Section 1
Preview this deck
Carcinoma
Front
| 5 | 0 | ||
| 4 | 0 | ||
| 3 | 0 | ||
| 2 | 0 | ||
| 1 | 0 |
Active users
0
All-time users
0
Favorites
0
Last updated
6 years ago
Date created
Mar 1, 2020
Cards (54)
Section 1
(50 cards)
Carcinoma
Solid food only progressive -no heart burn +weight loss >50 y/o
Lower esophageal ring
schatzki ring solid food only intermittent bread / steak
Linitis plastica
Thickened stomach wall due to diffuse infiltration by cancer cells
3 tests for the esophagus
1) endoscopy - therapeutic; diagnostic for lesions 2) barium swallow - assesses motility / function 3) manometry - gold standard to assess motility
Menetrier disease
Markedly thickened gastric folds (hypertrophy) decreased acid secretion protein-losing enteropathy b/c hypertrophy is in protein secreting cells cerebriform pattern on stomach precancerous gastric adenocarcinoma
Oral Hairy Leukoplakia
White patches Patches of the lateral tongue (#1 stie) Almost assoc w/ HIV (pre AIDS sign) Infreq seen in patients w/ other immunosupp Caused by EBV
Scleroderma esophagus
Solid and liquid food progressive chronic heart burn degeneration of myenteric plexus i.e. smooth muscle degenerates and LES is weak so patient cant swallow and has regurge
Signs of Sjogren's syndrome
Predominantly T-Cell infiltrates in exocrine tissues Autoantibodies anti-Ro (SS-A) and anti-La (SS-B), and rheumatoid factor Symptoms: cracked lips, dessicated oral tissues, fungal infections, difficulty speaking without fluids. Xerostomia- (decreased saliary production); Keratoconjunctivitis sicca- decreased tear production and subsequent corneal damage Typically middle aged females Bilateral parotid enlargement associated with non-Hodgkin's lymphoma
Chemical esophagitis
Alkaline solutions worse > acids worse > alkaline solids Alkali causes liquefactive necrosis (washes everything away) Acids cause coagulative necrosis, which kills the cells but leaves their skeleton intact, which leaves behind a protective eschar
Herpetic esophagitis
Infects epithelial cells Odynophagia HSV-1 Punched-out ulcers look for nuclear inclusions = ground glass → pushes chromatin to edges = margination Some cells are multinucleated with nuclear molding
Sialolithiasis
Formation of calculi in the ductal system of the salivary glands Most common cause of inflammation 80-90% of stones are in Wharton's duct (submandibular gland)
histo of squamous cell carcinoma versus adenocarcinoma
Sjogren's syndrome
Systemic autoimmune disorder associated with inflammation of epithelial tissues Most common medical disorder associated with xerostomia (dry mouth) and salivary dysfunction Primary SS Salivary and lacrimal gland disorder Secondary SS Occurs with other autoimmune diseases such as RA, SLE, scleroderma
Oral cancer associations
alcohol tobacco betel
Diffuse esophageal spasm
"corkscrew esophagus" solid and liquid food intermittent with chest pain
plumber vinson syndrome
post cricoid web + iron def anemia
Peptic ulcer description
Usually single 'Punched out', 'cookie cutter' i.e. smooth base and vertical sides, flat margins lesser curvature of stomach, antrum, duodenum
Squamous cell carcinoma of esophagus prevalence and risk factors
~50% Tobacco Alcohol Caustic ingestion Human papillomavirus? Achalasia Tylosis (palmoplantar keratoderma)
Erosion versus ulcer
erosion is superficial necrosis only involving the mucosa - heals with regeneration ulcer is necrosis involving layers beneath the mucosa - requires a scar to heal (fibrosis)
Adenocarcinoma of esophagus prevalence and risk factors
GERD/Barrett's esophagus Obesity Tobacco
Acute gastritis
Etiology : - Drugs : NSAIDs, ETOH, CA chemo. - Infection : H. pylori (acute infection), virus - Complication of other diseases : uremia - Mucosal damage (shock, trauma, burns, surgery) = 'Stress' Burns → Curling ulcer (↓ fluid volume → mucosal hypoxia) Brain trauma → Cushing ulcer (↑CN 10 firing → ↑ gastric acid secretion)
Lichen planus
usually asymptomatic, white, striated, bilaterally symmetrical lesions T-cell lymphocytic reaction to antigen treat with topical steroids
Sialoadentis
