Term
|
Definition
|
|
Term
|
Definition
| Viral (A, B, C); Autoimmune; Drugs/Toxins |
|
|
Term
| Viral Hepatitis damage location |
|
Definition
| Patchy involvement of entire lobule with slight accentuation in the region around the central vein |
|
|
Term
| Incidence of viral hepatitis |
|
Definition
|
|
Term
| Histology of acute Hepatitis |
|
Definition
| Ballooning degeneration; Necrotic hepatocytes (some mummified as acidophil bodies); Inflammation; Prominence of Kupffer cells; Usually regeneration; Variable cholestasis, fatty change, etc. |
|
|
Term
| Which Hepatitis viruses can be spread by ingestion of fecal matter via close contact, sexual contact or contaminated food? |
|
Definition
|
|
Term
| Which hepatitis virus can be spread by body fluids through: birth, sexual contact or sharing needles? |
|
Definition
|
|
Term
| Which hepatitis virus can be spread by body fluids through: birth, sexual contact or sharing needles? |
|
Definition
|
|
Term
| Which hepatitis virus is spread PRIMARILY by sharing needles, but can also be spread by sexual contact & birth. |
|
Definition
|
|
Term
| Symptoms of viral hepatitis |
|
Definition
| Loss of appetite, nausea, vomiting, abdominal pain, gray-colored bowel movements, joint pain, jaundice |
|
|
Term
| Which hepatitis virus has no potential for chronic infection? |
|
Definition
|
|
Term
| Which hepatitis virus causes symptoms in acute infection in <10% of children <6yo but 70-80% of persons >14 yo |
|
Definition
|
|
Term
| Which hepatitis virus causes chronic infection in >90% of infants but only 6-10% of older children and adults? |
|
Definition
|
|
Term
| Which hepatitis virus causes chronic infection in 75-85% of newly infected persons? |
|
Definition
| Hep C, but 15-25% of newly infected people clear the virus |
|
|
Term
| Which hepatitis virus rarely causes lasting liver damage? |
|
Definition
|
|
Term
| Which hepatitis virus causes chronic liver disease in 15-25% of infected persons? |
|
Definition
|
|
Term
| Which hepatitis virus causes chronic liver disease in 60-70% of infected persons? |
|
Definition
|
|
Term
| What are the serologic tests for Hep A? |
|
Definition
|
|
Term
| What are the serologic tests for Hep B? |
|
Definition
IgM anti-HBc is positive in acute infection only.
HBsAg in acute and chronic infection. |
|
|
Term
| Which hepatitis virus has no serologic marker for acute infection? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| No meds available for acute infection; Chronic infection requires monitoring and occasionally antivirals are used. |
|
|
Term
|
Definition
| Antivirals for acute infection. Monitoring and occasional antiviral use for chronic infection. |
|
|
Term
| For which Hepatitis viruses are there vaccines? |
|
Definition
| Hep A (2 doses 6 mo apart) and B (child: 3-4 doses over 6 to 18 months; adult: 3 doses over 6 months) |
|
|
Term
| Which Hepatitis viruses cause liver cancer? |
|
Definition
|
|
Term
| Which hepatitis virus(es) are commonly spread via BLOOD? |
|
Definition
|
|
Term
| Which hepatitis virus(es) are commonly spread via FECES? |
|
Definition
|
|
Term
| Which hepatitis virus(es) are commonly spread via SALIVA? |
|
Definition
|
|
Term
| Which hepatitis virus(es) are commonly spread PERINATALLY? |
|
Definition
|
|
Term
| Which hepatitis virus(es) are commonly spread via HETEROSEXUAL sex? |
|
Definition
|
|
Term
| Which hepatitis virus(es) are commonly spread via HOMOSEXUAL SEX? |
|
Definition
|
|
Term
| Which hepatitis virus(es) are commonly spread INTRA-FAMILY? |
|
Definition
|
|
Term
| Which is the most common hepatitis in travelers? |
|
Definition
|
|
Term
| Which hepatitis is rare in medical personnel? |
|
Definition
|
|
Term
| Which hepatitis is common in medical personnel? |
|
Definition
|
|
Term
| Which is the most common sporadic hepatitis virus? |
|
Definition
|
|
Term
| Which is the most common cause of fulminant hepatitis? |
|
Definition
|
|
Term
| Which is the most common cause of posttransfusion hepatitis? |
|
Definition
|
|
Term
| Which is the most common cause of hepatitis in drug addicts? |
|
Definition
|
|
Term
| Which is the most common hepatitis virus in homosexual males? |
|
Definition
|
|
Term
| What fraction of people with Hepatitis B and C had no risk factors, respectively? |
