Sunday, 7 July 2013

Some points

Menetrier disease
Dx: hyperplastic gastropathy with enlarged rugal folds and proliferation of mucus-producing cells of the stomach
increases mucus production leads to this "protein-losing gastroenteropathy" which causes hypoalbuminemia and peripheral edema
"Punched out" ulcers in lower segment of the esophagus. Organism?
Herpes Simplex Virus
What can Vinyl Chloride (used in the rubber industry) cause?
Angiosarcoma of the liver. It arises from blood vessels and is an extremely aggressive tumor.
What are the most important characteristics for metastatic potential in a carcinoid tumor?
Location and size
What type of epithelium is the esophagus composed of?
Nonkeratinizing squamous epithelium
What type of epithelium is found in Barret's esophagus?
Nonciliated columnar epithelium
Gastric heterotopia
small areas of normal gastric tissue found in ectopic locations, typically the small intestine
acid production can lead to ulcers which can cause GI bleeding
Herniation of abdominal viscera through the abdominal wall near the umbilicus
Meconium ileus
Seen in newborns with cystic fibrosis
Infant cannot pass meconium because viscid pancreatic secretions "get stuck" in small bowel
Can lead to perforation with peritonitis
Primary Sclerosing Cholangitis
Inflammation and fibrosis of bile ducts => alternating strictures and dilation with "beading" on ERCP
Associated with ulcerative colitis
Triad of: Jaundice, Fever, RUQ pain
Wilson Disease Lab Findings
Increased hepatic copper content
Reduced ceruloplasmin (a copper-binding protein)
Increased urinary copper excretion
Kayser-Fleischer rings in the iris
Where does Celiac disease caused the most damage
Proximal small bowel (because gluten antigens have not been digested yet)
Reye Syndrome
-Follows a viral infection (ie. Varicella or chicken pox)
-Sometimes related to ingestion of aspirin (salicylates) after a viral infection
-Messed up Macrophages lead to messed up metabolism leads to Liver and brain damage
-Liver shows microbesicular steatosis
-Brain shows edema
Patient complains of difficulty swallowing solids and liquids. What is an autoimmune explanation?
Scleroderma (Progressive Systemic Sclerosis)
Plummer-Vinson syndrome
Triad of:
1) Dysphagia (from esophageal webs in upper esophagus)
2) Atrophic glossitis
3) Iron Deficiency Anemia
Zenker's Diberticulum
False diverticulum in the upper esophagus
Where is oral squamous cell carcinoma most commonly located within the mouth.
#1: Floor of the mouth
#2: The tip of the tongue.
How do you differentiate between upper GI bleeding from esophageal varices and Mallory-Weiss tear?
-Esophageal varices usually present with no history of hematemesis.
-Mallory Weiss patients have longitudinal tears in esophagus from repeated bouts of vomiting.

Sx: Jaundice + Palpable Gallbladder (which is NOT tender) + Nonspecific symptoms (ie. abdominal pain)
Pancreatic Cancer

Melanoma Tumor Marker

Hepatocellular Carcinoma Tumor Marker
Alpha Feto-Protein and alph1-antitrypsin

Prostatic Carcinoma Tumor Marker
PSA and Prostatic Acid Phosphatase

Serous Cystadenocarcinoma of the ovary Tumor Marker

Gastric Adenocarcinoma
CEA and Bombesin

White oral plaques with 5% chance of turning into cancer

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