010715 stomach dis 4

Question 1

shape of H pylori

Answer 1

spiral shaped

Question 2

where does H pylori colonize exchlusively

Answer 2

gastric type epithelium

Question 3

effects of H pylori colonization

Answer 3

stimulates inflammatory responses

Question 4

hallmark of H pylori

Answer 4

neutrophilic infiltration

along with lymphocytes, plasma cells, macrophages

Question 5

where does early stage h pylori gastritis occur

Answer 5

confined to ANTRUM

Question 6

mechanism of h pylori in causing ulcers in its early stage

Answer 6

inhibits D cell somatostatin secretin so gastrin secretion is increased

acid secretion is increased, causing ulcers

Question 7

late stage of chronic h pylori gastritis occurs where

Answer 7

inflammation expands to CORPUS/FUNDUS

Question 8

mechanism of h pylori in causing ulcers in the late stage

Answer 8

in corpus/fundus, destroys parietal cells

decreased acid production causes gastrin increase

Question 9

how to diagnose h pylori infec?

Answer 9

serology (false positive b/c persists even after eradication)

endoscopic gastric mucosa biopsy
urea breath test
stool antigen test
false negative with recent antibiotics or PPI therapy

Question 10

adverse effects of h pylori infection

Answer 10

peptic ulcer
enteric infections
malnutrition (iron and B12 deficiency)
gastric neoplasia (adenocarcinoma, MALT lypmphoma, carcinoid)

Question 11

autoimmune gastritis

Answer 11

inherited form is associated with immune response in oxyntic mucosa against parietal cells and IF

Question 12

histology of autoimmune gastritis

Answer 12

lymphocytic inflam with destruc of parietal cells

Question 13

atrophic metaplastic gastritis

Answer 13

could be in body and fundus or antrum:
autoimmune
vs
H pylori

Question 14

gastritis vs gastropathy

Answer 14

gastritis: INFLAM associated mucosal injury (infectious, autimmune)
gastrophathy: epithelial cell damage and regeneration with MINIMAL OR NO ASSOCIATED INFLAM (bile, alcohol, aspirin, NSAIDs, ischemia)

Question 15

ulcer

Answer 15

destructive breach of mucosa that extends below muscularis mucosa

Question 16

erosion

Answer 16

destruction superficial to muscularis mucosa

Question 17

peptic ulcer disease-what are some causes?

Answer 17

90% due to
aspirin/NSAIDs (can directly cause rapid cell death and superficial mucosal injury in addition to reduced prostaglandin)

H pylori
surreptitious or unaware NSAID use

Question 18

complications of peptic ulcer disease

Answer 18

acute GI hemorrhage
chronic GI blood loss or iron def anemia
perforation, peritonitis, pancreatitis
gastric outlet obstruction
gastointestinal fistula
malabsoprtion

Question 19

symptoms of peptic ulcer dis

Answer 19

chronic dyspeptic epigastric pain
acute severe pain--indicates perforation
nausea
anorexia, weight loss
hematemesis
melena
recurrent postprandial vomiting (obstruction)
diarrhea (fistula)

or no symptoms

Question 20

dyspepsia

Answer 20

discomfort in upper abdomen

Question 21

anion gap acidosis can occur with

Answer 21

NSAID s

Question 22

ulcers can cause edema causing obstruction-true or false?

Answer 22

true

Question 23

salicylate

Answer 23

aspirin

Question 24

octreotide scan

Answer 24

to look for carcinoids and other tumors, sarcoidosis