|
Definition
|
|
Term
| Rank Hep A concentration in these body fluids: Serum, Urine, Saliva, Feces |
|
Definition
| Feces > Serum > Saliva > Urine |
|
|
Term
| What fraction of people infected with Hep A completely recover? |
|
Definition
|
|
Term
| What fraction of people infected with Hep B completely recover? |
|
Definition
|
|
Term
| What fraction of people infected with Hep C completely recover? |
|
Definition
|
|
Term
| Which types of Hep C are most common in USA? |
|
Definition
|
|
Term
| How is Hep E mostly transmitted |
|
Definition
| Fecally-contaminated drinking water |
|
|
Term
| What are other viral non-Hepatitis Virus causes of hepatitis? (4) |
|
Definition
| HSV, CMV, Adenovirus, EBV |
|
|
Term
| HLA B8, Dr3, Dr52 and Dr4 are associated with what? |
|
Definition
|
|
Term
| How to we treat autoimmune hepatitis? |
|
Definition
| Prednisone +/- Azathioprine |
|
|
Term
| What is NOT used to treat autoimmune hepatitis, which is used in viral hepatitis? |
|
Definition
|
|
Term
| What type of person classically gets Autoimmune Hepatitis? |
|
Definition
|
|
Term
| What serological findings are associated with Autoimmune hepatitis? |
|
Definition
| Hypergammaglobinemia, anti-Smooth muscle Ab, ANA |
|
|
Term
| What immunoglobulin is characteristic of Type 2 Autoimmune hepatitis? and what is a typical characteristic of a person who gets this disease? |
|
Definition
| anti-LKM-1 (liver kidney microsomal); Female children |
|
|
Term
| What immunoglobulin is associated with type 3 autoimmune hepatitis? |
|
Definition
| Antibody to soluble liver or soluble liver/pancreas Ag |
|
|
Term
| What pathological features are characteristic of drug-induced liver disease? |
|
Definition
| Disproportionate necrosis; Eosinophilia; Fatty change; Granulomas; Disproportionate cholestasis |
|
|
Term
| What are characteristics of Primary Biliary Cirrhosis |
|
Definition
| Chronic cholestatic liver disease; inflammatory destruction of intrahepatic bile ducts; middle-aged women; Elevated serum Alk Phos; Antimitochondrial antibodies; Classical destructive bile duct lesions with marked lymphocytic infiltrate ("florid duct lesion"); Ductopenia/absence of bile ducts in portal tracts |
|
|
Term
| What are characteristics of Primary Sclerosing Cholangitis? |
|
Definition
| Chronic cholestatic syndrome; Inflammation and obliterative FIBROSIS of intrahepatic and extrahepatic bile ducts; Young men; Ulcerative colitis; Elevated serum alkaline phosphatase; Radiographic multifocal irregular strictures and dilations (BEADING); Pathogenesis unknown; Periductal fibrosis and inflammation |
|
|
Term
| What are characteristics of Ascending Cholangitis? |
|
Definition
| Result from any lesions obstructing bile flow (e.g. choledocholithiasis); Usually enteric gram-negative aerobes; Fever; Acute inflammation of the wall of bile ducts with entry of neutrophils & leukocytes into the luminal space |
|
|
Term
| What are characteristics of Extrahepatic Biliary Atresia? |
|
Definition
| Obstruction of the lumen of extrahepatic biliary tree within the first 3 mo of life; the most frequent cause of death from liver disease in early childhood; progressive fibrosis and subsequent cirrhosis |
|
|
Term
| What is a genetic cause of iron overload? |
|
Definition
| Hereditary hemochromatosis (idiopathic, primary, genetic); 90% have C282Y mutation in HFE gene |
|
|
Term
| What are secondary causes of iron overload? |
|
Definition
Anemia and ineffective erythropoieses (thal major; sideroblastic anemia)
Liver disease (alcoholic cirrhosis; following portocaval anastamosis)
High iron intake (multiple transfusions; prolonged excessive medicinal iron ingestion; prolonged consumption of iron-laden wine, beer, etc) |
|
|
Term
| What are some characteristics of Hereditary Hemochromatosis? |
|
Definition
| Mostly males; HFE gene (C282Y); common in northern Europeans; Excessive body iron in parenchymal organs (liver, pancreas); Micronodular cirrhosis in all cases; DM & skin pigmentation (bronze diabetes) each in up to 75-80%; Cardiac failure is common cause of death; First symptoms usually appear in 5th-6th decades of life; Marked hemosiderin deposition in hepatocytes; Fibrosis & cirrhosis; diagnose C282Y homo gene or C282Y/H63D hetero; Quant tissue iron content of liver; Screen family; Treat w/phlebotomy |
