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pathology 2
GIT AND LIVER
| Question | Answer |
|---|---|
| These mouth sores can present during a cold or virus or just a fever. (unknown cause) | apthous ulcer (canker sore) |
| what's another name for herpes simplex | cold sores (vesicles) |
| what is thrush known as.... what causes it? when does it occur? | candidasis.... candida albicans (immunocompromised individuals) |
| what are the dangers of leukoplakia? | sq. cell carcinoma |
| is there pus in pyogenic granuloma> when do they occur? | no pus, "trauma" from skin eg) accidently bite lip |
| Is squamous cell carcinoma or basal cell carcinoma more dangerous? why? How are they confirmed? | SCC b/c BCC is slow growing... SCC scabbing and crusting never heals and would ned to do a skin biopsy. |
| 3 causes of sialadenitis | (inflammation of salivary gland) 1- viral mumps (parotid gland), 2 autoimmune-sjogrens syndrome(lacrimal glands & may affect all salivary glands), 3- bacterial (ascending bacteria from oral cavity OR duct obstruction by stone |
| what is viral mumps of pancreas or testis known as? | mumps orchitis |
| What are benign salivary gland tumors known as? | pleomorphic adenoma |
| factors and types of esophageal achalasia | 1- failure of lower esophageal sphincter to relax w/ swallowing, 2- decreased esophageal peristalsis, 3- primary achalasia (uncertain etiology), 4) secondary achalasia eg) Chagas disease |
| What causes Chagas disease? | Trypansoma cruzi destroys myenteric plexus |
| 2 types of hiatus hernia | 1-sliding(whole part of stomach can protrude into esophagus), 2- paraesophageal (one side of stomach shifts over esophagus) |
| What are 2 other things that could happen to esophagus other than hiatus hernia? | 1-Zenker's diverticulum(pouch), 2-Schatzki's rings-tight bands of fibrous tissue |
| diverticulitis vs diverticulosis | osis- pouch, itis- inflammation |
| what are esophageal varices? there cause? | dilated veins in esophageal wall, caused by obstruction to portal blood flow through liver.... occur in cirrhosis of liver and chronic alcoholism in US and portal hypertension in other countries |
| Lacerations in lower esophagus with tearing of varices can produce... | mallory-weiss syndrome which is massive life threatening hemorrhage |
| malena defined | blood in stools |
| what is hemoptysis? hematemesis? | hemoptysis -blood in lungs hematemesis- blood from GUT/ GIT |
| What's a cause of heartburn... and can lead to ______ which changes squamous epitherlium to________ | GERD- could lead to Barrets esophagus-epitherlium changes to columnar epi... greater increased risk of adenocarcinoma developing in glandular columnar epi of barrets esoph. |
| What consititutes most esophageal carcinomas? | US- half SCC, half adenocarcinoma... other countries 90% SCC |
| Two important causes of acute hemorrhagic erosive gastritis | alcohol consumption and heavy NSAID... shows hemorrhage and somtimes superficial ulcers... may caused hematemesis (vomiting blood) |
| 3 main types of chronic gastritis | 1-autoimmune chronic gastritis (< 10% of chronic gastritis), 2-chronic antral & distal body gastritis (H. Pylori => chronic pangrastritis =>multifocal atrophy, 3- chronic FUNDUS gastritis (organ speific autoimmune against gastric parietal cells) |
| what are the results of chronic fundus gastritis? | since parietal cells are destroyed there is NO gastric acid or intrinsic factor (resuting in pernicious anemia due to vit B12 deficiency) and (achlorhydria- decreased gastric acid occurs) |
| What is atrophic gastritis with gastric atrophy? | precursor for intestinal metaplasi and epithelial dysplasia which may develop into gastric adenocarcinoma... therefor a premalignant condition in stomach |
