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OPT GIT
| Term | Definition |
|---|---|
| dysphasia | difficulty swallowing |
| heartburn | retrosternal burning |
| hematemesis | vomiting blood |
| melena | blood in stool |
| esophageal varices | dilated veins that protrude into esophagus from portal hypertension that reverts blood to azygous system; especially in alcoholics and risk for rupture |
| esophagitis | injury and inflammation to esophageal mucosa; leads to esophageal carcinoma and Barrett esophagus |
| Barrett esophagus | seen in longterm GERD; stratified squamous epi replaced by columnar epic with goblet cells -increase risk of adenocarcinoma |
| esophageal carcinoma | can be squamous cell carcinoma (most common, Plummer-Vinson) or adenocarcinoma (Barrett esophagus) |
| cardia | region of stomach that is lined by foveolar cells that secrete mucin |
| fundus | region of stomach that is lined with endocrine G cells that secrete gastrin |
| body and antrum | regions of stomach that have chief cells to secrete pepsin |
| gastritis | inflammation of gastric mucosa, {majority of cases are chronic gastritis} |
| acute gastritis | usually transient in longterm NSAID/aspirin users |
| chronic gastrits | chronic mucosal inflammation that leads to mucosal atrophy and metaplasia; due to chronic infection of {Helicobacter pylori} |
| autoimmune gastritis | from autoantibodies to parietal cells; loss of intrinsic factor then leads to pernicious anemia |
| intestinal metaplasia | replacement of gastric epithelium with columnar epithelium with goblet cells -leads to gastric adenocarcinoma |
| gastric lymphoma | proliferation of lymphoid tissue in gastric mucosa from H. pylori |
| gastric ulceration | breaches of mucosa to submucosa or deeper |
| acute gastric ulceration | ulcers mainly in stomach and duodenum -{stress ulcers}- severe trauma and sepsis -{Curling ulcers}- extensive burns -{Cushing ulcers}- injury to CNS -chronic NSAIDs or steroid use |
| peptic ulcer disease (PUD) | solitary, relapsing lesions in response to excess acid -{the two most common causes are H. pylori and NSAID use} |
| Zollinger-Ellison syndrome | multiple peptic ulcers from {excess gastrin secretion} by a tumor; a paraneoplastic syndrome |
| gastric adenocarcinoma | first nodal involvement is seen in supraclavicular node {Virchow's node} |
| intestinal type | type of gastric adenocarcinoma that arises from gastric mucous cells having undergone metaplasia from chronic gastritis; differentiated |
| diffuse type | type of gastric adenocarcinoma that arises from gastric mucous cells not associated with chronic gastritis; poorly differentiated in infiltrative growth pattern |
| linitus plastica | stiffening of gastric wall from tumor; has leather bottle appearance |
| Krukenberg tumor | intraperitoneal spread of gastric adenocarcinoma in females to both ovaries |
| risk factors for gastric adenocarcinoma | 1. H. pylori infection 2. Epstein-Barr virus 3. chronic atrophic gastritis |
| Hirschsprung disease | -aka congenital megacolon; distention of colon due to lack of neural crest cell migration so some segments aganglionic and obstructions occur |
| hernia | weakness in peritoneal cavity that forms serosa-lined pouch |
| intestinal adhesions | caused by peritoneal inflammation and these develop during healing between bowel segments and abdominal wall |
| intussusception | telescoping of bowel into distal segment |
| volvulus | twisting of a loop of bowel about its attachment constricting venous outflow |
| colonic diverticulosis | blind pouch off the alimentary tract lined by mucosa, most commonly in colon -seen in refined, low-fiber diets in Western societies |
| hemorrhoids | vatical dilation of anal and perianal submucosal venous plexuses |
| diarrhea | increase in stool mass, frequency, or fluidity |
| bacterial/infectious enterocolitis | common when traveling with diarrhea; can ingest preformed toxin or enteric pathogen |
| most common malabsorption syndromes | 1. pancreatic insufficiency 2. celiac disease 3. Crohn disease |
| defective intraluminal digestion | failure to break down proteins, carbs, and fats; seen in {pancreatic insufficiency} |
| defective terminal digestion | classic example is {lactose intolerance}, a deficiency of lactase; inherited form is rare but acquired form is very common |
| defective transepithelial transport | {celiac disease} or gluten-sensitivity enteropathy is example of this |
| celiac disease | reduction of small intestine absorptive surface area leading to defective transepithelial transport of nutrients; sensitivity to protein gliadin -increased risk of T-cell lymphoma and intestinal adenocarcinoma |
| tropical sprue | malabsorption from an intestinal infection |
| Crohn disease (regional enteritis) | can affect any level of alimentary tract; deep {transmural} involvement with {skip lesions} and {non-caseating granulomas} -higher risk for colonic carcinoma |
| ulcerative colitis | in colon and limited to mucosa and submucosa; no granulomas or skip lesions -much much higher risk for carcinoma |
| polyps | tumorous mass that protrudes into lumen of the gut; can be neoplastic and non-neoplastic |
| hyperplastic polyp | most common type; multiple and small in rectum and left colon |
| hamartomatous polyp | includes juvenile and Peutz-Jeghers polyps |
| juvenile polyps | hamartomatous proliferation in children under 5 but also in adults |
| adenomatous polyps | aka colorectal adenomas; {neoplastic polyps} that appear to be familial and predispose to colorectal adenocarcinomas |
| sessile serrated adenoma | looks histologically like a hyperplastic polyp but has the malignant potential of an adenoma |
| familial polyposis syndrome | autosomal dominantly inherited diseases with greater chance for malignancies |
| familial adenomatous polyposis (FAP) | 500-2500 colonic adenomas that carpet mucosal surface; {due to a mutation of the tumor suppressor gene APC} with 100% risk of colon cancer |
| Gardner syndrome | extra intestinal tumors present, especially craniofacial; mutation on APC gene |
| Peutz-Jegher syndrome | small intestine hamartomatous polyps and melanotic pigmentations; increase cancer risk |
| Cowden syndrome | hamartomatous polyps in GIT; increased risk for breast and ovarian cancer |
| APC/β-Catenin pathway | pathway of colorectal carcinogenesis; {evolution of cancer occurs through morphologically identifiable stages} and follows the {adenoma-carcinoma sequence} |
| MSI (microsatellite instability) pathway | pathway of colorectal carcinogenesis with no clear morphologic correlates; due to inactivation of a DNA mismatch repair gene |
| Hereditary Nonpolyposis Colon Carcinoma Syndrome (Lynch syndrome) | inherited mutation of one of five DNA mismatch repair genes; example of MSI pathway |
| clinical stage | single most important prognostic indicator of colorectal carcinoma; determined by depth of invasion and presence or absence of lymph node metastasis |
| carcinoid tumors | arise from enterochromaffin cells of the gut; asymptomatic except affects of secretory products -tumors of the appendix are usually this type |
| Cushing syndrome | paraneoplastic syndrome with excess ACTH hormone produced |
| Carcinoid syndrome | seen with GIT carcinoids that have metastasized to liver; symptoms due to excess serotonin production |
| gastrointestinal lymphoma | H. pylori > B-cell, celiac disease > T-cell |
| McBurney's sign/point | pain or tenderness between belly button and iliac spine on the right side |
Created by:
aharnold
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