#pathology
GIT
الشيت ال3 مانزلتش د. عبير ركزت عليه كله

اختي من الدفعة 47 قالتلي دكتورة عبير تركز علي inflammatory bowel diseases والgastritis

🚩 Aphthous ulcers : (canker sores)
✔painful and recurrence
✔associated with: celiac disease & Behçet disease.
🚩Herpes simplex virus infection >>>> type 1.HSV1
Precancer condition: seq.cell.C
✔ leukoplakia
✔erythroplakia 🚫 most serious
🚩To different between candidiasis and leukoplakia ;
Leukoplakia can't scraped !✔✔
📌Seq.cell carcinoma in oral cavity 95%
✔mutation of TP53
✔HPV16
🚩Pyogenic granuloma >>> pregnancy tumor
🚩Sialadenitis : inflammation of salivary glands....
✔mucocele
✔repture duct
📌 pleomorphic adenoma 50% Bengin
📌mucoepidermoud carcinoma 15% malignant
📌Pleomorphic adenoma are non capsulated (capsula not fully developed)
📌 Achalasia; no relaxation/functional obstruction
🚩 ectopia: common in git ,
(Gastric mucosa in upper third of esophagus )
🚩Esophageal varices: in lower third
✔ dilated....portal circulation
✔Hematemesis
🚩esophageal varices;
Medical fatal, ( emergency)
🚩esophagitis --> precancer..
♦️ reflex esophagitis >> barrett esophagus
📌Mallory weiss tears;: sever vomiting
🚩 barrett esophagus: metaplasia >>>
✔adaptation
✔dysplasia >>precancer >> cancer.
🚩coffee ground hematemesis:
In clinical features of gastropathy /acute gastritis.
🔹️H . Pylori:
✔Adenocarcinoma
✔lymphoma
🚩hyperplastic Polyps must be distinguish from sessile serrated adenoma..by microscopic ↔️
🔹️Hyperplastic: serrated surface )
🔹️adenoma : serrated full length of glands
⚠️ impo
✔morphology of adenoma
✔colorectal carcinoma
✔gastric adenocarcinoma
🔹️Hyperplastic Polyps ↪ left colon &rectum
🔹️Adenoma ↪ right colon
🚩tumors in the proximal colon (right) often grow as polypoid ,exophytic masses; these tumors rarely cause obstruction.
🚩carcinomas in the distal colon (left) tend to be annular lesions that produce "napkin ring:" constructions and luminal narrowing
♦️Iron Deficiency anaemia/old male or postmenopausal female 👇🏼
Is gastrointestinal cancer until proven otherwise
⚠️ impo case !
📌changes in bowel habits:;
Left sided colorectal adenocarcinomas (may produce occult bleeding)
⚠️ impo case!
✔ pain in right lower quadrant
📌nausea, vomiting, low grade fever, mild elevated peripheral white blood cell count .
⬇️
Acute appendicitis

📌 mucocele :
Oral cavity
Appendix

✔ celiac disease " celiac sprue"
Gluten sensitive enteropathy
🚩 intussusception:
▫️Telescoped segment >>>intussusceptum
▫️lower receiving segment >> intussuscipiens
♦️Ischemic bowel disease resulting from hypoperfusion is most common at the splenic flexure , segmoid colon , and rectum:🔹️water shed zones :
Where tow arterial circulation terminate...
🔹️Inflammatory bowel disease:
✔Chronic condition
✔ microbiota
Immunity
Familial
✔CD &UC
✔extraintestinal manifestation
✔⚠️Ashkenazi
🔹️gastric adenocarcinoma
✔ intestinal >> APC
✔ DIFFUSE >>> CDH1
✔In gastric adenocarcinoma diffuse type:;
♦️ leather bottles ↪ linitis plastica
♦️Prognosis of gastric adenocarcinoma;
✔ based on depth of invasion. (Eraly or advanced)
✔more lymph nodes more stage
✔ distant metastatic
✔ infiltration
🔹️ carcinoid "gastric tumors"
Uniform cells with scant
🔹️chronic gastritis most common cause;:
H-pylori
Autoimmune
♦️complications of chronic gastritis:
✔peptic ulcer disease
✔mucosal atrophy and intestinal metaplasia
✔Dysplasia
✔Gastritis cystica

📌gastropathy : hypertrophy
🚩 inflammatory and hyperplastic Polyps 75%.
🚩fundic glands polyps never progress to malignant : protons pump inhibitors.
📌gastric adenocarcinoma 90%
📌peptic ulcer not become cancer.
🚩PUD .the residual gastric stump.. become cancer.
تجميعات من 47
#pathology

