impeded portal venous blood flow in the esophagus

Back 27

Esophageal Varices

Front 28

Esophageal Varices are present in approximately 66% of all pt with what disorder

Back 28

cirrhosis

Front 29

Rupture produces MASSIVE hemorrhage into the lumen
Rupture responsible for 50% of deaths in advanced cirrhosis

Back 29

Esophageal Varices

Front 30

Pleomorphic Adenoma and Warthin Tumor are examples of what types of tumors
They are generally considered (benign/malignant)

Back 30

Salivary Gland Tumors

benign

Front 31

Chronic reflux of stomach acid into the esophagus can lead to _________. Patients will complain of _________ (hint: taste) and recurrent heartburn

Back 31

Esophagitis

regurgitation of sour brash

Front 32

Barrett’s Esophogus is due to the _________change of squamous epithelium to __________glandular epithelium. This is prevalent in patients who ________and alcohol, and can progress to malignancy if untreated.

Back 32

- metaplastic change
- columnar glandular epithelium
- smoke

Front 33

The two primary types of esophageal carcinoma are

Back 33

Squamous cell and Adenocarcinoma

Front 34

Esophogus is known to be a precursor for

Back 34

adenocarcinoma

Front 35

most common type of Esophageal Carcinoma

Back 35

Squamous cell carcinoma

Front 36

A circumscribed pouch found in the proximal third of the esophagus is call

Back 36

Zenker diverticula

Front 37

Acute Erosive is Most Commonly caused by

Back 37

Aspirin and NSAIDS

Front 38

A patient who takes 325mg aspirin daily, along with some NSAIDs for back pain, and presents to you complaining of blood-tinged vomit, and non-specific stomach pain may have ________________.

Back 38

Acute Erosive

Front 39

the most common cause of non-erosive gastritis, when chronic reflux or peptic ulcers have been ruled out.

Back 39

Infectious Gastritis
--Helicobacter pylori

Front 40

Disruption in the mucosa of the stomach and / or proximal duodenum caused by gastric secretions
burning epigastric pain 1-3 hours after eating or awakens at night with pain

Back 40

Peptic Ulcer Disease

Front 41

“coffee-grounds” in stools (digested blood)

Back 41

Peptic Ulcer Disease

Front 42

Benign neoplasms of the stomach are 10 times more likely in patients with what

Back 42

pernicious anemia

Front 43

tumor of the smooth muscle of the muscularis layer

Back 43

Leiomyoma

Front 44

What disorder arises from gastric epithelium

Back 44

Epithelial polyps

Front 45

what type of Epithelial polyps
are considered pre-cancerous

Back 45

Adenomatous polyps

Front 46

Malignant Neoplasms most often develop where in the stomach

Back 46

distal stomach
(Seldom seen in the fundus)

Front 47

95% Malignant Neoplasms are?
and many also have what other illness

Back 47

adenocarcinoma

H. pylori

Front 48

what contributes to the development of stomach cancer but is inhibited by Vitamin C

Back 48

Nitrosamines

Front 49

Malignant Neoplasms peaks at what age

Back 49

50.

Front 50

Autoimmune Gastritis may result in what other disorder

Back 50

pernicious anemia

Front 51

Pt complain of a feeling of fullness after just a few bites of food
May have presence of blood in the stool

Back 51

Malignant Neoplasms

Front 52

complete blockage or occlusion of small intestine due to malformation

Back 52

Intestinal Atresia

Front 53

partial blockage of the lumen of the small intestine

Back 53

Stenosis

Front 54

Newborn vomiting up undigested milk

Back 54

esophageal atresia

Front 55

A chronic PATCHY granulomatous inflammation primarily involving the ileum and cecum of the bowel wall with transmural involvement is

Back 55

Crohn’s Disease

Front 56

Chronic inflammatory disease principally limited to the colonic mucosa of the large intestine. (More commonly on the left side of colon to rectum)
Inflammation is

