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pathology 1 exam 4

Dr. Kashif

Other name for Aphthous Ulcer Canker sore
Cold or viral infection is associated with Aphthous Ulcer doesn’t have to be viral though
Herpes simplex is associated with cold sores (vesicles, fluid filled lession)
Candidiasis is also known as Thrush
Candidiasis can occur in pt with compromised immune systems
Leukoplakia is thick white plaque
Leukoplakia can occur in pt that smoke
leukoplakia can lead to squamous cell carcinoma
Which condition is more sever, leukoplakia vs candidiasis leukoplakia (candidiasis is more easily treated, antifungal, pH adjustment…)
Intraoral wound due to trauma that does not heal is called Pyogenic Granuloma
rodent ulcer is what type of cancer basal cell carcinoma
Basal cell carcinoma is fast or slow slow growing
Sialadenitis is inflammation of salivary gland
What are the 3 causes of sialadenitis Viral, Autoimmune, Bacterial
What is the viral cause of sialadenitis mumps
Mumps mainly involves (3) parotid gland, in adults: pancrease or testis
Autoimmune cause of sialadenitis sjogrens syndrome
What is affected in sjogrens syndrome lacrimal glands and possibly all the salivary glands
Bening salivary gland tumors are known as pleomorphic adenoma
Bacterial cause of sialadenitis may be due to ascending bacterial infection from oral cavity
another cause of baterial infection may be due to duct obstruction by a stone
Esophageal Achalasia is failure of the lower esophageal sphincter to relax with swallowing
Esophageal Achalasia esophageal peristalsis is affected in which way deacreased
achalasia of uncertain etiology primary achalasia
secondary achalasia is due to a known underlying disease
secondary achalasia which destroys the myentric plexus of the esophagus chagas disease
bacteria that causes chagas disease trypansoma cruzi
trypansoma cruzi destroys the myentric plexus of the esphagus
Hiatus hernia 2 types sliding and paraeophageal
sliding type of hiatus hernia can be cause of heart burn or "GERD"
Pouches in the esophagus are called diverticulum ( paraesophageal)
zenker's diverticulum is a pouch in esophagus that food can get trapped in and cause an infection (may need to be surgically removed)
Tight bands of fibrotic tissue surrounding the esophagus are known as schatzki's rings
Hiatal hernias in adults usually always occur where the stomach meets the esophagus
Can occur high in esophagus zenker's diverticulum
Can be caused by obstruction to portal blood flow through the liver Esophageal Varices
What are esophageal varices dilated veins in the esophageal wall
most common cause of cirrhosis alcoholism
Lacerations in the lower esophagus with tearing of these veins can produce massive life-threatening hemorrhage
Lacerations in lower esophagus producing hemorrhage is known as Mallory-Weiss syndrome
Gastroesphageal Reflux Disease GERD is also known as Barrett's esophagus
What change occurs in Barrett's esophagus Normal esophageal squamous epi. Is replaced by COLUMNAR epi
Barrett's esophagus increases risk of ______________ developing in glandular columnar epi adenocarcinoma
obstruction to portal blood flow may lead to portal hypertension
most common esophageal carcinoma squamous cell carcinoma
Acute Hemorrhagic Erosive Gastritis causes excess alcohol consumption and heay NSAID use
In acute hemorrhagic Erosive Gastritis, gastric mucosa shows: hemorrhage and sometimes superficial ulcers (erosions)
Acute Hemorrhagic Erosive Gastritis may cause hematemesis (vomiting blood)
Three main types of chronic gastritis autoimmune, Chronic antral and distal body, chronic fundus
T or F chronic fundus gastritis also has autoimmune cause TRUE
H. pyloris causes Increase acidity --->chronic antral and distal body gastritis
destruction of gastric parietal cells can lead to pernicious anemia (due to B12 def) AND Achlorhydria (decreased gastric acid)
parietal cells release HCL & intrinsic factor
Chron's or ulcerative collitis will not absorb B12 because Inflammation
Chronic gastritis can lead to gastric ______ atrophy
atrophic gastritis with gastric atrophy is a premalignant condition in the stomach
H. pylori is present in 90% of __________ ulcer patients and 70% _________ ulcer patients duodenal, gastric
