Systemic Patholgy - Gi (Test #2)

Front 1

The most common developmental abnormality to involve the esophagus and, on occasion, may be associated with vertebral defects, cardiovascular malformations, or other GI/GU abnormalities.

Back 1

Esophageal atresias

Front 2

This is usually located at or near the _____ _____ and most commonly results in a blind upper pouch and a lower segment which is frequently (80-90%) connected to the trachea or a bronchus by a fistulous tract

Back 2

Esophageal atresia

tracheal bifurcation

Front 3

Redundant mucosal folds that occur in the upper esophagus of middle-aged or elderly _____ and, when associated with severe _____ deficiency anemia and atrophic _____, is known as the _____ _____ syndrome.

Back 3

Esophageal webs/rings

women
iron
glossitis
Plummer-Vinson syndrome

Front 4

Where are esophageal rings located?

Back 4

Lower esophagus at the squamocolumnar junction

Front 5

This is a disorder of esophageal motility often first manifested in early adult life and characterized by the failure of the lower _____ _____ to relax. An associated loss of normal peristalsis in the distal _____ of the esophagus leads to functional obstruction, increased intralumenal pressures, and progressive esophageal dilatation.

Back 5

Achalasia

esophageal sphincter
2/3

Front 6

In what disease is there a slightly increased incidence of developing esophageal carcinoma in the dilated segment due to chronic irritation of the mucosal surface?

Back 6

Achalasia

Front 7

These are abnormal outpouches of esophageal mucosa and submucosa through weak areas in the muscle wall related to _____ intralumenal pressures or eversions of all layers of the esophagus resulting from the healing of _____ _____ external to the esophagus

Back 7

Diverticula

increased
inflammatory processes

Front 8

What is the most common diverticulum which is a pulsion diverticulum that develops on the posterior wall of the esophagus proximal to the _____ muscle?

Back 8

Zenker diverticulum

cricopharyngeal

Front 9

Refers to a protrusion of a portion of the stomach above the diaphragm.

Back 9

Hiatal hernias

Front 10

Traction from a scarred or congenitally shortened esophagus pulls the cardia of the stomach upward through the esophageal hiatus

Back 10

Sliding hernia (80-90%)

Front 11

A defect in the esophageal hiatus allows a portion of the stomach to protrude and lie alongside the esophagus to form an intrathoracic sac which, although infrequent, may become strangled and infarcted.

Back 11

Paraesophageal hernia (10-20%)

Front 12

_____ _____, from any cause, diverts the normal portal venous flow into the azygous system via the _____ (left gastric) veins and esophageal veins. This produces tortuous distended veins beneath the esophageal mucosa or in the _____ tissue which run parallel to the long axis of the esophagus.

Back 12

Portal hypertension
coronary
periesophageal

Front 13

What is largely associated with portal hypertension, and remain asymptomatic until rupture occurs?

Back 13

Esophageal varices

Front 14

Linear, longitudinal lacerations of the mucosa and submucosa occurring along the lesser curvature of the proximal gastric cardia or distal esophagus are most commonly seen after bouts of severe or prolonged vomiting, but occasionally develop after other "trauma"

Back 14

Mallory-weiss syndrome

Front 15

In some patients with longstanding, symptomatic reflux disease, the epithelium of the distal esophagus may undergo metaplastic change to a _____ epithelium initially resembling _____ _____ _____ and then intestinal mucosa with goblet cells (intestinal metaplasia) known as...

Back 15

Barrett esophagus

columnar
gastric cardia mucosa

Front 16

Overall, approximately 10% of patients with Barrett esophagus will subsequently develop invasive _____

Back 16

Adenocarcinoma

Front 17

Although the etiology of this neoplasm is unknown, predisposing factors include chronic alcohol and tobacco abuse and/or preexisting structural or functional abnormalities of the esophagus contributing to a chronic _____.

Back 17

Squamous cell carcinoma

esophagitis

Front 18

_____ and _____ carcinogens most likely play a major role in inducing _____ mutations that initiate progressive changes that will ultimately lead to malignancy involving squamous cell carcinoma.

Back 18

Environmental and dietary
genetic

Front 19

The development of a carcinoma is probably preceded by asymptomatic, slowly progressive _____ _____ which over the course of months to years becomes malignant, encircles the mucosa while penetrating into the _____, and presents as either a _____ _____ mass protruding into lumen (60%), a _____ _____ lesion that may erode through the esophageal wall and into surrounding structures (25%), or a _____ _____ into the wall causing rigidity and lumenal narrowing (15%).

