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Gastrointestinal
Pathology
199
Pathology
Graduate
01/17/2014

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Term
most common location of salivary gland tumor
Definition
parotid
Term
most common benign salivary gland tumor
Definition
pleomorphic (epithelial and mesenchymal)
Term
second most common benign salivary gland tumor
Definition
warthin tumor
Term
most common malignant salivary gland tumor
Definition
mucoepidermoid
Term
achalasia is loss of what plexus?
Definition
auerbachs
Term
dysphagia to solids and liquids
Definition
achalasia
Term
2' achalasia from
Definition
chagas and CREST scleroderma
Term
birds beck, increased risk of carcinoma
Definition
achalasia
Term
nocturnal cough and dyspnea
Definition
GERD
Term
painless bleeding of lower esophagus
Definition
esophageal varices
Term
punched out ulcers on esophagus
Definition
HSV1
Term
linear ulcers on esophagus
Definition
CMV
Term
white pseudomembrane in esophagus
Definition
candida
Term
painful hematemasis due to severe vomiting
Definition
mallory- weiss
Term
esophageal rupture from violent retching
Definition
boerhaave syndrome
Term
lye ingestion and acid reflux
Definition
esophageal strictures
Term
plummer vinson triad
Definition
dysphagia (esophageal web), glossitis, iron deficiency anemia
Term
barrett esophagus change
Definition
NKSS -> intestinal columnar with goblet cells
Term
cause of barrett
Definition
GERD
Term
causes of SCC of esophagus
Definition
alcohol, achalasia, cigaretts
Term
adenocarcinoma esophagus causes
Definition
barrett's, esophageal web, esophagitis, diverticula
Term
SCC esophagus location
Definition
upper 2/3
Term
adenocarcinoma esophagus location
Definition
lower 1/3
Term
most common ulcer cause
Definition
NSAIDS
Term
curling's ulcer
Definition
burnes -> decreased plasma volume -> sloughing of gastric mucosa
Term
cushing's ulcer
Definition
brain injury -> increased vagal stimulation -> increased Ach -> increased H+
Term
type A chronic gastritis
Definition
autoimmune, autoantibodies to parietal cells, pernicious anemia, achlorhydria
Term
type B chronic gastritis
Definition
H pylori, increased risk of MALToma
Term
type A gastritis location
Definition
fundus/body
Term
type B gastritis location
Definition
antrum
Term
gastric hypertrophy with protein loss, loo like brain gyro, parietal cell atrophy, increase mucous cells
Definition
menetrier's
Term
virchow's node
Definition
left supraclavicular
Term
krukenberg's
Definition
bilateral mets to ovaries
Term
sister mary joseph nodule
Definition
SQ periumbilical metastasis
Term
acanthosis nigricans and leser trelat
Definition
stomach cancer
Term
signet ring cells
Definition
diffuse stomach cancer
Term
linitis plastica
Definition
diffuse stomach cancer
Term
pain greater with meals
Definition
gastric ulcer, ischemic colitis
Term
causes of gastric ulcer
Definition
H pylori, NSAID
Term
pain decreases with meals
Definition
duodenal ulcer
Term
duodenal ulcer cause
Definition
H pylori, ZE syndrome
Term
tx of peptic ulcers
Definition
CAP = clarithro, amoxicillin (metro if allergic) and PPI
Term
malabsorption of fat and fat soluble vitamins (ADEK)
Definition
pancreatic insufficiency
Term
causes of acute pancreatitis
Definition
gallstones, ethanol, trauma, sepsis, mumps, autoimmune dx, scorpion stings, hypercalcemia, hypertriglyceridemia, ERCP, drugs
Term
elevated amylase and lipase
Definition
acute pancreatitis
Term
epigastric abdominal pain radiating to back
Definition
acute pancreatitis
Term
can lead to CID, ARDS, diffuse fat necrosis, hypocalcemia
Definition
acute pancreatitis
Term
chronic pancreatitis is associated with
Definition
alcoholism and smoking
Term
risk factors for pancreatic adenocarcinoma
Definition
tobacco, chronic pancreatitis, >50, jewish and african american males
Term
CA19-9
Definition
pancreatic adenocarcinoma
Term
pancreatic adenocarcinoma symptoms
Definition
pain radiating to back, weight loss, trousseau, courvoisier
Term
pancreatic adenocarcinoma symptoms
Definition
abdominal pain radiating to back, weight loss, trousseau, courvoisiers
Term
trousseau
Definition
migratory thrombophlebitis
Term
courvoisier
Definition
obstructive jaundice with palpable gallbladder
Term
similar to celiac, but effects entire small bowel
