Gastrointestinal System PDF

L1S1(Oral cavity and esophagus) Sunday, September 8, 2024 8:41 AM Cleft lip associated with down syndrome it also presents dif...

L1S1(Oral cavity and esophagus) Sunday, September 8, 2024 8:41 AM Cleft lip associated with down syndrome it also presents difficulty speaking and eating Macroglossia causes snoring and Infection difficulty in speech Pathology Page 1  Fibro myosarcoma Haemangioma:- regresses may require surgical intervention angiosarcoma Pleomorphic adenoma:-most common benign tumor of the salivary gland Squamous cell papilloma:- fingerlike projections that can happen in tongue inside cheek caused by HPV 6 and 11 Squamous cell carcinoma:- cause by HPV 16 and 18 There are nearly 160 types of HPV High risk HPV is oncogenic Low risk isnt Anterior to the tonsils of oral cavity most likely not HPV Before the tonsils could be HPV Rhabdomyosarcoma:- skeletal muscles inside the tongue Aphthous ulcer is a discontinuation in the mucosa of the oral cavity it is self- limiting common recurrent Caused by stress, Acidic content diet painful They are inside the oral cavity 1 if more far from each other Vesicles Most likely on the lips Acyclovir ointment Herpes simplex is a neurotropic virus it goes to the nerve root and has dermatomal distribution Pathology Page 2  Pseudomembrane made of squamous cells of the oral cavity covered by the fungal structures and hyphae Stain helps in PAS - Periodic Acid Shift Note:- what if white lesion covering tongue and can't be removed and they are a smoker its called Leukoplaqya If the entire oral cavity is red then its called erythroplaqua Candida spores are the inactive form when seen its not an infection Candida hyphae is the active form when seen it means there is infection Ex:- tooth with irregular surface, or artificial teeth Fibrous Epulis Pathology Page 3  Fibroblast Pregnancy hormones progesterone Staphylococcus infection and trauma Lobular arrangement BV Lymphocytes Dysplastic Pathology Page 4  Less than 50% arise form plakia Lateral border of the tongue very common site for it Upper lip not common Lower lip common To differentiate Aphthous ulcer from malignant ulceration from HSV ulcers Malignant ulcer has an Pyogenic granuloma ulcer idk irregular raised border biopsy There may also be lumps in the cervical lymph nodes indicating metastasis imaging should be done for staging Doesn’t resolve on its own Painless Normal Erythematous regular not so prominent border Resolves on its own Recurrent And painful HSV ulcer Associated with vesicles Resolves in 7 to 10 except immunocompromised Recurrent Pathology Page 5  Erythematous regular not so prominent border Resolves on its own Recurrent And painful HSV ulcer Associated with vesicles Resolves in 7 to 10 except immunocompromised Recurrent Ulcerative SCC is an endophytic It can be exophytic mass Case:- 50 year old female with dry eyes and mouth Sjogrens syndrome Dry eyes and mouth others just mouth Autoimmune so more common in female Over age of 40 A complication is also Also antidepressants and antihistamines Pathology Page 6  Mumps side effect is infertility in male kids To differentiate the swelling in mumps from tumors and stuff its painful That are made of calcium NO fluctuation Diff with fibroma is color its red with vascularization NO fluctuation Diff with pyogenic granuloma is light color Differ with exophytic scc is irregular border In mucous membrane Fluctuates when pressed Changes in size after being irritated by meals Pathology Page 7  Case:- Young painfully swollen appeared in few days We suspect viral infection Old slowly growing painless We suspect tumors Epithelial Myoepithelial Myxoid stroma with elongate d nucleus in basophili c backgrou nd Pathology Page 8  Mainly lung Pathology Page 9 Pathology Page 10 The major macromolecular components of mucus are the mucin glycoproteins, Pathology Page 11 Pathology Page 12 Tracheoesophageal fistula (TEF) Atresia:- a condition in which an orifice or passage in the body is (usually abnormally) closed or absent Fistula:- abnormal opening btw two hollow organs Sx:- Immediately throwing food up Weight loss Chocking Investigation:- NG tube ( to check that the NG tube has reached the stomach correctly u can attach a syringe and create a negative vacuum space that will pull gastric juice towards you meaning u get there another way to check is pushing air in and putting a stethoscope on the stomach to hear the sound of air reaching there X-Ray Pure atresia gasless stomach cause Ultrasound (pre birth) u will also see high amount of amniotic fluid cause the child cant drink it Pathology Page 13  Sx:- Fibrous tissue in the liver due to cirrhosis puts pressure on the liver veins creating backflow and pressure on the esophageal veins Melena Hematemesis High alcohol intake Jaundice Forceful vomiting after alcohol intake Pathology Page 14 If its transmural (Horizontal full thickness) is called Boerhaave and requires surgical intervention Budding Yeast Pseudohyphea Pathology Page 15  Hiatal hernia Protrusion of the stomach through the diaphragm opening Pregnancy obesity things that increase abdominal pressure enlarged opening of the diaphragm cause of age or congenital Also basal cell hyperplasia more than 4 layers And connective tissue elongation into the upper 1/3rd of the epithelium This is before dysplasia Pathology Page 16  Becoming columnar with goblet cells 95% of adenocarcinoma originates from barretts esophagus others maybe due to smoking Large dark cells with irregular borders Pathology Page 17 Pathology Page 18  Weight loss in pts with esophageal and oral cancers"- Loss of appetite Dysphagia TNF-∝ relaesed by cnacer cells causing muscle wasting Pathology Page 19  Both are more common in men cause they smoke more Pathology Page 20  Cases:- Elder, Dysphagia, Weight loss, Chronic smoker and alcohol middle third lesion We suspect SCC Chronic uncontrolled GERD with dysphagia weight loss lower third of esophagus We suspect Adenocarcinoma Pathology Page 21