|
|
Term
| What are some characteristics of Wilson Disease? |
|
Definition
| Genetic (AR); Disorder of copper metabolism; Gene is ATP7B on Chr13: Cu-transporting ATPase; over 300 muts; Impaired copper excretion into bile & failure to incorporate copper into ceruloplasmin; Hepatic disease; Kayser-Fleisher ring (slit-lamp exam); Coombs-negative hemolytic anemia due to rapid release of Cu from liver; Neuro signs first indication in 40%; Dx via hepatic biopsy for copper content; Tx: chelation |
|
|
Term
|
Definition
| Most commonly diagnosed genetic liver disease in infants and children; Pulmonary emphysema & liver disease; excessive accumulation of dysfunctional A1AT in hepatocytes; PAS(+), diastase-resistant globules in hepatocytes; Dx by serum quantification or phenotype determination |
|
|
Term
| What are some characteristics of Hepatocellular Carcinoma (Hepatoma)? |
|
Definition
| 90% of all primary liver cancers (but by far there are more mets in liver than 1' liver tumors); Strongly linked to prevalence of HBV infection (80-90% of cases in some areas, 6-13% in N. Amer.); Cirrhosis in 75-90% in Western countries; 13-43% in N. Amer. ass'd w/HCV; Also Aflatoxin B1 from moldy grains and peanuts; Looks like liver: single mass in a cirrhotic liver but may be multiple nodules or diffusely infiltrative; Elevated serum alpha-fetoprotein in ~50% of cases; 5y survivial <5% (but select patients >80%) |
|
|
Term
| What are some characteristics of Metastatic Liver cancer? |
|
Definition
| Most common malignant neoplasm of the liver; Colon, Breast, lLung, Pancreas; Multiple nodules in a non-cirrhotic liver |
|
|
Term
| What are some characteristics of Cholangiocarcinoma? |
|
Definition
| Adenocarcinoma with substantial fibrosis; Etiology unknown; Primary sclerosing cholangitis; ass'd with HCV, liver fluke, hepatolithiasis; Recurrent pyogenic cholangitis in SE Asia |
|
|
Term
| What are some characteristics of Angiosarcoma? |
|
Definition
| One of the few human cancers with specific carcinogens identified: vinyl chloride, arsenic, Thorotrast. |
|
|
Term
| What are some characteristics of Hepatocellular (Liver Cell) Adenoma? |
|
Definition
| Usually in young women with use of oral contraceptives; abdominal pain; rupture; Looks like normal liver but no central veins or portal areas |
|
|
Term
| What are some characteristics of Focal Nodular Hyperplasia? |
|
Definition
| Probably hyperplastic growth response to arterial malformation; Well demarcated but poorly encapsulated mass with a prominent central fibrous scar |
|
|
Term
| What are some characteristics of Hepatic Hemangioma? |
|
Definition
| Most common benign tumor of the liver; should not be mistaken for mets (do not perform blind percutaneous biopsy) |
|
|
Term
| What type of vitamin malabsorption occurs due to stomach disease? |
|
Definition
| Lack of instrinsic factor production due to pernicious anemia affects Vitamin B12 absorption in terminal ileum. Thought to be due to autoimmune chronic gastritis. May cause Megaloblastic Anemia and Neurologic spinal cord disease. |
|
|
Term
| Besides Vitamin B12, what else is absorbed in the terminal ileum? |
|
Definition
|
|
Term
| What diseases of the pancreas cause malabsorption? |
|
Definition
| Cystic Fibrosis and Pancreatitis |
|
|
Term
| What diseases of the small bowl cause malabsorption? |
|
Definition
General: Celiac disease, Tropical sprue, Whipple's disease
Specific: Disaccharidase deficiency, Abetalipoproteinemia, Bacterial overgrowth syndrome |
|
|
Term
| What controls release of food from the stomach to the duodenum? |
|
Definition
| Pyloric muscle controlled by Gastrin and Vagus nerve |
|
|
Term
| What is- and what causes dumping syndrome? |
|
Definition
| Food transits GI too quickly; get steatorrhea and malabsorption. Occurs following Gastrectomy and Gastrojejunostomy. |
|
|
Term
| What is absorbed in the proximal small intestine? |
|
Definition
| Amino acids, sugars, lipids, fat soluble vitamins (ADEK), iron, calcium, water soluble vitamins (B group incl. folate, Vit C) |
|
|
Term
| What is absorbed in the large intestine? |
|
Definition