Definition
tropical sprue
Term
tropical sprue tx
Definition
abx and folate
Term
PAS positive fomay macrophages
Definition
whipples
Term
malabsorption with arthralgias cardiac and neurologic symptoms
Definition
whipples
Term
organism with whipples
Definition
Tropheryma whippelii
Term
most common disaccharide deficiency
Definition
lactase
Term
osmotic diarrhea with milk intake
Definition
lactase deficiency
Term
fat accumulation in enterocyte, and neurologic manifestations
Definition
abetalipoproteinemia
Term
decreased synth of api B
Definition
abetalipoproteinemia
Term
causes of pancreatic insufficiency
Definition
CF, obstructing cancer and chronic pancreatitis
Term
ab in celiac
Definition
anti gliadin, anti tissue transglutaminase
Term
blunting of villi, hypertrophy of crypts and lymphocytes in lamina propria
Definition
celiac sprue
Term
associated with dermatitis herpetiformis
Definition
celiac sprue
Term
ulcer complication
Definition
hemorrhage and perforation
Term
Inflamm bowel: any portion of GI
Definition
crohn's
Term
Inflamm bowel: skip lesions
Definition
crohns
Term
Inflamm bowel: transmural inflammation
Definition
crohn's
Term
Inflamm bowel: cobblestone mucosa
Definition
crohn
Term
Inflamm bowel: string sign
Definition
crohn
Term
Inflamm bowel: granuloma
Definition
crohn
Term
Inflamm bowel: strictures
Definition
crohn's
Term
Inflamm bowel: fistulas
Definition
crohns
Term
Inflamm bowel: migratory polyarthritis
Definition
crohn's
Term
Inflamm bowel: erythema nodosum
Definition
crohn's
Term
Inflamm bowel: corticosteroids and infliximab
Definition
crohn's
Term
symptoms of irritable bowel
Definition
pain improves with defecation, change in stool frequency, change in appearance of stool
Term
rule of 2's for meckel's
Definition
2 in, 2 ft from ileocecal, 2% of population, first 2 years of life, 2 types of epithelia (gastric/pancreatic)
Term
currant jelly stools
Definition
intussusception
Term
telescoping of bowel into distal segment
Definition
intussusception
Term
insuss vs volvulus: childhood
Definition
intussusception
Term
intuss vs volvulus: elderly
Definition
volvulus
Term
where volvulus occurs
Definition
redundant mesentary, cecum and sigmoid
Term
double bubble
Definition
duodenal atresia
Term
associated with down syndrome
Definition
duodenal atresia
Term
bilous vomiting
Definition
duodenal atresia
Term
meconium ileus
Definition
in CF, plug obstructs intestine
Term
premature infants when fed too quickly
Definition
necrotizing enterocolitis
Term
pain out of proportion to physical findings
Definition
ischemc colitis
Term
bowel obstruction after recent surgery
Definition
adhesion
Term
bleeding in older patients
Definition
angiodysplasia
Term
angiodysplasia
Definition
tortuous dilation of vessels in cecum, terminal ileum and ascending colon
Term
symptoms of cardinoid
Definition
bronchospasm (wheezing) flushing, diarrhea, R sided heart murmur
Term
dense core bodies on EM
Definition
carcinoid tumor
Term
locations of carcinoid tumor
Definition
lungs, appendix, ielum, rectum
Term
effects of portal hypertension
Definition
esophageal varices, peptic ulcer -> melena, splenomegaly, caput medusae, ascites, hemorrhoids
Term
effects of liver cell failure
Definition
coma, scleral icterus, fetor hepaticus (breath smells musty), spider nevi, gynecomastia, jaundice, testicular atrophy, liver "flap" bleeding tendency, anemia, ankle edema
Term
aminotransferase diagnostic value
Definition
viral hepatitis (ALT > AST)
alcoholic hepstitis (AST > ALT)
Term
GGT diagnostic value
Definition
increased with heavy alcohol consumption
Term
alkaline phosphatase diagnostic value
Definition
obstructive liver disease, bone disease, bile duct disease
Term
amylase diagnostic value
Definition
acute pancreatitis, mumps
Term
lipase diagnostic use
Definition
acute pancreatitis
Term
ceruloplasmin diagnostic use
Definition
decreased in wilson dx
Term
ASA in child with chicken pox leads to
Definition
reye's syndrome
Term
ridings of reye
Definition
mitochondrial abnormalities, fatty liver, hypoglycemia, vomiting, hepatomegaly, coma
Term
mechanism of reye's
Definition
ASA metabolites decrease beta-oxidation by reversible inhibition of mitochondrial enzyme
Term
macrovesicular fatty change, reversible with alcohol cessation