Back 19

mucosal dysplasia
submucosa
polypoid fungating
necrotic ulcerative
diffuse infiltration

Front 20

Since these arise from submucosal mucous glands or a preexisting Barrett esophagus, they are more frequently seen in the distal esophagus. They are secondary to GERD and esophageal varices.

Back 20

Adenocarcinomas

Front 21

What disorder is a genetic trait of boys?

Back 21

Pyloric stenosis

Front 22

What are the different types of gastritis?

Back 22

Acute (erosive) gastritis
Acute peptic ulceration (stress ulcer)

Front 23

This is associated with a wide variety of predisposing factors (aspirin, toxins, etc) which can alter mucosal blood flow causing ischemia, or interfere with the protective mucoid barrier that prevents acid digestion of the gastric mucosa.

Back 23

Acute (erosive) gastritis

Front 24

This is basically an exaggeration of acute erosive gastritis in which the mucosal erosion penetrates the _____ mucosa. They tend to arise initially in the _____ stomach but, depending on the severity, multiple ulcers may involve the entire gastric mucosa and, occasionally, the _____.

Back 24

Acute peptic ulceration (stress ulcer)

muscularis
proximal
duodenum

Front 25

What form of gastritis initially appears within 24 hours after severe trauma

Back 25

Acute peptic ulceration (stress ulcer)

Front 26

Histologic changes in _____ _____ gastritis consist of mild localized or diffuse superficial _____ and _____ infiltrates of the lamina propria while _____ _____ gastritis is characterized by heavier and deeper inflammatory infiltrates with thinning of the mucosa, atrophy of the glands, and surface epithelial atypia.
What are these characteristics associated with?

Back 26

Chronic (nonerosive) gastritis

chronic superficial
lymphocytic and plasmacytic
chronic atrophic

Front 27

What are the two forms of chronic (nonerosive) gastritis?

Back 27

Chronic autoimmune (fundal) gastritis
Chronic infectious (antral) gastritis

Front 28

This results from autoimmune destruction of the gastric parietal cells and is therefore most prominent in the _____ and body of the stomach.

Back 28

Chronic autoimmune (fundal) gastritis

fundus

Front 29

These patients produce antibodies directed against intrinsic factor, intrinsic factor-Vitamin B12 complexes, and gastric parietal cells.

Back 29

Chronic autoimmune (fundal) gastritis

Front 30

What disease is associated with concomitant Helicobacter pylori infections?

Back 30

Chronic infectious (antral) gastritis

Front 31

Although the initial infection may be silent, it may also produce an acute gastritis with neutrophilic infiltrates. This is most prominent in the proximal antral region.

Back 31

Chronic infectious (antral) gastritis

Front 32

There is parietal cell destruction, and an associated surface intestinal metaplasia and dysplasia increases the risk of gastric carcinoma in these individuals.

Back 32

Chronic infectious (antral) gastritis

Front 33

Resulting from acid-pepsin digestion of non-acid secreting mucosa, these are usually solitary lesions occurring in the duodenum (most frequent) or stomach.

Back 33

Chronic peptic ulcer disease

Front 34

This refers to a group of uncommon disorders that are characterized by exaggeration of the gastric rugal folds which radiologically may simulate diffuse gastric carcinoma or lymphoma.

Back 34

Hypertrophic gastropathy

Front 35

This is a disorder which most frequently afflicts middle-aged _____ and usually presents with _____ pain, anemia secondary to blood loss, and _____ secondary to loss of large amounts of protein from the gastric mucosa.

Back 35

men
epigastric
hypoproteinemia

Front 36

The enlarged rugae found in Menetrier disease may be seen in the ____ and/or the _____.

Back 36

Fundus
Antrum

Front 37

This disorder is generally recognized as a potentially pre-malignant condition and should be followed with periodic endoscopy.

Back 37

Menetrier Disease

Front 38

Histologically, there is hyperplasia of the surface mucus-producing cells and gastric pits with variable degrees of atrophy of the underlying gastric glands which may cause low acid secretion.

Back 38

Menetrier Disease

Front 39

Enlargement of the gastric glands secondary to parietal and chief cell hyperplasia. Clinically, these patients are hypersecretors of acid and may suffer from chronic peptic ulcer disease.

Back 39

Hypersecretory gastropathy

Front 40

Similar both clinically and pathologically to hypersecretory gastropathy, here the parietal cell hyperplasia is secondary to gastrin stimulation from an associated gastrinoma.

Back 40

Zollinger-Ellison Syndrome