| Mainly fluids and electrolytes |
|
|
Term
| What does the pancreas secrete? |
|
Definition
| Bicarbonate-rich fluid with enzymes: lipase, amylase & trypsin |
|
|
Term
| Where does the pancreas secrete its products? |
|
Definition
| Into the duodenum through the Ampulla of Vater (common orifice with Common Bile Duct) |
|
|
Term
| What are the pancreatic enzyme important for digesting? |
|
Definition
| Fat, carbohydrates and protein |
|
|
Term
| What control pancreatic enzyme release? |
|
Definition
| Secretin and Cholecystokinin (CCK) from SI mucosa |
|
|
Term
| What does the liver secrete that aids digestion and how is its release controlled? |
|
Definition
| Bile salts (stored in gallbladder), which solublize fat. Under Cholecytokinin control. |
|
|
Term
| What does pancreatic lipase do? |
|
Definition
| It breaks dietary triglycerides into fatty acids and monoglycerides, which combine as micelles. |
|
|
Term
|
Definition
| FFAs and monoglycerides enter mucosal cells and are freed from their bile salts. They then reform TGs, which combines with cholesterol and lipoprotein to form chylomicrons, which then enter the lymphatics and are stored in different parts of the body. |
|
|
Term
| What are some general symptoms of malabsorption? |
|
Definition
| Weight loss, muscle wasting, finger clubbing, general edema, anemia, tetany/osteopenia/rickets, bruising/bleeding, skin/mouth/eye signs. Failure to thrive in Peds. |
|
|
Term
| What are symptoms of malabsorption due to problems with the pancreas or small intestine? |
|
Definition
| Low levels of Serum albumin, Plasma lipids, Blood glucose, Serum iron, Serum calcium, Vit D, Vit A, Vit K (PT) |
|
|
Term
| How can you distinguish between low iron and low B12 and/or folate? |
|
Definition
Low iron: microcytic hypochromic anemia
Low B12/Folate: macrocytic anemia |
|
|
Term
| Which diseases of malabsorption are due to problems with brush border enzymes? |
|
Definition
| Celiac disease, tropical sprue and lactose intolerance. |
|
|
Term
| What is Zollinger-Ellison syndrome? |
|
Definition
| The combination of a gastrinoma (non-beta islet neuroendocrine tumor of pancreas) + gastric acid hypersecretion + severe peptic ulceration. Excess gastrin from the tumor causes excess acid, which inactivates pancreatic enzymes and causes ulcers. |
|
|
Term
| What can cause bile acid deficiency? |
|
Definition
| Hepatobiliary dysfunction, Bile duct obstruction, Ileal dysfunction or resection/decreased bile salt uptake |
|
|
Term
|
Definition
| Autoimmune disease in response to gliadin component of gluten protein in wheat, barley or rye. Associated with HLA-DQ2 and HLA-DQ8. Affected people have antibodies against gliadin and tissue transglutaminase. They have malabsorption due to decreased GI surface area. |
|
|
Term
|
Definition
| Etiology unknown but inflammation of the bowel, possibly due to disordered response to intestinal bacteria. Decreased SI surface area causes malabsorption. |
|
|
Term
| What is abetalipoproteinemia? |
|
Definition
| Genetic (AR) defect(s) in apoB-100 and apoB-48, causes inability to synthesize lipoproteins. Causes malabsorption of fats and fat-soluble vitamins. See decreased CM, VLDL, LDL. Fat accumulation within enterocytes. Symptoms of Vitamin E deficiency are most apparent. Occurs withing first few months of life. RBCs show acanthocytes/Burr cells due to abnormal lipid membrane |
|
|
Term
| What is an infectious cause of malabsorption? |
|
Definition
|
|
Term
| What are some conditions associated with Celiac disease? |
|
Definition
| Dermatitis herpetiformis (24%); DM type I (3-8%); Selective IgA deficiency (up to 8%); Down syndrome (up to 16%); Small long term risk of LYMPHOMA and SMALL INTESTINAL ADENOCARCINOMA if untreated |
|
|
Term
| What is the best serologic screening test for Celiac disease? |
|
Definition
| Anti-tissue transglutaminase (tTGA). Others are: IgA (total) and IgA anti-endomysium antibodies (AEA) |
|
|
Term
| How to you treat celiac disease? |
|
Definition
| Gluten free diet (zero tolerance) and a multivitamin may be needed |
|
|
Term
|
Definition