Definition
hepatic steatosis
Term
neutrophilic infiltration, mallory bodies
Definition
alcoholic hepatitis
Term
AST > ALT
Definition
alcoholic hepatitis
Term
irreversible 'hobnail' sclerosis around zone III
Definition
alcoholic cirrhosis
Term
nutmeg liver caused by
Definition
R sided heart failure, and Budd-Chiari syndrome
Term
occlusion of IVC or hepatic veins
Definition
budd chiari
Term
ascites and varicose with absence of JVD
Definition
budd chiari
Term
causes of buds chiari
Definition
hyper coagulable state, polycythemia vera, pregnancy and hepatocellular carcinoma
Term
physiologic jaundice of newborn
Definition
immature UDP-glucuronyl transferase -> UC bili -> jaundice
Term
phototherapy tx
Definition
newborn jaundice, crigler-najjar I
Term
mildly decreased UDG glucuronyl transferase
Definition
gilbert, CN-II
Term
bilirubin increases with fasting and stress
Definition
gilbert
Term
absent UDP-glucuronyl transferase
Definition
crigler-najjar I
Term
tx plasmapheresis
Definition
crigler-najjar II
Term
responds to phenobarbital
Definition
CN II, gilbert
Term
bilirubin metabolism dx: increased conjugated
Definition
dubin-johnson and rotor
Term
black liver
Definition
dubin johnson
Term
defective liver bile ecretion
Definition
dubin johnson and rotor
Term
most common primary malignant tumor of liver
Definition
hepatocellular carcinoma
Term
causes of hepatocellular carcinoma
Definition
Hep B and C, Wilson's, hemochromatosis, alpha-1AT deficiency, alcoholic cirrhosis and aflatoxin
Term
tender hepatomegay, ascites, polycythemia, and hypoglycemia
Definition
hepatocellular carcinoma
Term
increased AFP
Definition
hepatocellular carcinoma
Term
autoimmune hepatitis ab
Definition
anti-mitochondiral -
ANA, anti-smooth mm, anti-LK microsomal +
Term
panacinar emphysema with cirrhosis
Definition
alpha-1AT deficiency
Term
cirrhosis with PAS positive globules in liver
Definition
alpha-1AT deficiency
Term
inadequate copper excretion -> accumulation in liver, brain, cornea, kidneys an joints
Definition
wilson's
Term
feature of wilson's
Definition
decreased ceruloplasmin, hemolytic anemia, basal ganglia degen, asterixis, dementia, dyskinesia, dysarthria
Term
wilson's tx
Definition
penicillamine
Term
triad of hemochromatosis
Definition
cirrhosis, DM, and skin pigmentation
Term
complication of hemochromatosis
Definition
CHF, testicular atrophy and increased risk of hepatocellular carcinoma
Term
hemochromatosis labs
Definition
increased: ferritin, iron, transferrin
decreased: TIBC
Term
hemochromatosis tx
Definition
phlebotomy and deferoxamine
Term
HLA with hemochromatosis
Definition
HLA-A3
Term
extra-hepatic obstruction -> increased pressure in intrahepatic ducts -> fibrosis and bile stasis
Definition
secondary biliary cirrhosis
Term
biliary tract dx: pruritis, jaundice, dark urine
Definition
secondary biliary cirrhosis, primary sclerosing cholangitis
Term
biliary tract dx: increased conjugated bilirubin, increased all phis and increased GGTP
Definition
secondary biliary cirrhosis, primary biliary cirrhosis and primary sclerosing cholangitis
Term
increased serum mitochondrial ab (IgM
Definition
primary biliary cirrhosis
Term
biliary tract dx: pruritus without jaundice
Definition
primary biliary cirrhosis
Term
onion skin of bold ducts -> beading on ERCP
Definition
primary sclerosing cholangitis
Term
biliary tract dx: hypergammaglobulinemia
Definition
primary sclerosin cholangitis
Term
biliary tract dx: with UC
Definition
primary sclerosing cholangitis
Term
risk factors for gallstones
Definition
female, fat, fertile, forty
Term
cholesterol stones associated with
Definition
obesity, crohns, CF, advanced age, clofibrate, estrogns, multiparty, rapid weight loss, and Native American origin
Term
pigment stones seen in
Definition
hemolysis, alcoholic cirrhosis, advanced age and biliary infection
Term
biliary colic
Definition
obstruction of common duct by gallstones causes bile duct contraction
Term
gallstone diagnosis
Definition
with radionuclide biliary scan, US
Term
charcot's triad
Definition
jaundice, fever, RUQ pain
Term
murphy's sign
Definition
inspiratory arrest on deep palpation due to pain
Term
causes of cholecystitis
Definition
gallstones, ischemia or infectious (CMV)
Term
what happened if you see air in biliary tree?
