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Flashcards in Week 3 Deck (59):
1

Ulcers are a breach of the ___ of the wall of the alimentary tract organ thate extends through __ __ into the __ or deeper. Very Common.

mucosa
muscularis mucosa
submucosa

2

Erosion is __ damage of the mucosa of the wall of the alimentary tract. Sloughing of __ cells.

superficial
epithelial

3

*3 differences between erosions and ulcers

Erosions are superficial
Erosions tend to be multiple. Ulcers tend to be solitary.
Erosions may be healed in several days whereas ulcer require months to years

4

3 factors that cause a peptic ulcer

Exposure
Location
Presence of Helicobactor Pylori

5

Peptic ulcer is caused by exposure of alimentray tract to excess of stomach __ and stomach __

acidity
pepsin

6

Peptic ulcer is caused by exposure of alimentray tract to excess of stomach __ and stomach __

acidity
pepsin

7

*Where may peptic ulcer occur and in what percentages?

Duodenum- 80%
Lesser curvature of stomach- 20%
esophagus (very rare)

8

*It was found that Helicobactor Pylori was in __% of all stomach peptic ulcers and in __% of all duodenal ulcers. __ can heal a peptic ulcer.

70
100
TMT

9

*Aggressie forces of peptic ulcers are __ __ and __ __

stomach acidity
pepticc activity

10

In puerto rico and Russia, __% of ulcers are in stomach

80

11

Components of mucosa barrier:

Surface mucous secretion: mechanical coverage
Bicarbonate Secretion into mucosa: alkalinize- come to mucous from blood

12

Mucous Barrier is sensitive to __ and __. Can easily be compromised by things like smoking. People who smoke will not be able to get rid of __ __ because of impairment to mucosa. __ can activate sympathetics and aggravate this.

sympathetics
apoxia
peptic ulcer
Stress

13

___ produce ulcers because they prevent ___.

NSAIDs
Prostaglandins

14

Prostaglandins inhibit the production of __ by __ cells. Gastrin produced in the distal part of the stomach leads to production of ___

gastrin
G
HCl

15

Aggravating causes of peptic ulcer

H. Pylori
NSAIDs/ Aspirin
Cigarettes
Alcohol, esp. wine and beer
Impaired regulation of acid-pepsin secretion

16

*Ulcer is most commonly found in the __ __ of the __. Duodenal peptic ulcer usually occurs in the __ __, the most __ portion

lesser curvature
stomach
duodenal bulb
proximal

17

6 Complications of peptic ulcers

Hemorrhage
Perforation
penetration into adjacent organs
Pyloric stenosis
Transfer into cancer
Contracture/ stricture

18

*Hemorrhage is extremely dangerous. __: Black stool and vomit will look like __ with __ color. THIS IS THE MOST COMMON COMPLICATION

Melena
coffee
milk

19

*Ulcer Perforation may cause ___. Complete breach of stomach wall. Accumulation of gas under __ side of the diaphragm- due to escaped gas from a complete perforation of stomach

Peritonitis
Right

20

*Ulcer Perforation may cause ___. Complete breach of stomach wall. Accumulation of gas under __ side of the diaphragm- due to escaped gas from a complete perforation of stomach

Peritonitis
Right

21

Penetration of ulcer into liver or other organ: can accumulate just under the __ in the __. due to perforation damage adjacent organ. Gastric Air bbble is supposed to be on the __.

diaphragm
liver
left

22

Pyloric Stenosis: During maturation of CT that gets laid down during healing process, the __/__ tissue shrinks

Connective
scar

23

*__ ulcers may transfer into cancer. __ ulcers never do.

Stomach
Duodenum

24

Hypertrocphic pyloric stenosis is ___ narrowing of the pyloric canal lumen in ___. Congenital is seen in __ in every __ births. Condition must be resolved in __-__ weeks or death results.

permanent
newborns
1 in 300
1-2

25

Achalasia is failure of contraction of __ __ sphincter. What are the 3 major findings?

lower esophageal
Aperistalsis
Incomplete/partial relaxation of lower esophageal sphincter
Contraction/ Spasm of LES

26

Achalasia is associated with neurological problems originating from __ nerve and __, and ___ plexus

vagus
ganglion
myenteric

27

Chaga's Disease: Caused by __ __ and damages the __ __

trypanosoma Cruzi
Myenteric Plexus

28

2 Signs and symptoms of Achalasia

Dysphagia
Regurgitation

29

Those with Achalasia have a redisposition to __ __

Esophageal Adenocarcinoma

30

Those with Achalasia have a redisposition to __ __

Esophageal Adenocarcinoma

31

Hiatal (Diaphragmatic) Hernia: Separation of __ crura and __ of the space between the __ crura and __ wall

Diaphragmatic
widening
muscular
esophageal

32

95% of iatal hernias are __ AKA __ in which there is movement of the __ portion of the stomach through the __. Is __ shaped and associated with __ and __ __

sliding
axial
upper
diaphragm
bell
regurgitation
heart burn

33

95% of iatal hernias are __ AKA __ in which there is movement of the __ portion of the stomach through the __. Is __ shaped and associated with __ and __ __

sliding
axial
upper
diaphragm
bell
regurgitation
heart burn

34

Hiatal Paraesophageal Hernia: AKA ___ hernia. Part of stomach bulges through an opening near the __ --> Compression of __ blood flow by __ --> venous ___ --> __ __

