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