Medicine /USMLE - GI Flashcards Part 8

USMLE - GI Flashcards Part 8

Medicine25 CardsCreated 5 days ago

This deck covers key concepts related to gastrointestinal conditions, histology findings, and associated risks, focusing on topics like celiac sprue, gastritis, ulcers, and inflammatory bowel disease.

Celiac Sprue Histology Ab findings? Screening Associated with Increased risk for

Blunting of villi. Crypt hyperplasia. Lymphocytes in LP Anti-endomysial, anti-tissue transglutaminase, and anti-gliadin Abs Serum levels of tissue transglutaminase Abs used for screening Associated with dermatitis herpetiformis Moderately increased risk for malignancy (T cell lymphoma)
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Key Terms

Term
Definition
Celiac Sprue Histology Ab findings? Screening Associated with Increased risk for
Blunting of villi. Crypt hyperplasia. Lymphocytes in LP Anti-endomysial, anti-tissue transglutaminase, and anti-gliadin Abs Serum levels of tissue tra...
Acute Gastritis MoA What can cause it? Especially common among
Disruption of mucosal barrier --> inflammation "U want a SNAC?" Caused by stress, NSAIDs (↓ PGE --> ↓ gasric mucosa protection), Alcohol, Uremia, Burn...
Curling's Ulcer
↓ plasma volume --> sloughing of gastric mucosa
Cushing's ulcer
↑ vagal stimulation --> ↑ ACh --> ↑ H production
Acute vs Chronic Gastritis
Erosive vs Non-Erosive
Type A Chronic Gastritis What part of stomach? Pathology Produces what? Associated with what?
Fundus and Body AutoAbs to parietal cells Produces pernicious Anemia and Achlorhydria Associated with other immune disorders

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TermDefinition
Celiac Sprue Histology Ab findings? Screening Associated with Increased risk for
Blunting of villi. Crypt hyperplasia. Lymphocytes in LP Anti-endomysial, anti-tissue transglutaminase, and anti-gliadin Abs Serum levels of tissue transglutaminase Abs used for screening Associated with dermatitis herpetiformis Moderately increased risk for malignancy (T cell lymphoma)
Acute Gastritis MoA What can cause it? Especially common among
Disruption of mucosal barrier --> inflammation "U want a SNAC?" Caused by stress, NSAIDs (↓ PGE --> ↓ gasric mucosa protection), Alcohol, Uremia, Burns (Curling's ulcer), Brain Injury (Cushing's ulcer) Especially common among alcoholics and NSAID users (RA pts)
Curling's Ulcer
↓ plasma volume --> sloughing of gastric mucosa
Cushing's ulcer
↑ vagal stimulation --> ↑ ACh --> ↑ H production
Acute vs Chronic Gastritis
Erosive vs Non-Erosive
Type A Chronic Gastritis What part of stomach? Pathology Produces what? Associated with what?
Fundus and Body AutoAbs to parietal cells Produces pernicious Anemia and Achlorhydria Associated with other immune disorders
Type B Chronic Gastritis What part of stomach? Frequency Pathology Increased risk of what?
Antrum Most common type of chronic gastritis Caused by H pylori infection Increased risk of MALT lymphoma
Type A vs B Chronic Gastritis
"ABA, BAB" A is in Body and from Autoimmunity B is in Antrum and from Bacteria
Menetrier's Disease What is it? Cancerous? Description
Gastric hypertrophy with protein loss, Parietal cell atrophy, ↑ mucous cells Precancerous Rugae of stomach are so hypertrophied that they look like brain gyri
Stomach Cancer What kind of cancer? Does it spread? Often presents with
Almost always adenocarcinoma Early aggressive local spread and node/liver metastases Often presents with acanthosis nigricans
Stomach Cancer: Diffuse Associated with? Histology Gross
Not associated with H pylori Signet ring cells Stomach wall grossly thickened and leathery (linitis plastica)
Virchow's Node
Involvement of Left Supraclavicular Node by metastasis from stomach
Krukenberg's Tumor Presents with Histology
Bilateral metastases from stomach to ovaries Presents with abundant mucus Signet ring cells
Sister Mary Joseph's Nodule
Subcutaneous periumbilical metastasis
Intestinal Stomach Cancer What causes it Associated with Common location Looks like
Caused by H pylori infection, dietary nitrosamines (smoked foods), achlorhydria, chronic gastritis, Associated with Type A blood Commonly on lesser curvature Looks like ulcer with raised margins
Peptic Ulcer Disease
Gastric Ulcers | Duodenal Ulcers
Gastric Ulcer Pain Weight H pylori Causes Risk Often occurs in what kind of pt?
Pain increases with meals Weight loss H pylori in 70% ↓ mucosal protection against gastric acid; NSAID use Risk of Carcinoma Often occurs in older patients
Duodenal Ulcer Pain Weight H pylori Causes Risk Histological changes
Pain decreases with meals Weight gain H pylori in 100% ↓ mucosal protection or ↑ gastric acid secretion Generally benign Hypertrophy of Brunner's glands
Ulcer Complications
Hemorrhage or Perforation
Location of Hemorrhage from Ulcer
Gastric or Duodenal Ulcers | Posterior > Anterior
Location of Perforation from Ulcer
Duodenal | Anterior > Posterior
Ruptured gastric ulcer on the lesser curvature --> bleeding from
Left Gastric Artery
Ulcer on posterior wall of the duodenum --> bleeding from
Gastroduodenal Artery
Inflammatory Bowel Disease
Crohn's Disease or Ulcerative Colitis
Crohn's Disease Etiology Distribution Location Gross XR
Disordered response to intestinal bacteria (Th1 mediated) Any portion of the GI tract; usually terminal ileum and colon; rectal sparing Skip Lesions Transmural inflammation; Cobblestone mucosa, creeping Fat, linear ulcers, fissures, fistulas Bowel wall thickening --> "string sign" on barrium swallow x ray