What is the most common salivary gland tumor?
What is are the characteristics of a pleomorphic adenoma?
1. Painless, moveable mass
2. High rate of recurrence
What are characteristics of a Warthin's tumor?
2. Heterotopic salivary gland tissue trapped in a lymph node, surrounded by lymphatic tissue
What is the most common type of malignant salivary tumor?
What is the pathophysiology of achalasia?
Failure of relaxation of the LES due to loss of myenteric plexus (Auerbach's plexus)
What are findings in achalasia?
1. Dysphagia to liquids and solids
2. High LES opening pressure and uncoordinated peristalsis
What is seen on barium swallow in achalasia?
1. Dilated esophagus with area of distal stenosis
2. "Bird's beak"
What condition does achalasia predispose to?
What are the primary causes of achalasia?
1. Chagas' disease
What findings are seen in gastoesophageal reflux disease?
2. Regurgitation upon lying down
3. Nocturnal cough
What findings are seen with esophageal varices?
1. Painless bleeding of submucosal veins in lower 1/3 of the esophagus
What are the causes of esophagitis?
5. Chemical ingestion
What are findings seen in Mallory Weiss syndrome?
Mucosal lacerations at the gastroesophageal junction due to severe vomiting, leading to hematemesis
Which populations are most at risk for Mallory Weiss syndrome?
What are findings in Boerhaave's syndrome?
Transmural esophageal rupture due to violent retching
What are risk factors for developing esophageal strictures?
1. Lye ingestion
2. Acid reflux
What are findings in Plummer Vinson syndrome?
1. Dysphagia due to esophageal webs
3. Iron deficiency anemia
What is the pathophysiology of Barret's esophagus?
Chronic acid reflux causes replacement of stratified squamous epithelium of the distal esophagus by intestinal columnar epithelium (metaplasia)
What conditions are associated with Barrett's esophagus?
2. Esophageal ulcers
3. Esophageal adenocarcinoma
What are eight risk factors for esophageal cancer?
3. Barrett's esophagus
5. Diverticuli (e.g., Zencker's)
6. Esophageal web (e.g., Plummer-Vinson)
What is the most common kind of esophageal cancer in the US?
What is the most common kind of esophageal cancer in the rest of the world?
Squamous cell carcinoma
What is the esophageal distribution of squamous cell esophageal cancer?
Upper 2/3 of esophagus
What is the esophageal distribution of adenocarcinoma of the esophagus?
Lower 1/3 of esophagus
What are the common findings of the malabsorption syndromes?
3. Weight loss
What is the cause of tropical sprue?
What is the treatment of tropical sprue?
How much of the small bowel can tropical sprue affect?
All of it
What is the cause of Whipple's disease?
Infection with Tropheryma whippelii
What is seen on histology with Whipple's disease?
PAS stained macrophages in the intestinal lamina propria
What extraintestinal symptoms may accompany Whipple's disease?
2. Cardiac symptoms
3. Neurological symptoms
What is the population most at risk for Whipple's disease?
What is the pathophysiology and findings of celiac sprue?
Autoantibodies to gluten (gliaden) in wheat and other grains lead to steatorrhea
Findings include antibodies to gliadin and tissue transglutamase, blunting of villi, and lymphocytes in the lamina propria
What portion of the bowel is primarily affected in celiac sprue?
The proximal part
What is the most common disaccharidase deficiency?
What are the causes of lactase deficiency?
2. Acquired (gastroenteritis)
What is the histological appearance of the bowel in lactase deficiency?
What is the pathophysiology of abetalipoproteinemia?
Failure to synthesize apoB leads to an inability to generate chylomicrons; this leads to fat accumulation in enterocytes and an inability to secrete VLDL into the bloodstream
At what age does abetalipoproteinemia present?
What are the most common causes of pancreatic insufficiency?
1. Cystic fibrosis
2. Obstructing cancer
3. Chronic pancreatitis