| where do peptic ulcers occur? | GI tract with acid -peptic gastric juice exposure...98% in first part of duodenum or gastric antrum 4;1 btw duodenum and stomach |
| there's a strong casual relationship btw peptic ulcers and_____ | H. pylori (which only grows on surface mucus layer of gastric type mucosa (can be treated by antibiotics) |
| what are 3 complications of ulcers? | bleeding, perforation, and duodenal obstruction |
| What is Meckel's diverticulum? | congenital diverticulum in ileum |
| what's a congenital disease in colon? | Hirschprungs disease (Mega colon) =>absence of myenteric Auerbach plexus |
| What is gastroparesis | weak gut |
| 2 major categories of infectious enterocolitis | 1-enterotoxigenic enterocolitis (Ecoli and vibrio cholerae) bacteria multiply on mucosal surface 2-enteroinvasive enterocolitis (Ecoli,Shigella, Salmonella, Yersinia, Campylobacter, Clostridium difficile)invade bowel & damage mucosal epi cells=> necrosis |
| what can infectious enterocolitis cause? | hyperperistalsis ... diarrhea |
| what 4 types of viruses infect superficial epithelial cells in the small intestine and cause diarrhea? | 1-rotovirus, 2-calciviruses (eg-Norwalk), 3-adenovirus, 4-astrovirus |
| what is a malabsorption syndrome, and 3 most common causes? | fx of nl abs of fat, carbs, protein, fat soluble vitamins, H2O/ 1-pancreatic insufficiency (cystic fibrosis), 2-celiac disease, 3-crohns disease/UC=> BULKY AND FATTY STOOLS |
| in celiac disease- where is inflammation present?... a strong genetic susceptibility is present with... | small bowel mucosa and destroys/flattens mucosal villi=>reduced nutrient abs... HLA types being associated |
| What is whipples disease and what's it caused by? | T-whippilei bacteria... diarrhea, joint px, CNS involvement (headache, seizures), malabsorption syndrome |
| another name for cystic fibrosis and the basic defect is.... | mucoviscidosis.... ABN function of an epithelial cell membrane chloride channel (mutations in the CFTR gene cause CF) |
| Why is cystic fibrosis a malabsorption syndrome? | causes destruction of exocrine secretory pancreas w/ decreased secretion of pancreatic digestive enzymes in duodenum |
| diverticulosis of sigmoid colon is interlinked with ... | constipation |
| what are the varying symptoms of ischemic (lack of blood flow) bowel disease? | ABD px, diarrhea(may be bloody), hemorrhagic bowel infaction, |
| an idiopathic cause of ischemic bowel disease is when the bowel rolls on itself called... | volvulus... requires surgery |
| another type of of ischemic bowel disease in infants. | intussusception of bowel in which intestine gets pushed on itself |
| 2 noninfectiousinflammatory bowel diseases | 1-crohn's (anywhere, more common in distal small bowel and/colon *transmural-involves full thickness of bowel wall *may show small granulomas) 2-ulcerative colitis (only colon- begins distally in rectal area) |
| crohns vs ulcerative colitis | crohns:skip lesions, granulomas, transmural affects more gut, UC: pseudopolyps, high chances colon cancer, affects more distal |
| 2 factors for pathogenesis of IBD..... genetic susceptibility of IBD | 1-strong immune response against nl bowel flora, 2-defects in nl intestinal epithelial barrier function which may allow nl bowel flora to have access to mucosal lymphoid tissue and initiatae immune response 15% ibd have affectred first degree relatives |
| What may form btw bowel loops b/c of transmural inflammation | fistulae |
| in chronic ulcerative colitis the inflammation is confined to .... | mucosa and submucosa... colectomy may be required for complications like severe diarrhea and bleeding |
| both crohns and CUC are associated w/ increased risk of developing | colonic or small bowel adenocarcinoma in diseased areas... and associated enteropathic arthritis => theres an increase of HLA B27 histocompatibility antigen |