📌Liver injury ^degeneration :
a-ballooning (swollen hepatocyte)
b-foamy (hepatocyte containing bile)
c-steatosis(fat droplet in hepatocyte)
📌necrosis of liver : councilman bodies:
centrilobular -focal-piecemeal -massive
📌Cirrhosis↪end of chronic liver Dis
📌massive hepatic necrosis or cirrhosis lead to↪hepatic failure
📌fibrosis:response to inflammation ➡irreversible(nodule of regenerating hepatocyte surrounded by fibrous band↔️Cirrhosis
📌 most common cause micronodular cirrhosis ↔️ alcohol
♦️Grigler-Nijjar 1 syndrome
No Glucoronyl transferase ✔️

♦️Gilbert syndrome
Mutation in Glucoronyl transferase ✔️
✔ Risk factor of hepato cellural carinoma :
🔹️HBV ,, HCV
🔹️Aflatoxin ,, Alcoholism
🔹️Cirrhosis ,, Carcinogene substance
✔most common benign lesions of the liver
are hemangiomas
✔commonest primary malignancy
Hepatocellular carcinoma
✔most common hepatic neoplasm are
metastatic carcinomas
✔ hemangiomas Can cause severe intra-abdominal bleeding
📌 Benign tumour of liver:
1. hemangioma ( more common )
2. Adenom
📌 Malignant Liver tumour :

1.( HCC) Hepato cellular carcinoma commonest primary tuomor ✔

2.Metastatic carcinoma ( most common hepatic neoplasm )
📌hepatitis
caused by
1/A;B;C;D;E;F;viruse
rarely by
2/ EPstein Barr viruse;
3/HCV;
4/CMV
5/autoimmume
6/drugs&toxin
7/alcohol
♦️HAV......
RNA-benign-self limited-
never cause chronic hepatitis
transmitted by feco/oral route
♦️HBV......
DNA-chronic hepatitis
-present in all body fluid exept stool..
spread by➡blood or body fluid contact
▫️Ground glass cell
▫️risk of hepatocellular carcinoma.
♦️HCV......
RNA
most common cause of transfusion associated hepatitis
⬆⬆risk of hepatocellular carcinoma
♦️autoimmune hepatitis
more in female
Type 1 :; associated ē ANA &ASMA
Type 2 :; associated ē anti LKM1
♦️fulminant hepatitis
massive loss of parenchyma with collapsed reticulin framework &
preserved portal tracts
in chronic aggressive
🔥alcoholic liver Disease:
1-fatty liver:
✔fat droplet accumulate in hepatocyte ✔hepatomegaly-elevated bilirubin&alkaline phosphatase.


2-alcoholic hepatitis
✔hepatocyte swelling & necrosis -mallory body! -
✔neutrophilic infiltration-fibrosis-
at the time of fibrosis appears the damage is irreversible.
✔-elevated liver enzyme-fever.

3-alcoholic cirrhosis

📌wilson's disease (AR)
▫️Copper accumulated in liver & brain
▫️inherited disorder of copper metabolism
▫️kayser-fleischer ring at corneal limbus.
▫️low serum caeruloplasmin
▬▬▬▬▬▬▬▬▬▬▬▬

#pathology

Liver cirrhosis
جاي شورت نوت في الفاينل .

شرفت علينا دكتورة عبير اليوم وقالت كورس الGIT فوته كله لكن ردبالك تسيب COLORECTAL ADENOCARCINOMA
تلقاها في mcq, short note لكن المهم بتجيك

شرفت علينا د.الفيميل وقالت جايات 2 شورت نوت منه للفاينل

شرف علينا د. علي المالكي بس ماقال شي🌚

انا شرفت عليا دكتورة وقالت ان pleomorphic جايكم ف المعمل

شرف علينا دكتور في قسم الباثو بس منعرفش اسمه وهوا يحل في الامتحان قال ركزو علي اي حاجه يقولك هذي most common هذين اسئله الفاينل

ونحن شرفت علينا دكتورة رجاء وقالت الفرق في اشكال peptic alcer مهم جداً وهذا سؤال اورال

شرف علينا دكتور أحمد بن احسونة
ولما كمل شرح التاتوريال
ضاف نقطة mcq بشكل شفهي سألنا عليها وركز عليها وهي👇
Which of the following has more dangerous sequence to be coverted from polyps into carcinoma
A. Tubular adenoma
B. Villous adenoma
C. Tubulovillous adenoma
الجواب B