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GI Path

Terms in this set (62)

list malabsorption syndromes (6)
1. celiac sprue
2. tropical sprue
3. Whipple's disease
4. abetalipoproteinemia
5. pancreatic insufficiency
6. disaccharidase deficiency
esophageal cancer
mnemonic
SAC on A BED
S-squamous cel carcinoma
A-alcohol/achalasia
C-cigarettes

A-adenocarcinoma
B-barrett's esophagus
E-esophageal web/esophagitis
D-diverticula (ie, Zenker's)
auto-antibodies to gliadin and tissue transglutaminase
Celiac sprue
Whipple's disease
mnemonic
FOAMY WHIPped cream in a CAN

FOAMY (PAS-positive) macrophages

C-cardiac symptoms
A-arthralgias
N-neurological symptoms
Malabsoprtion Syndromes
mnemonic
These Will Cause Devastating Absorption Problems

T-tropica sprue
W-whipple's disease
C-celiac sprue
D-disaccharidase deficiency
A-abetalipoproteinemia
P-pancreatic insufficiency
loss of myenteric (Auerbach's) plexus
leads to
Achalasia
tx of peptic ulcer
triple therapy:
1. PPI
2. clarithromycin
3. amoxicillin (metronidazole if allergic)
symptoms associated w/
Malabsorption Syndromes
1. diarrhea
2. steatorrhea
3. weight loss
4. weakness
failure of neural crest cell migration
leads to
Hirschsprung's disease
increased alpha-fetoprotein =
hepatocellular carcinoma/hepatoma
Wilson's disease
(hepatolenticular degeneration)
mnemonic
Copper is Hella BAD
5, 1, 1, 1, 3

C-Ceruloplasmin decreased, Cirrhosis, Corneal deposits (Kayser-Fleischer rings), Copper accumulation, Carcinoma (hepatocellular)

H-Hemolytic anemia
B-Basal ganglia degeneration (parkinsonian symptoms)
A-Asterixis
D-Dementia, Dyskinesia, Dysarthria
tx of Wilson's disease
penicillamine
HLA-A3 associated
Hemochromatosis
Hemochromatosis
mnemonic
Hemochromatosis Can Cause Deposits

H-hemosiderin
C-cirrhosis
C-CHF
D-diabetes
Hereditary Hemochromatosis
treatment
repeated phlebotomy and deferoxamine
Cholesterol Stones
associations
1. obesity
2. Crohn's disease
3. cystic fibrosis
4. advanced age
5. clofibrate
6. estrogens
7. multiparity
8. rapid weight loss
9. Native American origin
Pigment Stones
associations
1. chronic hemolysis
2. alcoholic cirrhosis
3. advanced age
4. biliary infection
Cholelithiasis causes:
1. Cholecystitis
2. ascending cholangitis
3. acute pancreatitis
4. bile stasis
5. biliary colic
6. fistula b/w gallbladder and Sm Int
Acute Pancreatitis
mnemonic
GET SMASHED

G-galstones
E-ethanol
T-trauma

S-steroids
M-mumps
A-autoimmune disease
S-scorpion sting
H-hypercalcemia/hypertriglyceridemia
E-ERCP
D-drugs (i.e., sulfa drugs)
Pancreatic adenocarcinoma
presents w/
1. abdominal pain radiating to back
2. weight loss (due to malabsorption and anorexia)
3. migratory thrombophlebitis: redness/tenderness on palpation of extremities (Trousseau's syndrome)
4. obstructive jaundice with palpable gallbladder (Courvoisier's sign)
associated w/ CA 19-9
Pancreatic adenocarcinoma
ALT > AST
Viral hepatitis
AST > ALT
Alcoholic hepatitis

make a toAST w/ alcohol
associated w/ CEA
colorectal cancer (CRC)

pancreatic adenocarcinoma to lesser degree.
skip lesions
Crohn's disease
rectal sparing
Crohn's disease
cobblestone mucosa
Crohn's disease
creeping fat
Crohn's disease
noncaseating granulomas and lymphoid aggregates
Crohn's disease
transmural inflammation
Crohn's disease
disordered response to intestinal bacteria
Crohn's disease
autoimmune IBD
Ulcerative colitis
loss of haustra -> lead pipe appearance on imaging
Ulcerative colitis
Esophageal varices
painless bleeding of submucosal veins in lower third of esophagus
Boerhaave syndrome
transmural esophageal rupture due to violent retching
Mallory-Weiss syndrome
mucosal lacerations at gastro-esophageal junction due to severe vomiting
Mallory-Weiss syndrome
leads to
hematemesis
Mallory-Weiss syndrome
usually found in:
alcoholics and bulimics
Esophageal strictures
associated w/
lye ingestion and acid reflux
causes of gallstones (4)
1. increased cholesterol
2. increased bilirubin
3. decreased bile salts
4. gallbladder stasis
radiolucent gallstones
cholesterol stones
radiopaque gallstones
pigment stones
Charcot's triad of cholangitis
1. jaundice
2. fever
3. RUQ pain
inspiratory arrest on deep palpation due to pain
positive Murphy's sign -> gallstones
gallstones most often cause
(3 others)
cholecystitis

also, ascending cholangitis, acute pancreatitis, bile stasis
inflammation of gallbladder
cholecystitis
causes of cholecystitis (3)
1. gallstones (usually)
2. ischemia (rarely)
3. infectious - ie, CMV (rarely)
what may be increased in cholecystitis if bile duct becomes involved
alkaline phosphatase
autodigestion of pancreas by pancreatic enzymes
acute pancreatitis
pt presents with anorexia, nausea, and epigastric abdominal pain that radiates to her back
acute pancreatitis
labs: elevated amylase, elevated lipase
acute pancreatitis
pancreatic adenocarcinoma
risk factors (4)
1. tobacco (not EtOH)
2. chronic pancreatitis (esp > 20 years)
3. age > 50 years
4. Jewish and black males
pt presents with abdominal pain that radiates to the back, weight loss, migratory thrombophlebitis, and obstructive jaundice with a palpable gallbladder
pancreatic adenocarcinoma
dx cholelithiasis with:
radionuclide biliary scan, ultrasound
paroxysmal pain in the abdomen or bowels
colic
tx cholelithiasis with
cholecystectomy
black pigment stones indicate
hemolysis
brown pigment stones indicate
infection
cholelithiasis
risk factors
4 F's
female, fat, forty, fertile (pregnant)
pt with jaundice, tender hepatomegaly, ascites, polycythemia, and hypoglycemia
hepatocellular carcinoma/hepatoma
a common benign liver tumor that typically occurs at age 30-50
cavernous hemangioma
why are biopsies contraindicated for cavernous hemangiomas?
risk of hemorrhage
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