inflammation of a salivary gland Antibiotics Warm compress, massage, sialogogues (sour candy) Sialoendoscopy - newer technology Duct Marsupialization - risk of recurrence Gland Excision - open surgery with risks of nerve damage
Barrett's esophagus
metaplasia of esophagus from stratified squamous epithelium to intestinal simple columnar epithelium with goblet cells
Oropharyngeal cancer
Older patients - ETOH, tobacco younger pts- HPV 16, 18
Zollinger-Ellison syndrome
Gastrin-secreting tumor (often in the pancreas) associated with ulcers
Adenocarcinoma of esophagus histo
Zenker's diverticulum
Pulsion diverticulum caused by incomplete relaxation of the upper esophageal sphincter (UES) Killian's triangle- weakness between inferior constrictor and cricopharyngeus Symptoms- Dysphagia, regurgitation of undigested food, halitosis, cough, and aspiration pneumonia Occurs most commonly in older men
Achalasia
Solid and liquid food progressive no regurgitation weight loss LES is intact! with no relaxation
Histo of dysplastic barrett's esophagus
Herpetic esophagitis histo
3 ways malignancies can grow
fungating / polypoid infiltrating ulcerating
Autoimmune chronic gastritis
Autoimmune destruction of gastric parietal cells (body and fundus) = T cell mediated damage → Type IV Hypersensitivity reaction Ig against parietal cells or Ig against intrinsic factor are diagnostic but not the cause of the damage. Features → atrophy of mucosa, inability to produce acid → achlorhydria with ↑ gastrin (↓Acid) levels and antrum G-cell hyperplasia (loss of negative feedback) → Megaloblastic (pernicious) anemia r/t ↓IF →↑ risk for gastric adenocarcinoma: chronic inflammation induces intestinal metaplasia - goblet cells present in stomach* VERY HIGH YIELD Most common cause of Vit B12 def
Peptic Stricture
Solid food only progressive +heart burn no weight loss
places stomach cancer commonly spreads
L Supraclavicular node (Virchow node) Periumbilical Node (Sister Mary Joseph) Ovaries (Krukenburg Tumor)
Dysphagia roadmap
Intestinal adenocarcinoma
Arises from metaplastic intestinal epith. → intestinal glands i.e. chronic gastritis w/ intestinal metaplasia → dysplasia → adenoCA
Traction diverticulum
Formed by the pulling force of contracting bands of adhesion or adjacent inflammation (cervical spine hardware; lymph nodes from histoplasmosis or TB) True diverticulum- all layers of the esophagus
Symptoms of GERD
heart burn regurge chest pain cough tooth decay laryngitis can present with esophageal stricture
Diffuse adenocarcinoma
Stomach is diffusely thickened i.e. linitis plastica symptom is early satiety gastric mucous cells that are poorly differentiated and dis-cohesive (don't form glands) mucous cells = signet ring cells + desmoplasia
Epidemiology of infectious esophagitis
immunocompromised with AIDS, cancer, tranplant OR DM, ETOH abuse, elderly, systemic antibiotics Caused by candida, herpes, CMV
Hiatal hernia
protrusion of a part of the stomach upward through the hiatus of the diaphragm 95% are sliding 5% are paraesophageal
Cytomegalovirus images
wide/long ulcers grossly nuclear inclusions nuclearmegaly and cytomegaly
Pleomorphic adenoma (benign mixed tumor)
The most common salivary gland neoplasm; represents 50% of all and 90% of the benign ones most likely a parotid mass
Candida overview
Budding yeast pseudohyphae visible with PAS stain infects epithelial cells
Pulsion diverticulum
Formed by pressure within the hollow organ causing herniation of mucosa through the muscle False diverticulum- only mucosa and submucosa
malignancy growth pattern image
Eosinophilic esophagitis
allergy or diet mediated? influx of eosinophils into mucosa clinically, you'll see a ringed esophagus
Cytomegalovirus esophagitis
acquired through sexual contact infects cells of the lamina propria like endothelial cells and fibroblasts
Oral Leukoplakia
formation of white spots or patches on the mucous membrane of the tongue, lips, or cheek caused primarily by irritation Can be on spectrum from hyperkeratosis to degrees of epithelial dysplasia to in situ carcinoma
Section 2
(4 cards)