Chronic Gastritis

Question 1

What is chronic gastritis?

Answer 1

Inflammatory diseases of the stomach

Question 2

What is the most common cause of chronic gastritis in the US?

Answer 2

Helicobacter pylori

Question 3

What is the most common pattern of H. pylori gastritis?

Answer 3

Nonatrophic antral-predominant gastritis

Question 4

What are characteristics of multifocal atrophic gastritis?

Answer 4

• Not linked to autoimmune phenomena
• Associated with reduced acid secretion (hypochlorhydria)

Question 5

Compare and contrast Mutlifocal atrophic gastritis and autoimmune atrophic gastritis

Answer 5

Common: Pathology is similar

Different: AG is restricted to the fundus and body and MAG is confined mainly to the antrum and corpus

Question 6

What is the key histological finding in atrophic gastritis?

Answer 6

Conspicuous reduction of number of glands

Question 7

What characteristic is common both autoimmune gastritis and multifocal atrophic gastritis?

Answer 7

Intestinal metaplasia

Question 8

Those with either autoimmune gastritis or multifocal atrophic gastritis are predisposed to….?

Answer 8

Carcinoma of the stomach

Question 9

What is the most common extranodal site of lymphoma?

Answer 9

Stomach

Question 10

What are most gastric lymphomas composed of?

Answer 10

Low-grade B-cell tumors of the mucosa-associated lymphoid tissue lymphoma (MALToma)

Question 11

What is aumtoimmune atrophic gastritis?

Answer 11

Chronic diffuse inflammatory disease of the body and fundus of the stomach associated with autoimmunity

Question 12

What is AAG associated with?

Answer 12

Pernicious Anemia

Question 13

What is pernicious anemia?

Answer 13

Megaloblastic anemia caused by malabsorption of vitamin B12 owing to a deficiency of intrinsic factor

Question 14

What sites of the stomach are affected by AAG?

Answer 14

Body, fundus; Lacking involvement of the antrum

Question 15

What are Abs to in AAG?

Answer 15

Parietal cells and Intrinsic factor

Question 16

Why is serum gastrin increased in AAG?

Answer 16

G-cell hyperplasia in antral mucosa

Question 17

What are the two major autoAbs in AAG?

Answer 17

• Cytotoxic Abs to Parietal cells
• Intrinsic Factor Abs that interferes with the intrinsic factor-vit B12 complex absorption

Question 18

What is reactive gastropathy typically caused by?

Answer 18

Ingstion of NSAIDs

Question 19

How is reactive gastropathy different from H. pylori gastritis?

Answer 19

Inflammation is minimal in reactive

Question 20

Causes of granulomatous gastritis?

Answer 20

TB, sarcoid, Crohn’s

Question 21

What is seen on endoscopy of a stomach with gastric antral vascular ectasia (GAVE)?

Answer 21

“Watermelon Stomach”

Question 22

What is another name for hyperplastic hypersecretory gastropathy?

Answer 22

Menetrier Disease

Question 23

What does Menetrier Disease cause?

Answer 23

Severe loss of plasma proteins

Question 24

What is the cause of childhood Menetrier’s? Adult?

Answer 24

Childhood - CMV; Adult - overexpression of transforming growth factor-alpha (TGF-alpha)

Question 25

What are the gross findings of Menetrier disease?

Answer 25

Enlarged gastric rugae remniscent of the cerebrum

Question 26

To what mucosa is Menetrier disease restricted?

Answer 26

Oxyntic mucosa

Question 27

What are generally the presenting Syx of Menetrier disease?

Answer 27

Postprandial pain relieved by antacids

Question 28

What type of condition is Menetrier disease classified as?

Answer 28

Precancerous condition