Definition
fistula between GB and small intestine
Term
hepatocellular jaundice
- type of bilirubin
- urine bilirubin
- urine urobilinogen
Definition
- direct/indirect
- increased
- normal/decreased
Term
obstructive jaundice
- type of bili
- urine bili
- urine urobilinogen
Definition
- direct
- increased
- decreased
Term
hemolytic jaundice
- type of bili
- urine bili
- urine bilinogen
Definition
- indirect
- absent
- increased
Term
Inflamm bowel: continuous starting in rectum
Definition
UC
Term
Inflamm bowel: mucosal and submucosal inflammation
Definition
UC
Term
Inflamm bowel: lead pipe on imaging
Definition
UC
Term
Inflamm bowel: crypt abscesses
Definition
UC
Term
Inflamm bowel: sclerosin cholangitis
Definition
UC
Term
Inflamm bowel: associated with colorectal CA
Definition
UC
Term
Inflamm bowel: a/w pyoderma gangrenosum
Definition
UC
Term
Inflamm bowel: a/w ankylosing spondylitis
Definition
UC
Term
Inflamm bowel: a/w uveitis
Definition
UC
Term
tx of UC
Definition
ASA preparations, 6-MP, infliximab, colectomy
Term
kids cause of appendicitis
Definition
lymphoid hyperplasia after viral infection
Term
adult cause of appendicitis
Definition
obstruction, fecalith
Term
initial diffuse periumbilical pain -> localized pain in RLQ
Definition
appendicitis
Term
diverticular disease most commonly in ___ colon
Definition
sigmoid colon
Term
diverticulosis is a/w ____
Definition
low fiber diets
Term
cause of diverticulosis
Definition
increased intraluminal pressure and focal weakness in colonic wall
Term
LLQ pain, fever, leukocytosis
Definition
diverticulitis
Term
cause of hirschsprung's
Definition
failure of NC cell migration -> no auerbach's and meissner's
Term
dialted coon proximal to aganglionic
Definition
hirschprung's
Term
type of polyp with CA
Definition
villous
Term
hyperplastic polyps
Definition
most common; in rectosigmoid colon
Term
juvenile polyps
Definition
sporadic; <5 y/o; 80% in rectum
Term
Peutz-Jeghers
Definition
multiple nonmalignant hamartomas with hyper pigmented mouth, lips, hands, genitalia
Term
FAP
Definition
APC gene on chromosome 5q; thousands of polyps; 100% progress to CRC
Term
gardner's syndrome
Definition
FAP + osseous and soft tissue tumors; retinal hyperplasia
Term
turcot's
Definition
FAP and CNS tumor
Term
HNPCC
Definition
aka lynch; DNA mismatch repair genes; 80% to CRC; proximal colon
Term
locations of CRC
Definition
rectosigmoid > ascending > descending
Term
exophytic mass, iron deficiency, weight loss
Definition
ascending CRC
Term
infiltrating mass, partial obstruction, colicky pain, hematochezia
Definition
descending CRC
Term
apple core lesion on barium enema
Definition
CRC
Term
CRC tumor marker
Definition
CEA
Term
microsatellite instability pathway
Definition
DNA mismatch repair -> sporadic and HNPCC
Term
APC/betacatenine pthway
Definition
85%;
loss of APC -> increased colonic risk
KRAS mutation -> adenoma
loss of p53 -> CA
Term
most common sites of carcinoid tumor
Definition
appendix, ileum, and rectum
Term
dense core bodies on EM
Definition
carcinoid tumor
Term
symptoms of carcinoid syndrome
Definition
wheezing, R sided heart murmurs, diarrhea, flushing
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