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GI > 2. Stomach Pathology > Flashcards

2. Stomach Pathology Flashcards

1
Q

Gastropathy

A

the stomach mucosa is damaged but NO INFLAMMATION is present

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2
Q

gastritis

A

INFLAMMATION of the gastric mucosa

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3
Q

What is the difference between gastropathy and gastritis?

A

presence of inflammation

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4
Q

What is seen histologically during gastritis

A

neutrophils

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5
Q

acute gastritis

A

sudden inflammation or swelling in the stomach mucosa (neutrophils are present)

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6
Q

chronic gastritis

A

long-term stomach lining inflammation

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7
Q

what is present, histologically, in chronic gastritis

A

lymphocytes and plasma cells

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8
Q

what is the main cause of chronic gastritis

A

helicobacter pylori

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9
Q

helicobacter pylori gastritis

A

helicobacter-associated gastritis. H. pylori is the primary cause of chronic gastritis

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10
Q

What are the anatomic regions of the stomach

A

cardia
fundus
corpus
antrum/pylorus

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11
Q

what is the histology of the stomach

A

mucosa
submucosa
muscularis externa
serosa

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12
Q

What is food called entering the stomach

A

bolus

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13
Q

chyme is made is what part of the stomach

A

corpus

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14
Q

what are the parts of the mucosa

A

epithelium
lamina propria
muscularis mucosa

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15
Q

what is the lamina propria

A

space b/t epithelium

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16
Q

what is in the muscularis mucosa

A

muscle in mucosa

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17
Q

what are the parts of the submucosa

A

fats
fibrous tissue
blood vessels
lymphatics

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18
Q

what are the parts of the muscularis/propria/externa

A

inner oblique
middle circular
outer longitudinal

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19
Q

what is a unique layer to the stomach

A

inner oblique

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20
Q

what is the purpose of the muscularis/propria/externa?

A

it is layers of muscles/fibrous tissue to assist with churning/breaking down food into chyme

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21
Q

what are parts of the serosa

A

epithelium
connective tissue

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22
Q

gastric foveolae

A

mucous neck cells - contain cytoplasmic mucous globulins that protect the lining during digestion

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23
Q

gastric glands

A

parietal cells

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24
Q

muscularis mucosae

A

chief cells

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25
Q

What is the pH of mucous neck cells

A

alkaline

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26
Q

describe the the stomach cardia?

A

rich in mucous cells and has gastric pits
@ top of stomach
made of mucous cells
forms columnar epethelium

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27
Q

describe the stomach corpus

A

less coiled pits
similar to the cardia
mucosa is deeper
have ECL

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28
Q

Paracrine signaling

A

leads to a histamine for the ECL that encompasses the mucus, parietal cells(HCl), and chief cells (pepsinogen)

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29
Q

describe the stomach pylorus

A

deeper gastric pits
gastric glands are deeper in rich G and D cells (secrete somatostatin and gastrin)

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30
Q

What are things that cause normal damage to the stomach lining

A

gastric acidity
peptic enzyme

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31
Q

What are things that can injure the stomach lining

A

H. pylori infection
NSAID
tobacco
alcohol
gastric hyperacidity
duodenal-gastric reflux

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32
Q

What are protective factors against normal damage

A

surface mucus secretion

bicarbonate secretion into mucus

epithelial barrier function

epithelial regenerative capacity

elaboration of prostaglandins

33
Q

what levels of the stomach lining are affected by injury

A

mucus

34
Q

What are protective factors against injury

A

ischemia
shock
NSAID

35
Q

what is found in ulcer

A

mucosal lining is completely gone when an injury is not treated properly

-Necrotic debris
-Nonspecific acute inflammation
-Granulation tissue
-Fibrosis

36
Q

what is the etiology of gastritis

A

-frequent use NSAID (long-term use of non-steroidal anti-inflammatory drugs)

-extreme stress

-bile

-elderly

-alcohol and smoking

37
Q

how do NSAIDS affect the stomach

A

inhibits COX-dependent synthesis of prostaglandins and mucus production

38
Q

how does stress contribute to gastritis

A

uremia inhibits gastric bicarbonate transporters

39
Q

how does bile contribute to gastritis

A

bile reflux into stomach

bile acid’s alkalinity has a higher pH causing an imbalance = acute gastritis

40
Q

how does elderly contribute to gastritis

A

reduced mucin and bicarbonate secretion

41
Q

how does alcohol and smoking contribute to gastritis

A

direct injury to mucosal cells and increased ROS

42
Q

what is the duration of acute gastritis

A

few days or weeks or once the inflammation is gone

43
Q

What are the symptoms of acute gastritis

A

loss of appetite
upper abdominal discomfort (pain/bloating)
nausea
vomiting
indigestion
burning feeling

