Block 14 > Path: GI Disorders 1 > Flashcards

Path: GI Disorders 1 Flashcards

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1
Q

3 common sources of Upper GI Bleeding

A

Duodenum ulcer, Stomach ulcer, Esophageal varices

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2
Q

Hematemesis

A

Bright red or coffee ground vomit

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3
Q

melena

A

Black tarry stool

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4
Q

Nasogastric lavage confirms what?

A

Upper source of bleed

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5
Q

3 main signs of upper GI bleeding

A

Hematemesis, Melena, Nasogastric lavage

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6
Q

Dilated submucosal veins in the lower esophagus secondary to portal HTN

A

Esophageal varices

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7
Q

What is the most common cause of esophageal varices

A

cirrhosis

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8
Q

Is Rupture of esophageal varices a medical emergency?

A

Yes

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9
Q

Sudden increase in intra-abdominal pressure from vomiting and alcohol abuse can lead to what?

A

Esophageal tears

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10
Q

What are the two types of esophageal tears

A

Superficial: Mallory-Weiss Tears, Transmural: Boerhaave syndrome

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11
Q

Superficial: Mallory-Weiss Tears produce _____________

A

Hematemesis (vomiting of blood)

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12
Q

Do Superficial: Mallory-Weiss Tears heal quickly?

A

Yes

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13
Q

Transmural: Boerhaave syndrome is a _______________ esophageal rupture

A

Full-thickness

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14
Q

Transmural: Boerhaave syndrome, what is usually required for treatment?

A

Prompt surgical intervention

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15
Q

Esophageal irritation and inflammation due to reflux of gastric contents into the lower esophagus

A

GERD

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16
Q

What is the most common cause of esophagitis?

A

GERD

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17
Q

What may trigger GERD?

A

Abrupt increase in intraabdominal pressure

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18
Q

Predisposing factors to GERD

A

Alcohol and tobacco use, Obesity, Hiatal hernia, Delayed gastric emptying

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19
Q

How does GERD present?

A

Heartburn, nocturnal cough and/or asthma-like symptoms

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20
Q

What endoscopy and biopsy findings appear with GERD

A

Erythema and inflammation of the squamous mucosa

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21
Q

Intestinal Metaplasia of the distal esophageal mucosa

A

Barrett esophagus

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22
Q

In Barrett esophagus, replacement of ________________ with ___________________________ occurs

A

Nonkeratinized stratified squamous with non-ciliated columnar epithelium containing goblet cells

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23
Q

Barrett Esophagus is a complication of chronic ___________

A

GERD

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24
Q

Is Barrett esophagus reversible?

A

Yes

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25
With Barrett esophagus, there is an increased risk of _____________________
Esophageal adenocarcinoma
26
How does the esophagus appear in Barrett Esophagus?
Appears as tongues of red, velvety mucosa
27
Is squamous cell carcinoma of the esophagus associated with Barrett esophagus?
No
28
Is squamous cell carcinoma of the esophagus associated with GERD?
No
29
What part of the esophagus is involved with squamous cell carcinoma?
Anywhere, upper and middle 3rd most common
30
Is adenocarcinoma of the esophagus associated with Barrett esophagus?
Yes
31
Is adenocarcinoma of the esophagus associated with GERD?
Yes
32
What part of the esophagus is involved with adenocarcinoma?
Lower one-third
33
Acute inflammation, erosion and hemorrhage of the gastric mucosa
Acute gastritis
34
Acute gastritis is an imbalance between _______________ and _______________ of the stomach
Mucosal defenses and acidic environment
35
What are some risk factors for acute gastritis?
Chronic aspirin or NSAID use, Alcohol use, smoking
36
Presence of _______________ in the mucosal epithelium represents active inflammation in acute gastritis
Neutrophils
37
What are the two main causes of chronic gastritis?
1. Helicobacter pylori infection (most common), 2. Autoimmune gastritis
38
What is the mechanism behind H. Pylori causing gastritis?
H. Pylori produces urease which converts urea to ammonia and increases the local gastric pH to protect the bacteria from acid
39
Diagnostic tests for H.pylori gastritis
Anti H-pylori antibodies, Urea breath test
40
Autoimmune Gastritis shows autoantibodies against ____________ and ______________
Parietal cells H+/K+ ATPase, Intrinsic Factor
41
How does autoimmune gastritis appear morphologically?
Mucosal atrophy with loss of glands and parietal cells
42
With autoimmune gastritis, there is increased risk for __________________
Gastric carcinoma
43
PUD are solitary ulcers of the _____________ and _______________
Proximal duodenum, Distal stomach
44
Predisposing factors to PUD
H.pylori infection - most common, Chronic NSAID and Aspirin use, steroid use, smoking
45
How does h. Pylori infection impact gastric secretions and mucosal defenses?
Increases gastric secretions, Decreases mucosal defenses
46
Peptic ulcers are 4x more common in the _______________ than in the _____________
Proximal duodenum than in the stomach
47
What defect appears with PUD?
Punched out defect
48
Are heaped-up margins in PUD more characteristic of benign or malignant lesions?
Malignant
49
How does a peptic ulcer present pain wise?
Epigastric burning or aching pain that is worse at night
50
Complication of PUD
Iron deficiency anemia
51
What causes duodenal ulcers?
H. pylori
52
Duodenal ulcers present with epigastric pain that ____________ with meals
Improves
53
Are duodenal ulcers malignant?
Almost never
54
Two causes of gastric ulcers
H. Pylori and NSAIDs
55
Gastric ulcers present with epigastric pain that ______________ with meals
Worsens
56
Gastric ulcers have an increased risk of _______________
Gastric carcinoma
57
Malignant proliferation of gastric epithelial cells
Gastric adenocarcinoma
58
Risk factors for gastric adenocarcinoma
H. Pylori, Chronic gastritis, Smoked fish and meats diet
59
Where do bulky tumors present with gastric adenocarcinoma?
Lesser curvature of antrum
60
What growth in gastric adenocarcinoma leads to diffuse rugal flattening and leatherbottle stomach
Infiltrative growth
61
Gastric Adenocarcinoma is asymptomatic until late in the course, what symptoms appear late?
Weight loss, Abdominal pain, Anorexia, Vomiting
62
What is the most important factor at time of diagnosis in gastric adenocarcinoma
Tumor stage
63
What tumor can metastasize to one of both ovaries with gastric adenocarcinoma?
Krukenberg tumor
64
What are the two paraneoplastic manifestations of gastric adenocarcinoma?
Acanthosis nigricans, Leser-Trelat sign
65
Hyperpigmented velvety plaques should make you think of what paraneoplastic diagnosis in gastric adenocarcinoma?
Acanthosis nigricans
66
Sudden appearance of multiple seborrheic keratoses should make you think of what paraneoplastic diagnosis in gastric adenocarcinoma?
Leser-Trelat sign
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