Back 56

Ulcerative Colitis

Front 57

common viral illness cause of diarrhea in children <2 yo

Back 57

Rotavirus

Front 58

most common pathogenesis for toxogenic bacterial diarrhea

Back 58

V. cholera/E. coli

Front 59

common cause of diarrhea; prevalent on cruise ships/field environment

Back 59

Norwalk virus

Front 60

most common pathogenesis for invasive bacterial diarrhea

Back 60

Yersinia/Campylobacter

Front 61

caused by toxins which pull fluid into the lumen

Back 61

Toxogenic

Front 62

usually affects proximal small intestine, resolves in ~48h

Back 62

Viral

Front 63

direct invasion and damage of the mucosa

Back 63

Invasive

Front 64

Pt usually younger (<10) will be inconsolable for some minutes, then fine for a period of time, then inconsolable again
(intermittent colicky pain)

Back 64

Intussusception

Front 65

One section of bowel telescopes into the adjacent section

Back 65

Intussusception

Front 66

Can occur at any age, usually years to months after surgery, POST-SURGICAL SCARRING, fibrosis, and contraction can kink the bowel causing obstruction

Back 66

Adhesions

Front 67

Occurs most frequently in middle-aged to elderly men
Section of bowel twists and closes the lumen causing complete obstruction, b/c of congenital abnormality of bowel or mesentery

Back 67

Volvulus

Front 68

A portion of the bowel loops into the inguinal canal, the femoral canal, or through a defect in the abdominal wall

Back 68

Hernia

Front 69

the most common type of hernia is

Back 69

Inguinal

Front 70

Autoimmune disorder leading to destruction and flattening of the intestinal villi which results in malabsorption
- Wheat gluten sensitivity

Back 70

Celiac sprue

Front 71

what is the treatment for tropical sprue

Back 71

Tetracycline and folate

Front 72

A rare systemic infection caused by Trophermya whippelii
malabsorption and infiltration of the lamina propria by bacteria filled macrophages

Back 72

Whipple disease

Front 73

Whipple disease can be successfully treated with

Back 73

long-term antibiotics

Front 74

Bowel wall is thickened and edematous with enlarged mesenteric lymph nodes

Back 74

Whipple disease

Front 75

lack of lactase that breaks down lactose, when it reaches large bowel where bacteria metabolize the sugar causing gas, bloating, and often diarrhea

Back 75

Lactose intolerance

Front 76

Asymptomatic, herniation of the mucosa and submucosa of the colonusually, found incidentally on colonoscopy

Back 76

Diverticulosis

Front 77

Pt will complain of pain where with diverticulitis

Back 77

in LLQ
( w/ fever and leukocytosis)

Front 78

Inflammation of a diverticulum usually due to retained fecal matter
Fermentation causes gasses to form which causes the diverticulum to swell and become inflamed

Back 78

Diverticulitis

Front 79

Where are the majority of diverticula found?

Back 79

Sigmoid colon

Front 80

Approximately 50% of intestinal cancers develop in the rectosigmoid area
Most start off as neoplastic polyps

Back 80

Adenocarcinoma

Front 81

Occult bleeding is common and pt may be anemic
Physical exam of the rectum may reveal a “napkin-ring” lesion

Back 81

Adenocarcinoma

Front 82

What is the most common location of intestinal cancers?

Back 82

Rectosigmoid colon

Front 83

Appendicitis may occur due to

Back 83

trapped fecal material

Front 84

AKA fecal stone

Back 84

fecalith

Front 85

Pt c/o cramps and generalized abdominal pain which localizes over hours to Right lower Quadrant (RLQ), may vomit, may have fever and leukocytosis

Back 85

Appendicitis

Front 86

The appendix is located in which of the following abdominal quadrants?

Back 86

Right lower Quad

Front 87

A 51-year-old woman with Lupus has developed pernicious anemia. Which of the following is the most likely cause of the anemia?

Back 87

Autoimmune gastritis

Front 88

An 18-month-old child is presented to your clinic with vomiting, severe watery diarrhea, and low-grade fever for 12 hours. You suspect

Back 88

Rotavirus