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66 Cards in this Set
- Front
- Back
mucosal webs -
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ledgelike mucosal protursions usually in the upper esophagus,
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achalasia -
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failure to relax
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the constellation of webs, iron deficiency anemia, glossitis, and cheilosis is called
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the plummer-vinson syndrome
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a luminal concretion of indigestible ingested material -
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bezoars
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diffuse invasion of macroscopic growth of gastric carcinoma throughout the wall creates a rigid thickened stomach,called -
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linitis plastica
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inlet patch -
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ectopic gastric mucosa in the upper third of the esophagus
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Heterozygous loss-of-function mutations in the receptor tyrosine kinase RET account for the majority of familial cases and approximately 15% of sporadic cases, of??
additional mutations: RET ligand glial-derived neurotrophic factor, endothelin, and the endothelin receptor |
hirschsprung disease
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high amplitude esophageal contractions in which the outer longitudinal layer of smooth muscle contracts before hte inner circular layer, diagnosis?
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nutcracker esophagus - short lived esophageal obstruction
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dital esophageal rupture and mediastinitis, diagnosis?
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boerhaave syndrome
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adherent gray white pseudomembrane composed of densely matted fugal hyphae and inflammatory cells coverring the esophageal mucosa, diagnosis?
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candidiasis
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basal epithelial cell apoptosis, mucosal atrophy, and submucosal fibrosis without significant acute inflammatory infiltrates in the esophagus, diagnosis?
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graft versus host disease
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a large number of intraepithelial eosinophils, particularly superficially in the esophagus, diagnosis?
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eosinophilic esophagitis
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mucosal polyps, composed of firbous and vascular tissue, or adiopose tissue, in the esophagus, diagnosis?
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fibrovascular polyps or penduculated lipomas respectively
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sessile lesions with a central core of connective tissue and a hyperplastic papilliform squamous mucosa, diagnosis?
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squamous paillomas
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what cells are found in each part of the stomach?
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The antral glands are similar but also contain endocrine cells, such as G cells, that release gastrin to stimulate luminal acid secretion by parietal cells within the gastric fundus and body.
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loss of the superficial epithelium, generating a defect in the mucosa that is limited to the lamina propria, in the stomach, diagnosis?
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erosion
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individuals with shock, sepsis, or severe trauma, are more likely to get what type of ulcer?
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stress ulcers
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ulcer occuring in the proximal duodenum and associated with severe burns or trauma, called?
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curling ulcers
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gastric, duodenal, and esophageal ulcers arising in persons with intracranial disease, diagnosis?
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cushing ulcers
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ulcer in which there is no scarring and thickening of blood vessels is?
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acute ulcer, scaring and thickening of blood vessels is a sign of chronic ulcers
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What are the top three complications of gastric ulcers?
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bleeding: 20%, 25% of ulcer deaths
perforation: 5%, 2/3 of ulcer deaths obstruction: mostly in chronic ulcers, most often associated with pyloric channel ulcers, duodenal ulcers, crampy abdominal pain, |
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patient presents with antral gastritis with high acid production but hypogastrinemia, diagnosis?
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H. Pylori infection
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what polymorphism is associated with development of pangastritis post h. pylori infection?
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IL-1beta
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antral mucosa that is erythematous and has a coarse or even nodular appearance, with intraepithelial neutrophils, pit abscesses, and subepithelial plasma cells, diagnosis?
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H pylori infection - intraepithelilal neutrophils and subepithelial plasma cells are really characteristic of H. pylori gastritis
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patient presents with decreased acids production, and hypergastrinemia, with inflammation in the body of the stomach, diagnosis?
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autoimmune gastritis against parietal cells
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defective gastric acid secretion -
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achlorhydria
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foveolar hyperplasia, glandular regenerative changes, and mucosal edema, post gastric surgery, diagnosis?
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reactive gastrophathy
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longitudinal stripes of edematous erythematous mucosa alternating with less severely injured mucosa that is sometimes referred to as watermelon stomach, diagnosis?