Rolling
esophagus
venous
diaphragm
infarction
wet gangrene

35

Zenker Divertculum: close to __ __ sphincter. Cause of __ __. No dysphagia, just __.

upper esophageal
aspiration pneumonia
regurgitation

36

Mid-Esophageal Diverticulum: In the middle of the esophagus; cause by pulling of the __ wall developing scar tissue from ___ of ___ nodes

esophageal
lymphadenitis
paratracheal/esophageal lymph

37

Mid-Esophageal Diverticulum: In the middle of the esophagus; cause by pulling of the __ wall developing scar tissue from ___ of ___ nodes

esophageal
lymphadenitis
paratracheal/esophageal lymph

38

Mallory Weiss Syndrome: Irritation of __ esophagus due to prolonged __. AKA ___. Common in __. Bleeding/ hemorrhage in __% of cases. Rupture of esophagus leads to __

distal
vomiting
Laceration
Alcoholics
10
death

39

Barret Esophagus: Replacement of normal __ __ mucous squamous epithelia by __ __ epithelia that have __ cells.
-Prolonged __ due to increased acidity
-Drinking __ __ can help
-Increaes chance of ___

distal stratifies
metaplastic columnar
goblet
heartburn
Baking soda
cancer

40

Zollinger Ellison Syndrome- hypersecretion of __ by gastrin-producing tumors known as ___.
-BEnign tumors of __(3)__
-Increased gastrin leads to increased ___, causes peptic ulcers
-Malignant because tumors metastisize to ___ --> death from __ __
-Manifested by diarrhea in __% of cases

gastrin
gastrinoma
pancreas, duodenum, para-duodenal tissues
HCl
Liver
hepatic failure
50

41

Major Problem with Rheumatic fever is with the ___

heart

42

Strep throat is inflammation of __ __. Infection that goes into circulation can lead to __ and __

Palatine Tonsils
Glomerulonephritis
Rheumatic Fever

43

GMN and Rheumatic fever are both due to streptococcal infection by __ __ __ __

Beta Hemolytic Streptococcal Group A

44

Rheumatic Fevr results in specific immune response including formation of ___- but in some people antigens in all 3 layers of the heart are similar and the antibodies can act against the antigens of the __, __ and __. This is known as __ __

antibodies
endocardium
myocardium
Pericardium.
Molecular Mimicry

45

Rheumatic Fever is manifested by formation of __ __. This is characterized by __ arthritis.There is no damage to __ in rheumatic fever.

acute arthritis
migrating
joints

46

Which 3 manifestations for Rheumatic Fever are very rare?

Erythema Annulare (marginatum)
Formation of subcutaneous nodules around knuckles
Sydenham Chorea

47

Sydenham Chorea involves mild __ of __ vessels. Usually develops in which gender and age group?

vasculitis
cerebral
Girls

48

100% of cases of Rheumatic Fever involving the heart result in __ __ if __ __

Rheumatic Myocarditis
Sydenham's Chorea

49

What are 3 effects that Rheumatic Fever has on the heart?

Aschoff's Nodules
Rheumatoid Pericarditis
Rheumatic Endocarditis

50

Rheumatic Pericarditis occurs in __-__% of cases, and is the __ sign. There is a space between the parietal and visceral layers of the pericardium filled with fluid to allow for movement. __ inflammation causes __ to create __ strands resulting in roughening of both layers so that the heart can't move easily or smoothly. This forms ___.

10-15
2nd
Fibrinous
Fibrinogen
Fibrin
bruits

51

Rheumatic Endocarditis has the most common involvement: __%. In the endocardium and involves the __ of the heart

80
valves

52

What is the order of Inflammation in Rheuatic Fever

Mitral Valve
Aortic Valve
Tricuspid Valve

53

Mitral Valve inflammation causes....(

Pulmonary edema (pooling of blood in lungs)
Hypertrophy of left atrium
Stenosis of the valves
Congestive heart failure
Compressed Bronchi
Esophageal Deviation

54

Aortic Valve stenosis causes __ __ hypertrophy which can lead to __ __ and __ deviation of the heart.

Left Ventricular
heart failure
left

55

What are 4 other possible causes of aortic insufficiency

Bacterial Endocarditis
Tertiary Syphilis
Rheumatoid Arthritis
***Decreased Diastolic Pressure** TQ- results from backflow of blood through faulty aortic valve
-pts usually unaware of stenosis
- Can even reach as low as 0

56

__ __ inflammation is very rare

Tricuspid Valve

57

Mitral stenosis is the most common pathology in the case of __ __

Rheumatic Endocarditis

58

Mitral Stenosis: What are complications?

Left atrium is MC place for thrombi formation. It causes full obstruction of the opening

59

Dilation of the left atrium by pressure and work load leads to __ stenosis. Pressure in LA can equal pressure in pulmonary artery and lead to stasis- this can lead to __ edema

mitral
pumonary