Gastrointestinal Pathology Lecture Notes

Thirty Q&A flashcards covering GERD, gastritis, pancreatitis, IBD (Crohn disease and ulcerative colitis), and viral hepatitis as outlined in the lecture notes.

What cellular adaptation occurs in the esophagus during GERD and why?

Metaplasia: squamous epithelium converts to glandular epithelium in response to chronic exposure to acidic gastric contents.

Name two serious complications that can arise from long-standing GERD.

Esophageal ulcers and esophageal adenocarcinoma.

List three common clinical manifestations of GERD.

Epigastric pain, burning chest pain (heartburn), and regurgitation of acidic/bitter material.

How is acute gastritis defined?

Sudden, reversible inflammation of the gastric mucosa, usually due to ingestion of irritants such as aspirin, alcohol, or microorganisms.

Give three examples of irritants that commonly precipitate acute gastritis.

Aspirin, alcohol, and certain microorganisms.

Briefly describe the pathophysiology of acute gastritis.

Irritants inhibit protective mucus production, leaving mucosa vulnerable to acid, causing inflammation ranging from erythema to erosion or perforation.

Name two typical clinical manifestations of acute gastritis.

Mild–severe abdominal pain and indigestion (dyspepsia).

What is chronic gastritis and its most common infectious cause?

Persistent gastric mucosal inflammation, most often caused by Helicobacter pylori infection.

How does H. pylori contribute to the development of chronic gastritis?

The bacterium produces toxins that destroy gastric mucosa, provoking chronic inflammation, mucosal atrophy, and impaired acid secretion.

Give three possible manifestations of chronic gastritis.

Dyspepsia, loss of appetite, and anemia (can also be asymptomatic).

Define pancreatitis.

Inflammation of the pancreas leading to autodigestion by pancreatic enzymes.

Identify two major etiologic factors for acute pancreatitis.

Gallstone obstruction of the pancreatic duct and heavy alcohol consumption.

Describe the characteristic pain associated with acute pancreatitis.

Sudden, intense, dull/steady upper abdominal pain that often radiates to the back.

Name two additional systemic manifestations of acute pancreatitis.

Jaundice (with full duct blockage) and fever (with systemic inflammation).

What characterizes chronic pancreatitis?

Ongoing pancreatic inflammation with irreversible structural changes and loss of function.

Explain how chronic alcohol use leads to chronic pancreatitis.

Alcohol causes enzyme protein accumulation and duct obstruction, leading to ischemia, fibrosis, and eventual loss of exocrine and endocrine function.

List three clinical manifestations of chronic pancreatitis.

Severe intermittent abdominal pain, steatorrhea (fatty stools), and weight loss.

What is inflammatory bowel disease (IBD)?

Chronic inflammatory disorders of the GI tract, most commonly involving the small and large intestines.

How do Crohn disease lesions differ from ulcerative colitis lesions?

Crohn disease has patchy transmural "skip" lesions anywhere in the GI tract (commonly ileum/ascending colon), whereas ulcerative colitis has continuous superficial lesions limited to the colon/rectum.

Name four common clinical manifestations of Crohn disease.

Abdominal pain, chronic diarrhea, malnutrition/weight loss, and low-grade fever (occult blood may be present).

Define ulcerative colitis.

Chronic inflammatory disease limited to the mucosa and submucosa of the large intestine, beginning in the rectum and extending proximally in a continuous pattern.

What is the hallmark endoscopic appearance of ulcerative colitis?

Continuous superficial ulcerations with possible hemorrhagic lesions and abscesses in the colon.

List three typical clinical manifestations of ulcerative colitis.

Bloody diarrhea, abdominal pain, and anemia with fatigue/weakness.

What is viral hepatitis?

Inflammation of the liver resulting in hepatic cell necrosis, most often caused by hepatotropic viruses (A, B, C).

How is Hepatitis A primarily transmitted?

Fecal–oral route via person-to-person contact or ingestion of contaminated food or water.

What are the main transmission routes for Hepatitis B?

Exposure to infected blood and body fluids, including perinatal (mother-to-infant) transmission.

How is Hepatitis C typically acquired?

Contact with infected blood, most commonly via shared needles or transfusions prior to screening.

Which hepatitis types are usually acute versus chronic?

Hepatitis A is usually acute; Hepatitis B and C commonly progress to chronic infection.

List three key manifestations of the icteric (jaundice) phase of viral hepatitis.

Jaundice, hepatomegaly, and clay-colored stools with dark urine.

What is hepatomegaly, and during which phase of hepatitis does it often appear?

Enlargement of the liver; it commonly appears in the icteric phase and may persist into recovery.