| Acute "travellers" diarrhea; resembles celiac disease; occurs mainly in Caribbean, South India, tropical SE Asia; affects both residents and visitors; due to bacterial overgrowth of enterotoxigenic organisms (E. coli & Haemophilus); may cause persistent malabsorption if untreated; responds to broad spectrum antibiotics |
|
|
Term
| What is Whipple's disease? |
|
Definition
| Rare infection caused by bacterial actinomycete - Tropheryma whippelii; affects adults (30s-40s); predominately males; systemic/any organ incl. GI, CNS, joints; symptoms: malabsorption and ARTHROPATHY (which is NOT seen in Celiac disease), also see fever, CNS complaints, lymphadenopathy and hyperpigmentation; Dx via SI biopsy, EM analysis + PCR of tissue sample; biopsy shows macrophages filling lamina propria with PAS+ cytoplasmic granules; treat w/antibiotics |
|
|
Term
| What are the consequences of lactase deficiency? |
|
Definition
| Osmotic diarrhea and increase hydrogen gas production |
|
|
Term
| Describe congenital lactase deficiency |
|
Definition
| Rare inherited deficiency; malabsorption begins with initiation of milk feeding; explosive frothy stools, abdominal distention; malabsorption corrected by cessation of milk products |
|
|
Term
| Describe aquired lactase deficiency |
|
Definition
| Acquired in adults, more common in Native Americans and African-Americans. Sometime ass'd w/viral or bacterial enteric infections; biopsy shows normal mucosa; responds to diet; lack of diagnosis leads to decreased iron absorption |
|
|
Term
| What is bacterial overgrowth syndrome? |
|
Definition
| When normal bacterial modulators fail: gastric acid, rapid movement, prominent lymphoid system. Get increased bacterial colonization in the upper GI. Caused by stasis of SI contents: post-surg blind loop, obstruction, abnormal motility (muscular or neurogenic) diabetes, scleroderma, amyloid) |
|
|
Term
| How does bacterial overgrowth syndrome cause malabsorption? |
|
Definition
| Direct injury to mucosal cells; Direct utilization of nutrients by bacteria; Deconjugation of bile salts resulting in poor micelle formation |
|
|
Term
| Should there normally be fat in feces? |
|
Definition
|
|
Term
| What is the D-Xylose tolerance test? |
|
Definition
| D-Xylose does not need digestion, it is simply absorbed. A fixed amount is ingested and urine and blood levels are measured. If levels are low then there is an absorption problem (as in Bacterial overgrowth syndrome) as opposed to a digestive problem. |
|
|
Term
|
Definition
| A chronic, usually solitary lesion in any part of GI that is exposed to acid-peptic juices |
|
|
Term
| Where are peptic ulcers most commonly found? |
|
Definition
| First portion of duodenum and the antrum of the stomach. |
|
|
Term
| What do GE reflux and Barret esophagus manifest as and where? |
|
Definition
| Peptic ulcer disease at the gastroesophageal junction. |
|
|
Term
| Where does peptic ulcer disease manifest in patients with Zollinger-Ellison syndrome? |
|
Definition
| The duodenum, stomach and jejunum |
|
|
Term
| What epithelial disorder is seen in Meckel diverticulum? |
|
Definition
| Peptic ulcer disease as there is ectopic gastric mucosa |
|
|
Term
| What is the lifetime risk of developing PUD in US for men and women? |
|
Definition
| 10% for males; 4% for females |
|
|
Term
| What fraction of people with duodenal ulcers and gastric ulcers have H. pylori infections, respectively? |
|
Definition
| 85-100% and 65%, respectively |
|
|
Term
| What type of drugs also causes peptic ulcers, and how? |
|
Definition
| NSAIDs via direct chemical irritation and inhibition of prostaglandin synthesis necessary for mucosal protection |
|
|
Term
| Other than NSAIDs and H. Pylori, what else can cause peptic ulcers? |
|
Definition
| Cigarette smoking, high dose corticosteroids, self-exposed or exogenous psychologic stress (increased gastric acid secretion), Zollinger-Ellison syndrome, Duodenal ulcers |
|
|
Term
| How far to peptic ulcerations extend into the mucosa? |
|
Definition
| They extend beyond the muscularis mucosae, usually into muscularis propria. |
|
|
Term
| Describe the clinical symptoms of peptic ulcers. |
|
Definition
| Epigastric pain, which tends to be worse at night and 1 to 3 hours after meals during the day. Relieved by alkalis or food. |
|
|
Term
| How are peptic ulcers treated? |
|
Definition