3 complications of ulcers bleeding, perforations, duodenal obstruction
H. Pylori peptic ulcers are most commonly where in the intestine & where in stomach Duodenum & antrum
ratio of duodenal vs stomach peptic ulcers 4:01
Treatment for H. pylori antibiotic
Meckel's diverticulum is located in the ileum
congenital disease located in the ileum meckel's diverticulum
Hirsch prung's diease is congenital disease in the colon
in Hirsch Prung's disease, there is absence of myentric and auerbach plexus --> no/weak peristalsis
Megacolon is seen in hirsch prung's disease
gastroparesis is defined weak gut, poor peristalsis
2 types of infectious Enterocolitis Enterotoxigenic and Enteroinvasive
bacteria that multiply on the mucossal surface and secrete an enterotoxin is associated with enterotoxigenic enterocolitis
bacteria invading the bowel wall and damaging the mucosal epithelial cells is associated with enteroinvasive enterocolitis
E coli Sigella, Salmonella, Yersinia, Campylobacter, Clostridium difficle… are associated with enteroinvasive enterocolitis
E. coli and vibrio cholerae are associated with enterotoxigenic enterocolitis
In both enterotoxic&enteroinvasive bacteria cause _______ and increase _________ leading to hyperperistalsis and increased secretion of fluid into bowel, leading to diarrhea
Of the enterocolitis, which one does not usually damage the mucosal epi cells enterotoxigenic
salmonelia has been linked to which disease typhoid
What 4 types of viruses cause gastroenteritis rotavirus, caliciviruses, adenovirus, astrovirus
Which viral gastroenteritis virus tends to infect children rotavirus
What are the most comon causes of malabsorptions syndromes in US pancreatic insufficiency, celiac disease, Crohn's, Ulcerative colitis
Cystic fibrosis is one of the causes of pancreatic insufficiency
The result/ sx in Malabsorption syndromes fatty stools, diarrhea
Celiac Disease is caused by sensitivity to gluten
gluten can cause inflammation in the sm bowel mucosa and destroys mucosal villi
T or F celiac diease has a strong genetic susceptibility TRUE
Whipple Disease is rare bacteria infection T. Whippilei
T. Whipplei causes sx diarrhea, joint pains, CNS involvements (HA, seizures)
Whipple's disease is a _________ syndrome malabsorptions
Cystic Fibrosis is also known as mucoviscidosis
Basic defect is abnormal function of an epithelial cell membrane chloride channel cystic fibrosis
Can cystic fibrosis cause malabsortion yes. Of fats, proteins and carbs
Formation of pouches in colon Diverticulosis
Diverticula of sigmoid colon is an important cause of constipation
constipation can cause Diverticulosis? yes, it can go both ways
Ischemic Bowel Disease if is transmural (full thickness of muscle) can cause excruciating px, hemorrhagic bowel infarction
Causes of ischemic Bowel disease Gut rotating on itself (volvulus) and telescope curving on itself (intussusceptio)
Intussusception of bowel means intestine curving in on itself (telescope)
Volvulus of the bowel means rotation/twisting on itself
2 non infection inflammatory bowel diseases (IBD) are crohn's, Ulcerative colitis
Crohn's disease is also known as regoinal enteritis
Crohn's disease can affect any part of GI tract but usually DISTAL small or Colon
Ulcerative colitis can affect only Colon, begins from rectum and extends up
Difference between Crohn's and Ulcerative colitis location, Crohn's skip lesions & granulomas& transmural, UC pseudopolyps& inc risk colon cancer
Which IBD skip lesion crohn's
Which IBD peudopolyps Ulcerative Colitis
Which IBD granuloma Crohn's
Which IBD is transmural crohn's
Which IBD has increase risk for colon cancer both but ulcerative colitis more risk
15% of IBD patients have affected first degree relatives
Can IBDs be cured no, drugs and colectomy
In chronic ulcerative colitis, the inflammation is confined to the mucosa and submucosa
possible complications of colectomy severe diarrhea and bleeding
Crohn's and chronic UC are associated with increased risk of developing coloic or small owel ADENOCARCINOMA in diseased areas
Pt with crohn's or CUC that dev. Ass. Enteropathic Arthritis, there is an increased of B27 histocompatibility antigen