| Non neoplastic colon polyps:1-what accounts for 90% epithelial colon polyps >50, no malignant potential? 2-usually under age 5, 3- seen in pts w/ severe crohns or cuc | 1-hyperplastic polyps, 2- juvenile polyps, 3-inflammatory polyps |
| benign adenomatous colonic polyps: 1 what are useally on narrow stalk >90% of total? 2- has a wider base, 1% of total, 3-a mixture of 2 types of polyps, 5-10% of total | 1-tubular adenomatous polyp, 2-villous adenomatous polyp, 3- tubulovillous adenomatous....... most colonic adenocarcnomas arise from these |
| premalignant conditions of GI tract | 1 barrets esophagus-from GERD, 2- chronic atrophic gastritis- from chronic fundus-body or antral gastritis, 3inflammatory bowel disease-chohns, cuc, 4-adenomatous colonic polyps |
| 2 complications of severe liver disease | 1-hepatorenal syndrome (renal fx 2 to liver disease w/no intrinsic kidney disease 2- (hepatic encephalopathy-(elevated blood ammonia, impairs brain function and cause cerebral edema) |
| where is most of the bilirubin formed?... the path to formation | spleen... then carried on albumin to liver(at this point it's not water soluble and must be attached to albumin in blood plasma)... taken to hepatocyte... after processing it's water soluble and excreted into the bile CONGUGATED BILIRUBIN |
| Hereditary hyperbilirubinemia is broken into 2 categories, and each is further broken down into what 2 types? | 1 unconjugated hyperbilirubinemia I. Gilberts syndrome, II. crigler-Najjar syndrome, 2. conjugated hyperbilirubinemia: Dubin-johnson syndrome, rotar syndrome |
| conjugated vs unconjugated bilirubin | conjugated: processed by liver for excretion in the bile, unconjugated: NOT processed by liver (sx-jaundice) |
| what are the food borne types of hepatitis | HAV, HEV (SPREAD BY FECAL/ORAL ROUTE) never cause chronic |
| What are the blood borne types of hepatitis?... and they canc cause chronic hepatitis... | HBV, HCV, HDV |
| WHAT 2 TYPES OF HEPATITIS COEXIST/ coinfect? | HBV, HDV |
| The most dangerous type of hepatitis? | HBV, HCV |
| NO JAUNDICE HEPATITIS IS | acute anicteric |
| with jaundice hepatitis is | acute icteric |
| massive hepatic necrosis is known as | fulminant hepatitis |
| which hepatitis are a carrieir state, chronic, and asymptomatic | HBV, HCV, HDV |
| CHRONIC ACTIVE HEPATITIS IS WITH WHAT TYPES OF HEPATITIS | HBV, HCV, HDV |
| what hepatitis people develop lifelong immunity and recover and the liver returns to normal? | HAV (mostly US), HEV (Other parts of world, pregnant women mortality rate is 20%) |
| this hepatitis is spread mainly by drug needle use, STD and maternal child route (90% vertical transmission rate), 90% develop immunity and recover, 5% asymptomatic carriers, 5% chronic active hepatitis | HBV |
| What are HBVs 3 antigens... and what appears in blood....and corresponding antibodies? | HBsurfaceAg, HBcore Ag,HBeAg (both HBsurfaceAg and HBeAg appear in blood),... anti HBc, anti HBe and anti HBs |
| the 4 important serologic markers used to evaluate status of HBV infection in ored they appear | HBsAg first after infection, HBeAg, antiHBc, anti HBs (last-indicates immunity to HBV AND APPEARS IN 90% of pts who recover |
| what is window period in HBV markers? | MAY BE A DELAY AFTER HBsAg disappears before anti HBs appears (anti HBs does not appear in blood of chronic ASYMPTOMATIC carriers, HBsAg persists and HBeAg disappears |
| chronic active HBV | anti HBs does not appear in blood of chronic ACTIVE carriers, HBsAg and [HBeAg INDICATED CONTINUED VIRAL REPLICATION AND inflammation in liver] persists in blood |
| chronic HBV INFECTION IS ALSO KNOWN AS | GROUND GLASS HEPATOCYTES |
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abva
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