case studies Flashcards
effects of Helicobacter infection on stomach
acute and chronic inflammation, cell damage including atrophy, metaplasia and dysplasia, neoplasia (such as carcinomas and lymphomas)
define atrophy
shrinkage in size of cell or organ by loss of cell substance
define metaplasia
reversible change in which one adult cell type is replaced by another
define dysplasia
precancerous cells which show genetic and cytological features of malignancy (e.g. increase in nuclear:cytoplasmic ratio) but don’t invade underlying tissue
naming of neoplasms
according to cell of origin and whether benign or malignant
Helicobacter neoplasms
gastric adenocarcinoma, gastric lymphoma
what is classification of neoplasms based on
grading (degree of differentiation) and staging (how far tumour has spread)
what can Helicobacter cause in the stomach
gastritis
what are other causes of gastritis
oxygen deprivation, chemical agents, infectious agents, immunological reactions, genetic defects, nutritional imbalances, physical agents, aging
range of clinical outcomes of Helicobacter
may be asymptomatic or cause gastritis which can lead to cancers
features of acute inflammation
rubor, heat, swelling (oedema), pain, loss of function
what is the key inflammatory cell in acute inflammation and what is it responsible for
neutrophil polymorphs responsible for abscess formation
in acute gastritis, what forms
acute peptic ulcers
what are acute peptic ulcers
breaks in continuity of mucous membrane or skin
what regenerates and resolves acute peptic ulcers, restoring function
parenchymal cells
features of chronic inflammation
rubor, atrophy
what is the key inflammatory cell in chronic inflammation
lymphocytes
what does Helicobacter induce in chronic inflammation and what is the clinical significance
formation of lymphoid follicles with germinal centres, increasing risk of lymphoma
in chronic gastritis, what forms
chronic gastric ulcers
why can’t chronic gastric ulcers be restored
fibrosis occurs so scar tissue forms, allowing repair but not regeneration or restoration of function
what is granulomatous inflammation
subset of chronic inflammation; cluster of activated macrophages for cytokine secretion (not phagocytosis)
causes of granulomatous inflammation
infection (e.g. TB, fungi, Helicobacter), foreign material, reaction to tumours, immune diseases e.g. Crohn’s
define atherosclerosis
disease of intima in arteries causing plaque build up and subsequent inflammation
3 types of plaque
asymptomatic (quiescent), symptomatic stable, unstable
what do symptomatic stable plaques induce
ischaemia reducing oxygen supply
consequences of symptomatic stable plaques
stable angina, dementia, chronic lower limb ischaemia
what do unstable plaques increase risk of
rupture and acute ischaemic events
consequences of unstable plaques
unstable angina, myocardial infarction, cerebral infarction, acute lower limb ischaemia, aneurysm
why do aneurysms form due to unstable plaques
oxygen cannot enter arterial walls via diffusion so smooth muscle atrophy occurs, thinning the wall and making them more susceptible to bulging
fate of aneurysms caused by unstable plaques
rupture or cause thrombosis (which can then act as an embolus)