3 non neoplastic colon polyps hyperplastic, juvenile, inflammatory polyps
non neoplastic colon polyps that account for 90% of epithelial polyps hyperplastic
3 types of bening denomatous colonic polyps tubular, villous, tublovillus adenomatous polyp
Most colonic adenocarcinomas arise in pre-existing adenomatous colonic polyps
What can cause polyps decrease in fiber consumption
What disease has the whole intestine is covered with polyps familial adenomatous polyposis
What are 2 factors that contribute to IBD strong immune response against normal bowel flora, Defects in normal intestinal epithelial barrier
What are the 4 premalignant condition of GI tract? Barrett's esophagus, Chronic atrophic gastritis, IBD, Adenomatous colonic polyps
What causes Barrett's esophagus GERD
What is caused by either chronic fundus-body or antral gastritis chronic atrophic gastritis
Inflammatory bowel disease is caused by Renal Failure
In severe Liver Disease, which is secondary to it hepatorenal syndrome
What are 2 complications of severe liver disease hepatorenal syndrome, Hepatic Encephalopathy
What is a cause of Hepatic Encephalopathy elevated Blood Ammonia
Elevated blood ammonia can cause Cerebral edema and impair brain function
Liver produces which important _____ which lack of will cause increase blood ammonia Urea
Bilirubin is formed in the spleen
What are 2 categories of Hereditary HYPERbilirubinemia Unconjugated hyperbilirubinemia, conjugated hyperbilirubinemia
What are 2 types of unconjugated hyperbilirubinemia Gilbert's syndrome, Crigler-Najjar syndrome
What are 2 types of conjugated hyperbilirubinemia Dubin Johnson syndrome, Rotor syndrome
Conjugated or Unconjugated bilirubin has been proccessed by liver for excretion in bile Conjugated
What is a sign of excess bilirubin in body Jaundice
Which hepatitis virus is food borne A,E
Which hepatitis virus is blood borne B,C,D
Which hepatitis virus can coexist b,d
Which hepatitis virus are the most dangerous B & C
Which are clinical syndromes of viral hepatitis: Asymptomatic, actue anicteric hepatitis, acute icteric hepatitis, fluminant hepatitis, carrier state, chronic active hepatitis
What does acute anicteric hepatitis mean no jaundice
what does acute icteric hepatitis ean with jaundice
which of the clinical syndromes of viral hepatitis is the most dangerous fulminant hepatitis
why is fulminant hepatitis the most dangerous causes massive hepatic necrosis (could be due to durgs)
Which type of viral hepatitis cause carrier state chronic asymptomatic B,C,D
which type of viral hepatitis causes chronic active hepatitis B,C,D
which Hepatitis viruses are also described as STD's B & C
Which hepatitis viruses never cause chronic hepatitis A,E
Which hepatitis causes the most cases in the US A
Which hep viruses do people develop lifelong immunity and recover from illness A, E
Which hep viruse if contracted when pregnant can cause mortality (20%) E
Which hep viruse can mother transmit to child b
90% of persons develop immunity and recover Hep B
What are the 3 HBV antigens HBsAg (surface), HBcAg (core), HBeAg
Which HBV antigens appear in the blood HBsAg, HBeAg
T or F the 3 corresponding antibodies all appear in the blood TRUE
Which serologic marker is the 1st to appear after infection of HBV HBsAg
Which serologic marker is the last (4th) to appear after infection of HBV Anti HBs
Appears in 90% of patient who recover from HBV and indicated immunity Anti HBs
Ground glass appearance of hepatocytes is associated with Chronic HBV
define Window period delay after HBsAg disappears before Anti HBs appears
Persistence of HBeAg indicates continued viral replication and inflammation in the liver
Chronic Hepatitis is defined as persistence of symptoms or biochemical or serolodical evidence of infection > 6months
Which Hep viruses cause chronic hepatitis B,C,D
Which hep virus can only co-infect w/ HBV? HDV
Co-infection of HDV with HBV can occur at the same time or HDV may infect a person previously infected with HBV
Which virus is an incomplete viruse that does not have an envelope HDV
15-30% of patients with ___recover from acute infection HCV
In HCV at time of infection patient symptoms asymptomatic
4% of cause of ______ are result of transfusion hepatitis HCV