| Proton pump inhibitors or H2 histamine receptor antagonists to neutralize gastric acid. Surgical intervention. |
|
|
Term
| What are the complications of peptic ulcers? |
|
Definition
| Bleeding, perforation (2/3 of ulcer deaths) |
|
|
Term
| What are the two idiopathic inflammatory bowel diseases? |
|
Definition
| Crohn disease (CD) and Ulcerative colitis (UC) |
|
|
Term
| What ethnic group has the greatest rate of Idiopathic Inflammatory Bowel Disease? |
|
Definition
| Eastern European (Ashkenazi) Jews |
|
|
Term
| What diagnostic is seen in 75% of Ulcerative Colitis and only 11% of Crohn's Disease? |
|
Definition
| p-ANCA is in 75% of UC and 11% of CD |
|
|
Term
| What diagnostic is seen more often in Crohn's Disease? |
|
Definition
| anti-Saccharomyces cerevisiae (ASCA) is elevated in Crohn's Disease |
|
|
Term
| Can Crohn's Disease and Ulcerative Colitis always be differentiated? |
|
Definition
| No, often it's called Idiopathic Bowel Disease, indeterminate type |
|
|
Term
| What part of the GI does Crohn's Disease affect? |
|
Definition
|
|
Term
| What histologic finding is seen in Crohn's Disease? |
|
Definition
| Transmural inflammation and lymphoid aggregates. |
|
|
Term
| What is the classic sign of Crohn's disease? |
|
Definition
| Stenosis/obstruction ("String Sign" on X-ray) |
|
|
Term
| Describe the arrangement of Crohn's disease lesions |
|
Definition
| They are discontinuous ("skip" lesions) |
|
|
Term
| In what disease are Aphthous ulcers, linear ulcers ("cobble stone mucosa") and fissuring ulcers seen? |
|
Definition
|
|
Term
| What disease is associated with Fistula formation, Perianal disease and Granulomas (in 35% of resection specimens)? |
|
Definition
|
|
Term
| These clinical features describe what disease(?): diarrhea, fever, abdominal pain, loss of albumin, general malabsorption incl. B12, bile salts; migratory polyarthritis, sacroiliitis, ankylosing spondylitis, erythema nodosum, uveitis, moderate increased risk of GI cancer |
|
Definition
|
|
Term
| Where does Ulcerative Colitis manifest disease? |
|
Definition
| Only in the colon +/- backwash ileitis (minor ileum involvement); + the rectum is almost always involved |
|
|
Term
| Are there skip lesions in Ulcerative Colitis? |
|
Definition
| No, those are in Crohn's disease |
|
|
Term
| What disease has broad-based ulcers and pseudopolyps? |
|
Definition
|
|
Term
| How far into the mucosa does ulcerative colitis tend to extend? |
|
Definition
| Extends into crypts (crypt abscesses) and crypt distortion involving the entire mucosa but usually NOT into the muscle layer (not transmural) |
|
|
Term
| Toxic megacolon, perforation and colon cancer are local complications of what disease? |
|
Definition
|
|
Term
| These clinical features describe what disease(?): Bloody mucoid diarrhea, cramping lower abdominal pain, flare-ups precipitated by emotional or physical stress; arthritis; uveitis; erythema nodosum; pyoderma gangrenosum; PRIMARY SCLEROSING CHOLANGITIS |
|
Definition
|
|
Term
| These are all causes of what(?): NSAIDs, excessive alcohol consumption, heavy smoking, severe stress (trauma, burn, surgery), uremia, systemic infection, food poisoning, cancer chemotherapy and irradiation |
|
Definition
| Acute Gastritis/Gastric Erosions |
|
|
Term
| How to shock and sepsis cause Acute Gastritis/Gastric Erosions? |
|
Definition
|
|
Term
| How do aspirin and steroids cause Acute Gastritis/Gastric Erosions? |
|
Definition
| Decreased mucus production |
|
|
Term
| How to NSAIDs cause Acute Gastritis/Gastric Erosions? |
|
Definition
| Decreased prostaglandin production |
|
|
Term
| What is the number one cause of Chronic Gastritis? |
|
Definition
|
|
Term
| What organism is a curved, spiral or S-shaped gram-negative organism, which produces urease and colonizes the mucus-secreting epithelial cells of the stomach (not in the intestinal mucosa)? |
|
Definition
|
|
Term
| What causes chronic gastritis, peptic ulcer disease, gastric carcinoma as well as gastric MALT lymphoma? |
|
Definition
|
|
Term
| Serologic test for antibodies, Urea breath test and stool antigen test are all types of what? |
|
Definition
| Non-invasive tests for H. pylori |
|
|
Term