44
Q

stress-related mucosal injury is also known as

A

stress-induced acute gastritis

45
Q

what is included in stress-induced acute gastritis

A

increased uremea
associated with an illness

46
Q

curling ulcers in the proximal duodenum are associated with

A

severe burns or ulcers outside of the stomach

47
Q

cushing ulcers: gastric, duodenal and esophageal ulcers are associated with

A

intracranial disease (high incidence of perforation in gastric, esophagus, and duodenum

48
Q

what can you see histologically in acute gastritis?

A

mucus cells’ surface is damaged with no mucin

inflammatory defense lines within the lamina propia (feat neutrophils)

49
Q

what is the etiology of gastropathy

A

Helicobacter pylori (most common)
autoimmune (most common w/o hp)
chronic bile reflux
alcohol and tobacco

50
Q

what is the histology of gastropathy feature

A

cork-skewing of the epithelium

congestion of blood and epithelium

51
Q

what are the symptoms of gastropathy

A

less severe than acute gastritis but lasts longer

nausea and pain, occasional vomiting

52
Q

what does the histology of chronic gastritis feature

A

plasma cells
metaplasia cells
lymphocytes in the lamina propria and epethelium

53
Q

what is the gastric pH level

A

1.5-2

54
Q

how is HELICOBACTER PYLORI GASTRITIS spread

A

Either oral-oral or Fecal-oral contamination

55
Q

characteristics of HELICOBACTER PYLORI bacteria

A

gram negative
rod shaped bacilli

56
Q

what allows the bacteria to be motile

A

flagella

57
Q

what does HELICOBACTER PYLORI produce in the body

A

Urease

58
Q

Urease from h. pylori generates ammonia from urea causing what

A

increasing the gastric pH for survival

59
Q

what does h. pylori use to attach to epethial cells

A

adhesins (but they do not penetrate the surface of the mucus cells

60
Q

what toxins are associated in the disease progression of h pylori

A

cytotoxin-associated gene A (CagA)

61
Q

what is h pylori mainly focused

A

predominantly in the antrum

62
Q

h pylori can induce

A

metaplasia and lead to adenocarcinoma

63
Q

auto immune gastritis is AKA

A

as autoimmune metaplastic atrophic gastritis or type A gastritis

64
Q

auto immune gastritis main affects what part of the stomach

A

corpus

65
Q

In auto immune gastritis, parietal cells are damaged by

A

anti-parietal cell antibodies (90%)
antiintrinsic factor antibodies

66
Q

Hypochlorhydria

A

reduced serum pepsinogen concentration and high serum gastrin levels.

67
Q

Hypochlorhydria can cause

A

lack of vitamin 12 and acidity is affected

68
Q

AUTOIMMUNE GASTRITIS is not associated with what

A

h pylori

69
Q

AUTOIMMUNE GASTRITIS is associated with what diseases

A

Hasimoto’s thyroiditis
Addison’s

70
Q

AUTOIMMUNE GASTRITIS features what pathogensis

A

loss of parietal cells in the corpus

hyperplasia of G cells in antrum

Increased gastrin secretion

Stimulation of ECL in the corpus

Secretion of histamine to stimulate parietal cells

71
Q

In AUTOIMMUNE GASTRITIS, are parietal cells missing?

A

YES

72
Q

What secretes histamines

A

ECL

73
Q

When chronic gastritis is left untreated it can lead to

A

peptic ulcer disease
tumors

74
Q

what causes peptic ulcer disease in chronic gastritis

A

an imbalance between mucosal defense mechanisms and the damaging forces, partially gastric acid and pepsin

75
Q

Antral gastric PUD is caused by

A

h. pylori
smoking
NSAIDs
bile pancreatic juice reflux
Zollinger-Ellison disease

76
Q

Treatment options for chronic gastritis

A

antibodies
PPI
Antacid

77
Q

What do you need to diagnose chronic gastritis

A

test for h. pylori
stool test
breath test
upper GI endoscopy
Barium swallowing test

78
Q

In chronic gastritis, the breath test measure for what

A

urea + water = ammonia and carbon dioxide

GI (5 decks)

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