6. Case studies Flashcards
8 Causes of gastritis
Oxygen deprivation Chemical agents = drugs Infectious agents = helicobacter Immunological reactions = autoimmune Genetic defects Nutritional imbalances Physical agents Aging
What are the 3 effects of helicobacter infection on the stomach?
Inflammation: acute and chronic (including ulcers)
Cell damage: atrophy, metaplasia, dysplasia
Neoplasia: carcinoma and lymphoma
Range of clinical outcomes of Helicobacter pylori infections
Asymptomatic or chronic gastritis Chronic atrophic gastritis Intestinal metaplasia Gastric or Duodenal ulcer Gastric cancer MALT Lymphoma
What is an Ulcer and what is it caused by?
An open sore on an external or internal surface of the body
Caused by a break in skin or mucous membrane which fails to heal
Granulomatous gastritis
subset of chronic inflammation
collection of activated macrophages (granuloma)
involves specific immune reaction T-Cells
Causes of granulomatous gastritis
Infection: TB, fungi, helicobacter
Foreign material
Reaction to tumours
Immune diseases (sarcoid, Crohn’s)
What is the difference between acute and chronic ulcers?
Pattern of inflammation is different
Chronic ulcers have fibrosis, scarring associated with chronic ulcers. Repair but no regeneration.
Healing of acute gastric ulcer
Parenchymal cell regeneration
RESOLUTION
Healing of chronic gastric ulcer
Repair by connective tissue
SCAR TISSUE FORMATION
What cellular adaptations are seen with helicobacter gastritis?
Hyperplasia- increase in cell number
Hypertrophy- increase in cell size
Atrophy- shrinkage in size of cells
Metaplasia- reversible, 1 cell type replaced by another
Dysplasia- precancerous cells show genetic and cytological features/ malignancy but not invasion
How are neoplasms classified?
According to cell of origin and whether they are benign or malignant
What are benign and malignant tumours from glandular epithelium called?
Benign: Adenomas
Malignant: Adenocarcinomas
What is the grading of cancer based on?
degree of histological differentiation
What is staging of cancer based on?
How far tumour has spread
What is the main staging system?
TNM
Size and spread of tumour
Spread to regional lymph nodes
Presence of metastases
Atherosclerosis
Plaques form in the arteries
Loss of normal endothelium
Thrombosis and emboli can occur
Clinically important sites of atheroma
Coronary arteries
Carotid arteries
Aorta and/or iliac arteries
Why are stable atherosclerotic plaques a concern?
They just get bigger and bigger
Cause increasingly narrow arteries
Associated with angina, dementia, chronic lower limb ischaemia
What may thrombosis of atherosclerotic plaques lead to?
Unstable angina
Myocardial infarction
Cerebral infarction
Acute lower limb ischaemia
Why is weakening of arterial walls a concern?
Leads to aneurysm formation
What is an aneurysm?
An abnormal blood-filled bulge of a blood vessel, especially arteries
Result from weakening of the vessel wall
