,
,
, Question 5
A 58-year-old male with a history of gastroesophageal reflux disease (GERD)
undergoes an esophagogastroduodenoscopy (EGD). Biopsy reveals replacement of
the normal stratified squamous epithelium of the lower esophagus with columnar
epithelium containing goblet cells. This finding is most consistent with:
A. Barrett's esophagus
B. Esophageal varices
C. Gastric metaplasia
D. Esophageal carcinoma in situ
Correct Answer: A. Barrett's esophagus
Rationale: Barrett's esophagus is a condition in which the normal stratified
squamous epithelium of the lower esophagus is replaced by metaplastic columnar
epithelium containing goblet cells, a process known as intestinal metaplasia. This
occurs as an adaptive response to chronic acid exposure from GERD. Barrett's
esophagus is a premalignant condition that significantly increases the risk of
esophageal adenocarcinoma. Esophageal varices are dilated veins associated with
portal hypertension. Gastric metaplasia refers to the presence of gastric-type
epithelium in the esophagus, which is a different finding. Carcinoma in situ would
show dysplastic changes with intact basement membrane.
Question 6
A 45-year-old woman with a 20-year history of chronic hepatitis C infection presents
with fatigue, jaundice, and ascites. Liver biopsy reveals widespread fibrosis with
nodular regeneration and distortion of normal hepatic architecture. This pathologic
process is best described as:
A. Cirrhosis
B. Hepatic steatosis
C. Acute hepatitis
D. Hepatic adenoma
,
, Question 5
A 58-year-old male with a history of gastroesophageal reflux disease (GERD)
undergoes an esophagogastroduodenoscopy (EGD). Biopsy reveals replacement of
the normal stratified squamous epithelium of the lower esophagus with columnar
epithelium containing goblet cells. This finding is most consistent with:
A. Barrett's esophagus
B. Esophageal varices
C. Gastric metaplasia
D. Esophageal carcinoma in situ
Correct Answer: A. Barrett's esophagus
Rationale: Barrett's esophagus is a condition in which the normal stratified
squamous epithelium of the lower esophagus is replaced by metaplastic columnar
epithelium containing goblet cells, a process known as intestinal metaplasia. This
occurs as an adaptive response to chronic acid exposure from GERD. Barrett's
esophagus is a premalignant condition that significantly increases the risk of
esophageal adenocarcinoma. Esophageal varices are dilated veins associated with
portal hypertension. Gastric metaplasia refers to the presence of gastric-type
epithelium in the esophagus, which is a different finding. Carcinoma in situ would
show dysplastic changes with intact basement membrane.
Question 6
A 45-year-old woman with a 20-year history of chronic hepatitis C infection presents
with fatigue, jaundice, and ascites. Liver biopsy reveals widespread fibrosis with
nodular regeneration and distortion of normal hepatic architecture. This pathologic
process is best described as:
A. Cirrhosis
B. Hepatic steatosis
C. Acute hepatitis
D. Hepatic adenoma
