PATHOLOGY

Gastrointestinal

Click on the -?- to reveal/hide the answer.

Name the 6 risk factors for esophageal cancer:

A -?-Achalasia
B -?-Barretts esophagus
C -?-Corrosive esophagitis /C -?-Cigarettes
E -?-Esophageal web /E -?-EtOH
F -?-Familial

Matching: malabsorption syndromes

-?-celiac sprue autoantibodies to gluten in wheat & other grains; villus flattening & lymphocytic infiltrate
-?-disaccharidase deficiency most common is lactase deficiency → milk intolerance
-?-Whipple's disease PAS-positive macrophages
-?-tropical sprue Probably infectious; responds to antibiotics
celiac sprue tropical sprue Whipple's disease disaccharidase deficiency

Ulcers

identify as associated with either a gastric ulcer [G] or duodenal ulcer [D]:
-?-G pain greater with meals-weight loss
-?-D hypertrophy of Brunner's glands
-?-D pain decreases with meals-weight gain
-?-D almost 100% have H. pylori infection
-?-G H. pylori infection in 70%; NSAID use also implicated
-?-D due to ↑ gastric acid secretion or ↓ mucosal protection
-?-G due to ↓ mucosal protection against gastric acid

Inflammatory bowel disease

  CROHN'S DISEASE ULCERATIVE COLITIS
Possible etiology -?-Infectious Autoimmune
Location May involve any portion of the GI tract, usually the terminal ileum, small intestine & colon -?-Colitis=colon inflammation; continuous lesions with rectal involvement
Gross morphology Transmural inflammation; cobblestone mucosa, creeping fat, bowel wall thickening, linear ulcers, fissures -?-Mucosal inflammation; friable mucosal pseudopolyps with freely hanging mesentery
Microscopic morphology -?-Noncaseating granulomas Crypt abscesses & ulcers
Complications -?-Strictures, fistulas, perianal disease, malabsorption-nutritional depletion Severe stenosis, toxic megacolon, colorectal carcinoma
Extraintestinal manifestations Migratory polyarthritis, erythema nodosum -?-Pyoderma gangrenosum, sclerosing cholangitis

Matching: diverticular disease

-?-diverticulosis prevalence of diverticulosis in patients >60 yrs of age approaches 50%; caused by ↑ intraluminal pressure & focal weakness in the colonic wall; most frequently involves the sigmoid colon; associated with low-fiber diets; most often asymptomatic or associated with vague discomfort
-?-diverticulitis inflammation of diverticula classically causing LLQ pain; may be complicated by perforation, peritonitis, abscess formation, bowel stenosis
-?-diverticulum Blind pouch leading off the alimentary tract, lined by mucosa, muscularis, and serosa, that communicates with the lumen of the gut
diverticulum diverticulosis diverticulitis

Wilson's disease is characterized by:

A -?-Asterixis
B -?-Basal ganglia degeneration (parkinsonian symptoms)
C -?-Ceruloplasmin ↓, Cirrhosis, Corneal deposits (Kayser-Fleischer rings), Copper accumulation, Carcinoma (hepatocellular), Choreiform movements
D -?-Dementia

Jaundice

Jaundice Type Hyper-Bilirubinemia Urine Bilirubin Urine Urobilinogen
Hepatocellular conjugated/unconjugated -?- -?-Normal/↓
Obstructive -?-conjugated -?-
Hemolytic -?-unconjugated -?-Absent (alholuria)

Hereditary hyperbilirubinemias: matching

(item may be used more than once)
-?-Crigler-Najjar syndrome, type I findings jaundice, kernicterus, _ unconjugated bilirubin
-?-Dubin-Johnson syndrome grossly black liver
-?-Dubin-Johnson syndrome conjugated hyperbilirubinemia due to defective liver excretion
-?-Gilbert's syndrome mildly _ UDP-glucuronyl transferase
-?-Crigler-Najjar syndrome, type I treatment: plasmapheresis & phototherapy
-?-Gilbert's syndrome asymptomatic, but unconjugated bilirubin is elevated without overt hemolysis
-?-Crigler-Najjar syndrome, type I patients die within a few years
-?-Gilbert's syndrome associated with stress
Gilbert's syndrome Crigler-Najjar syndrome, type I Dubin-Johnson syndrome

Matching: Types of gallstones:

-?-mixed (radiolucent) most common type
-?-piment (radiopaque) Seen in patients w/ chronic RBC hemolysis, alcoholic cirrhosis, advanced age, biliary infection
-?-cholesterol (radiolucent w/ 10-20% opaque due to calcifications) associated with obesity, Chrohn's, cystic fibrosis, advanced age, clofibrate, estrogens, multiparity, rapid weight loss, Native American origin
cholesterol (radiolucent w/ 10-20% opaque due to calcifications mixed (radiolucent) piment (radiopaque)

The causes of acute pancreatitis are summarized in the mnemonic GET SMASHeD.

Name the causes. -?-Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune disease, Scorpion sting, Hyperlipideia, Drugs

Risk factors for gallstones are summarized in the 4 F's:

F -?-Female
F -?-Fat
F -?-Fertile
F -?-Forty

Pancreatic adenocarcinoma often presents with:

-?-abdominal pain radiating to back
-?-weight loss
-?-anorexia
-?-migratory thrombophlebitis (Trousseau's syndrome)
-?-pancreatic duct obstruction (malabsorption with palpable gallbladder)
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