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pathology 1 exam 4
Dr. Kashif
| Question | Answer |
|---|---|
| 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) |
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kfrancis
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