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Pathoma > 10.4 Stomach > Flashcards

10.4 Stomach Flashcards

1
Q

Gastroschisis

A

Congenital malformation of the anterior abdominal wall leading to the exposure of abdominal contents

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2
Q

Omphalocele

A

Herniation of the bowel into the umbilical cord due to failure of the intestines to return to the body cavity during development

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3
Q

What is the difference between gastroschisis and omphalocele?

A

In omphalocele the contents are covered in peritoneum and the amnion

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4
Q

Pyloric Stenosis

A

Congenital hypertrophy of the the pyloric smooth muscle

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5
Q

Which gender is pyloric stenosis more common in?

A

Males

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6
Q

What are the clinical manifestations of pyloric stenosis?

A
  • Nonbilious projectile vomiting
  • Visible peristalsis
  • Olive like mass in the abdomen
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7
Q

Does pyloric stenosis present at birth?

A

NO - classically develops after 2 weeks of birth

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8
Q

Acute Gastritis

A

Acidic damage to the mucosa due to imbalance between mucosal defenses and the acidic environment (too much acid or too little mucin)

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9
Q

What are the two types of chronic gastritis?

A
  • Autoimmune

- H. pylori

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10
Q

What are the risk factors of acute gastritis?

A
  • Severe burn
  • NSAIDs
  • Alcohol
  • Chemotherapy
  • Shock
  • Increased intracranial pressure
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11
Q

What is a Curling ulcer due to?

A

Severe burn

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12
Q

What is a Cushing ulcer due to?

A

Increased intracranial pressure

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13
Q

How do Cushing ulcers cause acute gastritis?

A

Increased vagal stimulation which increases ACh which binds the parietal receptor to increase acid production

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14
Q

What are the 3 receptors on parietal cells that increase HCl production when activated?

A
  • Histamine
  • ACh
  • Gastrin
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15
Q

Erosion

A

Loss of epithelium

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16
Q

Ulcer

A

Loss of mucosal layer

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17
Q

Chronic Gastritis

A

Long term inflammation of the stomach mucosa

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18
Q

Chronic Autoimmune Gastritis

A

Ab are made against the parietal cells or intrinsic factor as a result of the damage in the fundus and the body of the stomach

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19
Q

What type of hypersensitivity reaction is chronic autoimmune gastritis?

A

Type IV

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20
Q

What are the clinical features of chronic autoimmune gastritis?

A
  • Achorhydria
  • Atrophy of the mucosa
  • Antral G-cell hyperplasia
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21
Q

What is associated with chronic autoimmune gastritis?

A

Megaloblastic Anemia (pernicious anemia) - loss of intrinsic factor

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22
Q

What are people with chronic autoimmune gastritis at increased risk for?

A

Gastric Adenocarcinoma - chronic inflammation will induce intestinal metaplasia

23
Q

Chronic H. pylori Gastritis

A

Due to H. pylori infection

24
Q

What is the common site of H. pylori gastritis?

A

Antrum

25
Q

How does H. pylori survive in the stomach?

A

Urease converts urea to NH3 to neutralize the local acid

26
Q

Does H. pylori invade into the stomach cells?

A

No - they sit on the epithelium

27
Q

What are the clinical findings of H. pylori?

A

Epigastric abdominal pain

28
Q

What does H. pylori infection increase the risk for?

A
  • Gastric Adenocarcinoma

- MALT Lymphoma

29
Q

What is the treatment for H. pylori?

A

Triple Therapy

30
Q

Peptic Ulcer Disease

A

Solitary ulcer in the duodenum or in the stomach

31
Q

Where is the most common site for ulcers in PUD?

A

Duodenum

32
Q

What can be a rare cause of a duodenal ulcer?

A

Zollinger-Ellison Syndrome

33
Q

What will happen to the pain in duodenal ulcer with meals?

A

The pain will decrease

34
Q

What will be seen on biopsy of the duodenum if there are ulcers present?

A

Ulcer with hypertrophy of the Brunner glands

35
Q

What is a complication of duodenal ulcers?

A

Rupture which leads to bleeding from the gastroduodenal ulcer - complications of posterior ulcers

36
Q

What are the main causes of gastric ulcers?

A

H. pylori and NSAIDs

37
Q

What is the main cause of duodenal ulcers?

A

H. pylori

38
Q

Where will a ruptured gastric ulcer bleed from?

A

Left Gastric Artery

39
Q

Are duodenal ulcers related to cancer?

A

No - rarely malignant

40
Q

Are gastric ulcers related to cancer?

A

Yes - gastric carcinoma can cause ulcers

41
Q

What are the signs of a benign ulcer?

A

Small and punched out

42
Q

What are the signs of malignant ulcers?

A

Large and irregular with folding of the tissue

43
Q

Gastric Carcinoma

A

Malignant proliferation of columnar cells - adenocarcinoma

44
Q

What are the 2 types of gastric carcinoma?

A
  • Intestinal

- Diffuse

45
Q

Intestinal Gastric Carcinoma

A

Large irregular ulcer with heaped up margins

46
Q

Where is Intestinal Gastric Carcinoma generally located?

A

Lesser curvature of the antrum

47
Q

What are risk factors of Intestinal Gastric Carcinoma?

A
  • Intestinal metaplasia
  • Nitrosamines in smoked foods
  • Blood Type A
48
Q

Diffuse Gastric Carcinoma

A

Signey ring cells diffusely infiltrate the gastric wall with desmoplasia that results in a thickening of the stomach wall

49
Q

Linitis Plastica

A

Thickening of the stomach wall

50
Q

What are the risk factors of Diffuse Gastric Carcinoma?

A

Not associated with H. pylori, intestinal metaplasia or nitrosamines

51
Q

Leser-Trelat Sign

A

Dozens of keratoses all over the skin

52
Q

Where does gastric carcinoma spread to?

A

Virchow’s Node (Left Supraclavicular)

53
Q

What is periumbilical metastasis of Gastric Carcinoma known as?

A

Sister Mary Joseph Nodule - intestinal

54
Q

What is bilateral ovary metastasis of Gastric Carcinoma known as?

A

Krukenberg Tumor - diffuse

Pathoma (119 decks)

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