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gastric antral vascular ectasia
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thickened folds covered by small nodules with central aphthous ulceration, increase in the number of intraepithelial T lymphocytes, mostly CD8+ cells, in the stomach, diagnosis?
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lymphocytic gastritis
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granulomas, narrowing and rigidity of the gastric antrum, and transmural granulomatous inflammation of the stomach with aggregates of epithelioid histiocytes, diagnosis? and possible causes?
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granulomatous gastritis:
- gastric involvement of crohns disease -sarcoidosis -infections: mycobacteria, fungi, CMV, and H. pylori |
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how do chronic renal failure and hyperparathyroidism cause duodenal ulcres?
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hypercalcemia stimulates gastrin production and therefore increases acid secretion
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a round to oval, sharply punched out defect in the proximal duodenum, diagnosis?
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peptic ulcer
-heaped-up margins are more characteristic of cancers |
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patient presents with pain 1-3 hours after meals during the day, gets worse at night, and is releived by alkali or food, sometimes having nausea, vomiting, bloating, belching, diagnosis?
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peptic ulcers
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oxyntic atrophy comes with an increased risk of?
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gastric adenocarcinoma
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variations in epithelial size, shape, and orientation along with coarse chromatin texture, hyperchromasia, and nuclear enlargement, what are these hallmarks for?
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morphologic hallmakrs of dysplasia
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how do you tell the difference between reactive epithelial cells and dysplastic lesions?
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they both have increased epithelial proliferation and mitotic figures, but dysplastic lesions remain cytologically immature while the epithelial cells mature as they reach the mucosal surface
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reactive epithelial proliferation associated with entrapment of epithelial lined cysts, in the submucosa -
in the deeper layers of the gastric wall - |
gastritis cystica profunda gastritis cystica polyposa
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irregular enlargement of the gastric rugae, hyperplasia of foveolar mucous cells, with glands that are elongated with corkscrew-like appearance and cystic dilation, diagnosis?
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menetrier disease - caused by excessive secretion of transforming growth factor alpha,
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within the stomach there is a doubling of oxyntic mucosal thickness due to a fivefold increase in the number of parietal cells, diagnosis?
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zollinger-ellison syndrome - gastrinoma
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what polyp is likely to form due to chronic use of PPI's?
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fundic gland polyp
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what is the likely polyp to form in an individual with atrophic gastritis?
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inflammatory or hyperplastic polyps
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enlargement, elongation, and hyperchromasia of epithelial cell nuclei, epithelial crowding, and pseudostratification occuring in the antrum of the stomach, diagnossi?
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gastric adenoma -
low grade and high grade which would likely include glandular budding and gland-within gland, or cribiform, structures |
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Germline mutations in CDH1, which encodes E-cadherin, a protein that contributes to epithelial intercellular adhesion, are associated with what cancer?
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familial gastric cancers, usually the diffuse type
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what type of gastric cancer predominates in high risk areas?
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intestinal type, developing from precursor lesions including flat dysplasia and adenomas
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The t(11;18) --> API2-MLT fusion protein will lead to what cancer?
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MALToma
although most MALTomas are associatedw with H. pylori, if there is a genetic mutation association with the cancer, this will lead to antibiotic failure in treatment and the cancer will remain |
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reactive appearing b cell follicles may be present and plasmacytic differentiation can be observed in MALTomas, as well as tumor cells accumulating large amounts of pale cytoplasms, called?
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monocytoid
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Cancer in the GI with CD19 and CD20, expression, diagnosis?
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mature b cell tumor: MALTomas
they do not have: CD5 or 10 (immature B cell markers) |
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where is the typically the most dangerous place to find a carcinoid tumor in the GI?
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the midgut: jejunum and ileum - often multiple and tend to be aggressive, greater depth of local invasion, increased size, and presence of necrosis and mitosis are associated with poor outcomes
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young female has gastric GIST, paraganglionma, and pulmonary chondroma, diagnosis?
