Pathology - Exam 3 - Gi Tract

Front 1

The presence of a protective mucosal "barrier" formed by tight intercellular junctions between mucosal cells that prevents the back diffusion of H+ serves what purpose for the gastric mucosa?

Back 1

keeps it immune to the effects of hydrochloric acid-pepsin digestion

Front 2

In addition to the presence of a protective mucosal "barrier" formed by tight intercellular junctions between mucosal cells that prevents the back diffusion of H+, that gastric mucosa may also derive protection from what?

Back 2

a surface layer of insoluble mucus and the secretion of bicarbonate and prostaglandins

Front 3

The breakdown products of carbohydrates, lipids, and proteins are absorbed mostly across the...

Back 3

small intestinal mucosa

Front 4

The colon functions primarily to do what?

Back 4

reabsorb water and electrolytes

Front 5

Structural, functional, or obstructive disorders of the esophagus are frequently clinically manifested by what?

Back 5

dysphagia (difficulty swallowing)

Front 6

The most common developmental abnormality that involves the esophagus is what?

Back 6

esophageal atresia

Front 7

An early maternal clue to esophageal atresia is

Back 7

polyhydramnios (excess amniotic fluid)

Front 8

With esophageal atresia, the atretic portion is usually located where?

Back 8

at or near the tracheal bifurfaction

Front 9

Excessive salivation and regurgitation of food are clinical manifestations of what developmental condition?

Back 9

esophageal atresia

*because of a blind upper pouch that may or may not have a hypertrophic wall

Front 10

If the lower segment of the esophagus is connected to the trachea or a bronchus by a fistulous tract (which occurs in 80-90% of cases with EA) this is called...

Back 10

tracheoesophageal fistula

Front 11

A distended stomach and coughing spasms related to reflux of gastric secretions are clinical manifestations of what developmental condition?

Back 11

tracheoesophageal fistula

Front 12

A disorder of esophageal motility often first manifested in early adult life and characterized by the failure of the gastroesophageal sphincter to relax is called...

Back 12

achalasia

Front 13

A loss of normal peristalsis in the distal 2/3 of the esophagus leading to functional obstruction, increased intralumenal pressures, and progressive dilatation are associated with what esophageal condition?

Back 13

achalasia

Front 14

Progressive dysphagia, eventual regurgitation of ingested food, and (occasionally) aspiration pneumonia are clinical manifestations of what esophageal condition?

Back 14

achalasia

Front 15

Chronic irritation of the mucosal surface of the esophagus which is associated with achalasia leads to a slightly increased incidence of developing what in the dilated portion?

Back 15

esophageal carcinoma

Front 16

A protrusion of a portion of the stomach above the diaphragm is known as a...

Back 16

hiatal hernia

Front 17

A hiatal hernia can be due to what two things?

Back 17

a scarred or congenitally short esophagus

or

a defect in the diaphragm

Front 18

A sliding hernia is a hiatal hernia caused by what?

Back 18

a scarred or congenitally short esophagus

Front 19

A rolling hernia is a hiatal hernia caused by what?

Back 19

a defect in the diaphragm

Front 20

Although most cases are asymptomatic, <10% of patients with what condition will develop reflux esophagitis and "heartburn"

Back 20

hiatal hernia

Front 21

Portal hypertension, from any cause, diverts the normal portal venous flow into what....

via what veins?

Back 21

azygous system

via the coronary (left gastric) veins and esophageal veins

Front 22

Tortuous distended veins beneath the esophageal mucosa or in the periesophageal tissue can be caused by...

Back 22

portal hypertension

(which creates esophageal varices to divert normal portal venous flow)

Front 23

Esophageal varices associated with portal hypertension are asymptomatic until what occurs?

Back 23

rupture with ensuing hematemesis (frequently massive)

*rupture may be idiopathic or the result of trauma (vomiting)

Front 24

The condition of having linear, longitudinal lacerations of the mucosa and submucosa occurring along the lesser curvature of the proximal gastric cardia or distal esophagus that occur after bouts of "trauma" such as vomitting is called

Back 24

mallory-weiss syndrome

Front 25

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...

Back 25

bouts of severe or prolonged vomiting

*other trauma such as coughing, resuscitation, instrumentation, etc. can also cause Mallory-Weiss syndrome to develop

Front 26

Mallory-Weiss Syndrome is most commonly seen in what type of patients?

Back 26

chronic alcoholics

Front 27

What condition involves the reflux of gastric contents (acids, bile, pancreatic enzymes) into the lower esophagus?

Back 27

Gastro-esophageal reflux disease (GERD or reflux esophagitis)

**may or may not be associated with hiatal hernia

Front 28

What is Barrett esophagus and why does it occur?

Back 28

Barrett esophagus is when the mucosa of the distal esophagus undergoes metaplastic change to mucin secreteing epithelium

It occurs as an adaptive protective measure against reflux esophagitis

Front 29

Which condition can be asymptomatic or could present with dysphagia, retrosternal pain, and occasional hematemesis or melena?

Back 29

Gastro-esophageal reflux disease
(GERD, reflux esophagitis)

Front 30

True or False: In the US, esophageal carcinoma is a common malignancy but is decreasing in frequency.

Back 30

False.

Very uncommon but is increasing in frequency

Front 31

The most common neoplasm of the esophagus is

Back 31

squamous cell carcinoma

Front 32

The development of what esophageal neoplasm is probably preceded by asymptomatic, slowly progressive mucosal dysplasia which over the course of months to years becomes malignant, encircles the mucosa, and penetrates into the submucosa.

Back 32

squamous cell carcinoma

Front 33

Gradual onset of dysphagia leading to weight loss and malnutrition caused by obstruction of the esophagus is characteristic of

Back 33

carcinomas of the esophagus

Front 34

Which developmental condition occurs in 1:300-1:900 newborn babies with a 4:1 male predominance (freq the first born male) and may be an inherited trait?

Back 34

pyloric stenosis

Front 35

You palpate a small epigastric mass in a newborn. This newborn also exhibits projectile vomiting in its 3rd week of life. You suspect she has what?

Back 35

pyloric stenosis

Front 36

Chronic aspirin ingestion, alcohol, smoking, drugs, toxins, infections, uremia, stress, and shock are all recognized predisposing factors for what?

Back 36

acute (erosive) gastritis

Front 37

Acute (erosive) gastritis interferes with...

Back 37

normal gastric mucosa secretion of mucus and bicarbonate

Front 38

Normal gastric mucosa secretion of mucus and bicarbonate protects against...

Back 38

"autodigestion" of the gastric mucosa

Front 39

Evidence of bleeding, epigastric pain, nausea, and vomiting are symptoms of what inflammatory stomach disorder?

Back 39

acute (erosive) gastritis

Front 40

An exaggeration of acute erosive gastritis to where the mucosal erosion penetrates into the submucosa is a...

Back 40

stress ulcer

(acute peptic ulceration)

Front 41

Stress ulcers are usually ___ (big/small?) with a ______ (color) base due to acid digestion of RBCs.

Back 41

small
reddish-brown base

Front 42

True or False: Stress ulcers rarely extend deeper than the superficial submucosa

Back 42

True

Front 43

Ulcers which appear within 24 hours after extensive burns are called

Back 43

curling ulcers

Front 44

Ulcers which appear within 24 hours after acute brain damage are called

Back 44

cushing ulcers