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Exam 3 > Diseases Of The Stomach > Flashcards

Diseases Of The Stomach Flashcards

1
Q

Mucous cells of the stomach secrete….

A

Alkaline mucus that protects the epithelium against shear stress and acid

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2
Q

Parietal cells secrete

A

HCl and intrinsic factor

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3
Q

Chief cells secrete

A

Pepsin, a proteolytic enzyme

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4
Q

G cells secrete

A

Hormone gastrin, which signals parietal cells

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5
Q

ECL cells of the stomach secrete

A

Histamine

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6
Q

Dyspepsia

A

Aka indigestion
Symptoms include episodic epigastric pain, nausea, heartburn, bloating, dissension,

Food intake precipitates
No identifiable organic cause

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7
Q

Types of dyspepsia

A

Ulcer vs non-ulcer

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8
Q

Causes of dyspepsia

A 
PUD
GERD
Erosive esophagus
Gastric cancer
Biliary colic
Pancreas disease
Chronic mesenteric ischemia
Gastroparesis
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9
Q

Dyspepsia, bad warning signs

A 
New symptoms at older age
Weight loss
Dysphasia
GI bleeds
Failed response to acid blockade
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10
Q

Gastroparesis symptoms

A 
Nausea
Early satiety 
Vomiting
Bloating
Pain
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11
Q

Gastroparesis management

A

Multiple small meals
Low fat/fiber diet
Glucose control
Prokinetics (metoclopramide)

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12
Q

Causes of gastroparesis

A 
Diabetes
Connective tissue disorders
 Antichoinergic medications
Vagotomy
Preganancy
Thyroid disorder
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13
Q

Pernicious anemia pathophys

A

Antibodies attack parietal cells, decreased acid production, decreased intrinsic factor

Cant absorb b12
Leads to anemia

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14
Q

Signs of an ulcer

A 
Episodic epigastric pain
N/V
GI bleeds
Weight loss
Iron deficient
Gastric outlet obstruction
Perforation
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15
Q

PUD breaks the mucosa and extends through the ___________ ___________

A

Muscularis mucosa

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16
Q

Causes of PUD

A 
#1: NSAIDS
#2: H. Pylori

Also: zollinger Ellison syndrome
Infection (HSV, CMV, TB , syphillis) in immunocompromised
Stress
Radiation/chemo

17
Q

How to diagnose an ulcer

A

EGD w Bx
Barium

H. Pylori test and NSAID history for causation

18
Q

Ulcer treatment

A

Treat h pylori with abx
Stop smoking
Stop NSAID

Short term PPI therapy for 2 months
Re-scope to confirm healing

19
Q

PUD complications

A 
Mortality
Bleeding
Perforation
Gastric outlet obstruction
Penetrate pancreas
20
Q

What do H pylori do?

A

Secrete urease to hydrolyze urea into ammonia
Neutralize gastric acid
Penetrate gastric mucus layer
Adhere to gastric mucosa

21
Q

H pylori can cause…

A

Gastritis
PUD
MALT lymphoma
Gastric adenocarcinoma

22
Q

How do we diagnosis H pylori?

A

Gastric biopsy
Serum IgG
Stool Ag
Urea breath test

23
Q

Gastric adenocarcinoma presentation

A

Asymptomatic, presenting at late stage

Pain, early satiety, N/V, weight loss, anorexia, gastric ulcers

24
Q

Ulcers seen in the duodenum, what does this patient have?

A

zollinger-Ellison syndrome

25
Q

Zollinger Ellison Syndrome pathophys

A

Acid hyper Secretion due to gastrinoma

Excess gastrin means increased parietal cell stimulation and acid production. Hyperacidity means ulcers

Tumor location: pancreas or duodenum

Sporadic or part of MEN1 syndrome (parathyroid, pancreas, pituitary tumors)

50% malignant

26
Q

Zollinger Ellison syndrome presentation

A

Pain
PUD (unusual, unexplained locations)
Diarrhea, villous atrophy

27
Q

Causes of upper GI bleeding

A

PUD or variceal bleeds most common

Differential: AVMs, dieulafoy’s lesion, watermelon stomach, connective tissue disorder, tumor

28
Q

Watermelon stomach

A

Gastric antrum is vascularized
AVMs here ooze and cause anemia
Tx: cauterize via scope

29
Q

Dieulafoy’s lesion

A

Small arteriole at surface, no ulcer just vessel bleeding

30
Q

GI bleed risk ranking

A

Clean base. > flat spot > adherent clot > nonbleeding visible vessel > active bleed

31
Q

Complications post gastric bypass

A

Can still get ulcers from NSAIDS traveling in blood stream

Cant do ERCP for gallstones

Need to do laparoscopic imaging

Exam 3 (18 decks)

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