17-3 -- Stomach Flashcards
The Gastric Mucosa has many factors that protect it. List 5.
- Prostaglandins
- Mucous secretion and mucosal blood flow
- Bicarbonate secretion
- Epithelial barrier and regenerative capactiy
The Gastric Mucosa has many factors that protect it. List 5.
- Prostaglandins
- Mucous secretion and mucosal blood flow
- Bicarbonate secretion
- Epithelial barrier and regenerative capacity
The Gastric Mucosa has many factors that can damage it. List 3.
- Acid
- Peptic enzymes
- Injury - ex. H.pylori, NSAIDs, alcohol
The Gastric Mucosa has many factors that can damage it. List 3.
- Acid
- Peptic enzymes
- Injury - ex. H.pylori, NSAIDs, alcohol
Acute Gastritis
Inflammation of gastric mucosa when Neutrophils are present
With Acute Gastritis, what inflammatory cell must be present?
Neutrophils
Gastropathy
Inflammation of gastric mucosa when NO inflammatory cells present
What causes Gastritis?
Damaging forces overwhelm the protective factors of the mucosa
What can cause Acute Gastritis?
NSAIDs, alcohol, bile
How do NSAIDs cause Acute Gastritis?
(-) COX = DECREASED prostaglandin synthesis
prostaglandin is a protective factor
What histo signs will be present with Acute Gastritis?
Foveolar cell hyperplasia, edema
Neutrophils above the basement membrane
2 types of Chronic Gastritis and what causes them?
Type A - autoimmune
Type B - H.pylori
Type A Chronic Gastritis has what blood change?
Hypergastrinemia
Type A Chronic Gastritis location and damage?
Body and fundus of stomach
= Diffuse mucosal damage
Type A Chronic Gastritis has antibodies to?
Parietal cells and Intrinsic factor
= Decreased acid ==> Hypergastrinemia trying to compensate
Achlorhydria
Decreased gastric acid secretion
What symptoms may be seen with Type A Chronic Gastritis?
Pernicious anemia - LOW B12
= Glossitis and CNS issues
Type B Chronic Gastritis location and damage?
Antrum of stomach
= Patchy mucosal damage
Type B Chronic Gastritis acid production?
Normal - increased
Type A = decreased
Main cell types with Type A and B Chronic Gastritis?
Type A - lymphocytes and macrophages
Type B - Neutrophils
Pathogenesis for stress ulcers?
Local ischemia!
What do the stress ulcers look like?
Multiple, round with brown/black base anywhere in the stomach
How should you treat stress ulcers?
Treat underlying condition
Curlings and Cushings stress ulcers
Curlings = associated with extensive burns Cushings = brain/trauma and lesions
2 Non-stress ulcers?
GAVE
Dieulafoy lesion
Dieulafoy lesion
Abnormal artery at the lesser curvature of the stomach
= recurrent gastric bleeding
Penetrating ulcers will cause?
Referred pain
How do ulcers look with PUD?
SINGLE ulcer - punched out appearance
3 Complications of PUD?
Bleeding
Perforation
Obstruction
