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