Clinico-pathology of Gastric Disease (On Quiz) Flashcards
gastric pits and glands in the stomach are lined by what kind of cells
- simple columnar mucous cells
are parietal cells located higher or lower in the gastric glands?
what about chief cells?
- parietal - higher
- chief - lower
where does H. pylori live
does it adhere to intestinal cells?
- layer of mucous adherent to gastric pit cells
- no. it does not.
what’s the purpose of H. pylori utilizing urea
- converting it into ammonia and buffering local pH of the stomach
how do we stain H. pylori
- silver stain
how does H. pylori cause pathogenesis problems
what virulent factors does it have
- epithelial cells injury
- proteases
- ammonia
- cytotoxins
what is acute gastritis
- acute inflammation of the mucosa
how do burns cause acute gastritis
- curling ulcer
- decrease fluid volume leads to mucosal hypoxia
how does brain trauma cause acute gastritis
- Cushing ulcer
- increased vagal nerve firing increases gastric acid secretion
causes of acute gastritis
- drugs
- infection
- complications of other diseases
- mucosal damage
causes of chronic gastritis
- infectious
- autoimmune
what are chronic inflammatory cells
- lymphocytes
- plasma cells
- macrophages
what do we see in gross pathology and histology of chronic gastritis
- chronic inflammation
- atrophy of gastric glands and rugal folds
- intestinal metaplasia
how is autoimmune chronic gastritis caused
- autoantibody to parietal cell proteins
- leads to chronic inflammation
- destruction of parietal cells
result of autoimmune chronic gastritis
- gastric gland atropy
- decreased acid production
- decreased intrinsic factor
result of decreased intrinsic factor
- decreased B12 absorption leads to pernicious anemia
what is peptic ulcer disease
where do they most occur
how far does it go into those areas
- chronic ulcers in GI tract exposed to pepsin-acid luminal contents
- duodenum and stomach
- penetrates through muscularis mucosa into submucosa
causes of peptic ulcer disease
result
- H. pylori
- NSAIDs
- increased gastric acid
- combine with acid and pepsin to cause epithelial cell necrosis
importance of the mucus layer in gastroduodenal defense
- creates a pH gradient between stomach lumen and surface of epithelial cells
- protects cells from action of pepsin
importance of prostaglandins in gastroduodenal defense
- stimulate bicarbonate and mucus secretion
how many ulcers in peptic ulcer disease
what does it look like
- generally just one
- smooth base and flat margins “cookie cutter”
4 characteristic zones of an active ulcer
- fibrinopurulent exudate
- necrotic tissue
- granulation tissue
- fibrotic tissue/scar
complication of peptic ulcer
- hemorrhage
- perforation
- obstruction
how does Zollinger-Ellision disease occur
- gastronoma in pancreas secretes gastrin.
- increases gastric HCl secretion which leads to severe peptic ulceration
how does Menetrier disease occur
- hyperplasia of gastric pit mucus cells
- increased mucus secretion
- causes thick rugae in cerebriform pattern
MALT causes which cancer
- low grade B cell lymphoma
smooth muscle causes which cancer
is this benign or malignant
- Leiomyoma
- benign
how does an ulcerating malignancy compare to a peptic ulcer
- ulcerating has more irregular sides and looks more jagged
- not cookie cutter
left supraclavicular nodes are called
- Virchow node
periumbilical nodes are called
- Sister Mary Joseph nodes
Krukenberg tumor is of what organ
- ovary
2 Types of Gastric Adenocarcinomas
which is associated with forming glands
- diffuse type
- intestinal type - forms glands
Diffuse Type gastric adenocarcinomas arise from
can result in
- gastric mucous cells
- Linitis Plastica
Intestinal Type gastric adenocarcinomas arise from
- metaplastic intestinal epithelial cells
causes of gastric lymphoma
- H. pylori infection
- expansion of MALT due to chronic inflammation
what do you see on histology with gastric lymphomas
- lymphocytes destroy and replace glands