What percentage of patients with Hep C develop Chronic hepatitis
Do Antibodies against HCV produce immunity to the virus No
Since Antibodies against HCV do not producse immunity to the virus there is a high rate of progression (70-85%) to Chronic hepatits with complications
Development of post hepatitic cirrhosis,hepatocellular carinoma, fulminant hepatitis, Hepatorenal syndrome are possible adverse outcomes to chronic ______ HBV or HCV infections
Hepatocellular cariconma is a primary malignant tumor of liver cell origin
What are the 3 stages of Alcoholic Liver disease? 1.Fatty metamorphosis 2.Alcoholic Hepatitis 3.Cirrhosis
Which stages of Alcoholic liver disease are reversible 1 & 2 fatty metamorphosis and alcohilic hepatitis
Which stage is associated with lipid triglyceride droplets in liver ceels fatty metamorphosis
Which Hep viruses predispose pt to hepatocellular cancer B&C
Which stage is associated with lipid triglyceride droplets in liver cells and INFLAMMATION and may be fatal Alcoholic Hepatitis
Irreversible, progress may be halted if alcohol excess stops Cirrhosis
10-15% of pt with cirrhosis showed hepatic fibrosis and nodular regeneration
Mallory bodies is associated with alcoholic liver disease
Are eosinophilic aggregates of protein in cytoplasm of hepatocytes Mallory bodies
Fibrosis and nodular regeneration is associate with Cirrhosis
T or F people with cirrhosis are very itchy TRUE
Most comon cause of cirrhosis Alcoholic liver disease
Wilson's disease is associated with copper metabolism
Result of fibrosis and nodular regeneration is obstruction of blood and bile flow
Increased pressure in the portal venous system Portal Hypertension
Blood in the portal venous system seeks alternate routes to the right atrium
How does the blood in the portal venous system seek alternate routes by establishing PORTOSYSTEMIC VENOUS SHUNT
where do portosystemic venous shunts occur particularly in the lower esophagus (Esophageal varices) and Abdominal wal around umbilicus (Ceput medusae
What is caput medusae portosystemic venous shunt in abdominal wall around the umbilicus
What are 5 consequences of portal hypertension Ascites, portosystemic venous shut, congestive splenomegaly, hepatic encephalopathy, Esophageal lacerations&varices
Mallory-Weiss syndrome is Esophageal lacerations&varices
Ascites is fluid in abdominal cavity
Is NAFL (nonalcoholic fatty liver disease) a precursor to cirrhosis? yes
What are predisposing conditions to Nonalcoholic fatty liver obesity, type 2 diabetes mellitus, glucose intolerance, hyperlipidemia
In NAFL if there is associated INFLAMMATION and Hepatocyte destruction this is termed: Nonalcoholic steatohepatitis (NASH)
Define Hemochromatosis Excess Iron in body, difficulty processing Iron
What 4 organs does increase Iron affect Liver, Pancreas, skin, heart
Excess iron in pancreas may lead to diabetes mellitus
Excess iron in liver cirrhosis
Excess iron in the skin bronze color
Excess iron in mycardium cardiac enlargment
Wilson's disease is a disorder of copper metabolism
Excess Copper in liver cirrhosis (rare cause of cirrhosis)
Excess coper in brain Lenticular nucleus degeneration
Excess copper in Eyes Kayser-Fleisher rings (margin of cornea (limbus) )
What are the 2 types of Acute pancreatitis Acute interstitial pancreatitis, Acute necrotizing hemoorhagic pancreatitis
What are 2 main causes of Acute pancreatitis Gallstones, alcoholism
Comon infection that can affect pancreatic cells Mumps (viral)
What changes in Chronic pancreatitis Pancreatic tissue is replaced by Fibrous tissue
Chronic pancreatitis is most common in middle aged men, chronic alcoholics
Hypercalcemia and hyperlipoproteinemia are predisposing factors of acute and chronic pancreatitis
5th leading cause of cancer death in the US pancreatic adenocarcinoma
If pancreatic adenocarcinoma is located in the Head of pancreas Jaundice (60% located in head)
What is the 1st symptom of pancreatic cancer abdominal pain & severe back pain, by this time usually beyond cure
2 types of cholelithiasis cholesterol or bilirubin gallstones
What are two ddx methods for cholelithiasis ultrasound and MRI
gall stones (cholelithiasis) can cause cholecystitis (infection of gallbladder)
Created by: kfrancis