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Carney triad (GIST- GI stromal tumor)
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c-KIT is associated with what GI tumor?
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GIST - gain of function mutations
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the sigmoid colon and rectum get supplied with blood from?
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inferior mesenteric, pudendal, and iliac arterial circulations
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patient presents with suface epithelial atrophy, some necrosis and sloughing, with normal or hyperproliferative crypts in the splenic flexure, diagnosis?
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ischemic bowel disease - the surface epithelium is the most vulnerable to ischemic damage
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what are the four phases of nutrient absorption?
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(1) intraluminal digestion, in which proteins, carbohydrates, and fats are broken down into forms suitable for absorption; (2) terminal digestion, which involves the hydrolysis of carbohydrates and peptides by disaccharidases and peptidases, respectively, in the brush border of the small intestinal mucosa; (3) transepithelial transport, in which nutrients, fluid, and electrolytes are transported across and processed within the small intestinal epithelium; and (4) lymphatic transport of absorbed lipids.
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patient presents with increased numbers of intraepithelial CD8+ T cells, intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy, diagnosis?
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celiac disease
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FOXP3 gene mutation leads to what disorder?
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autoimmune enteropathy - IPEX: immune dysregulation, polyendocrinopathy, enteropathy, and X linkage,
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mutation in MTP leads to?
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*microsomal triglyceride transfer protein), enterocytes are unable to export lipoproteins and ffa's, then malabsorption of abetalipoproteinemia --> this leads to defects in lipid membranes causing burr cells
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what are the diagnostic criteria for irritable bowel syndrome?
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occurrence of abdominal pain or discomfort at least 3 days per month over 3 months, improvement with defectation, and a change in stool frequency or form
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NOD2 mutations lead to susceptibility to what disease?
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Crohn's disease
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a UC patient undergoes surgery to have their colon removed, now the distal segment of colon is erythematous, friabile, and has developed numerous mucosal lymphoid follicles, diagnosis?
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diversion colitis
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patient presents with rectal bleeding, mucus discharge, and an inflammatory lesion of the anterior rectal wall, diagnosis?
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solitary rectal ulcer syndrome --> with an inflammatory polyps
An inflammatory polyp may ultimately form as a result of chronic cycles of injury and healing. Entrapment of this polyp in the fecal stream leads to mucosal prolapse. Thus, the distinctive histologic features are those of a typical inflammatory polyp with superimposed mucosal prolapse and include lamina propria fibromuscular hyperplasia, mixed inflammatory infiltrates, erosion, and epithelial hyperplasia |
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macrocephaly, intestinal hamartomatous polyps, and benign skin tumors, typically trichilemmomas, papillomatous papules, and acral keratoses. A variety of other lesions derived from all three embryologic layers, including subcutaneous lipomas, leiomyomas, and hemangiomas, also occur, diagnosis?
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cowden syndrome
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harmartomatous polyposis with nail atrophy and splitting, hair loss, and areas of cutaneous hyperpigmentation and hypopigmentation, diagnosis?
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cronkhite-candada syndrome
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serrated architecture throughout the full length of the glands, including the crypt base, associated with lateral growth and crypt dilation, found in the right colon, diagnosis?
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sessile serrated adenoma - seperate from hyperplastic polyps (more commonly found in the left colon)
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How do tumors differ in their growth patterns from the proximal colon to the distal colon?
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Tumors in the proximal colon often grow as polypoid, exophytic masses that extend along one wall of the large-caliber cecum and ascending colon; these tumors rarely cause obstruction. In contrast, carcinomas in the distal colon tend to be annular lesions that produce “napkin-ring” constrictions and luminal narrowing
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tumor populated by immature cells derived from the basal layers of transitional epithelium
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basaloid - tumor populated by immature cells derived from the basal layers of transitional epithelium
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child has fusion of genes associated with ewing sarcoma and wilms tumor (EWS-WT1) --> t(11;22), what cancer will this cause?
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desmoplastic small round cell tumor of the peritoneum - aggressive tumor
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