| Rapid urease test, Histology, Culture and bacterial DNA detection by PCR are all forms of what? |
|
Definition
| Invasive/endoscopic methods of testing for H. pylori |
|
|
Term
| What is distinctive about the histology of H. pylori gastritis? |
|
Definition
| Chronic inflammation with intraepithelial neurophils in gastric epithelium |
|
|
Term
| What disease is characterized by intestinal metaplasia, glandular atrophy and inflammation confied to the gastric body? |
|
Definition
| Autoimmune (atrophic) gastritis |
|
|
Term
| What are the immunological targets of Autoimmune gastritis? |
|
Definition
| Parietal cells and intrinsic factor |
|
|
Term
| What are the consequences of losing parietal cells (2 major) |
|
Definition
| Achlorhydria (hypergastrinemia), Loss of intrinsic factor (pernicous anemia) |
|
|
Term
| What is a potential consequence of autoimmune gastritis? |
|
Definition
| Increased risk of carcinoid tumor |
|
|
Term
| What is multifocal (environmental) atrophic gastritis? |
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Definition
| Intestinal metaplasia and atrophy mostly in the antrum, initially caused by H. pylori. Low or normal gastric acid secretion, normal gastrin leve, no pernicious anemia, most common precursor of intestinal type gastric carcinoma. |
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Term
| These are all risk factors for what(?): Lack of refrigeration; Consumption of preserved, smoked, and salted foods; Water contamination with nitrates; Lack of fresh fruit and vegetables |
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Definition
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Term
| What do gastric ascorbic acid and beta-carotene have in common? |
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Definition
| Ascorbic acid (Vitamin C) and Beta-Carotene (Vitamin A) inhibit steps in the cascade leading to Gastric Adenocarcinoma formation |
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Term
| What are these risk factors for(?): Autoimmune atrophic gastritis; Previous partial gastrectomy: bile reflux; Adenomas; Menetrier disease |
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Definition
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Term
| These mutations are genetic factors for what(?): Germline mutations in CDH1 (E-cadherin); BRCA2; Beta-Catenin; Microsatellite instability; Hypermethylation of TGF-Beta-RII; BAX; IGFRII; p16/INK4a; p53 |
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Definition
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Term
| Where is carcinoma of the stomach typically located? |
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Definition
| Antrum and pylorus: 50-60%; Caria: 25% |
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Term
| Describe and Intestinal-type Gastric Carcinoma |
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Definition
| Well differentiate (gland formation); almost universal intestinal metaplasia; Etiology: diet, environment, H. pylori |
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Term
| Describe Diffuse-type Gastric Carcinoma |
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Definition
| Pooly differentiated (signet ring cells); linus plastica/leather-bottle stomach appearance; etiology unknown/genetics |
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Term
| What are some clinical manifestations of gastric carcinoma? |
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Definition
| Weight loss, abdominal pain, anorexia, nausea, vomiting, GI bleeding, anemia |
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Term
| Where do Gastric Carcinomas spread? |
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Definition
| Mets to local or distant LN; Local invasion of duodenum, pancreas and retroperitoneum; Mets to distant organs: liver & lungs; Mets to ovaries ("KRUKENBERG TUMOR") |
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Term
| What is the prognosis of Gastric Carcinoma? |
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Definition
| Depends primarily on staging; Overall 5y survival in US <30%; >90% for EARLY gastric cancer in US; <20% for advanced gastric cancer |
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