Gastric Diseases Flashcards
what gland is in the cardiac region of the stomach?
mucous cells
what two glands are in the antrum of the stomach
mucous and G cells
what twoglands are in the fundus of the stomach?
parietal and chief cells
where does H pylori live in the stomach?
in the layer of mucus adherent to the gastric pit cells
what stain is used to see H pylori?
silver stain
acute and chronic inflammation lead to what two types of stomach injury respectively?
acute gastritis and chronic gastritis
necrosis in the stomach leads to what stomach disorder?
peptic ulcer disease
chronic inflammation of the stomach can lead to what two types of sever stomach issues
gastric lymphomas and gastric adenocarcinoma
list the four etiologies of acute gastritis
drugs
infection
complication of another disease
mucosal damage
what is acute gastritis from a burn called?
curling ulcer
what is a brain trauma induced acute gastritis called?
cushing ulcer
how can brain trauma lead to acute gastritis?
increased activity of the vagus nerve leads to increased gastric acid secretion
what cell is mainly involved in acute gastritis?
PMNs
what are the three stages of acute gastritis from mild to severe
acute inflammation of mucosa
necrosis
hemorrhage
what is a common drug that causes acute gastritis?
NSAIDS
what are the two common causes of chronic gastritis?
h pylori
autoimmune
what cells are in charge of chronic gastritis?
lymphocytes, macrophages and plasma cells
chronic gastritis has a risk of developing into what?
metaplasia…cancer
what happens to glands and the rugae of the stomach in chronic gastritis?
they atrophy from the necrosis and they are become less prominent
if metaplasia occurs in chronic gastritis, what does it become?
simple columnar with absorptive and goblet cells
how is autoimmune chronic gastritis inherited?
autosomal dominant
explain how autoimmune chronic gastritis happens?
auto antibodies against parietal cells leads to chronic inflammation and destruction of the parietal cells…gland atrophy
in autoimmune chronic gastritis…if the parietal cells are destroyed then what is the acid level called?
hypochlorhidria or achlorhidria
in autoimmune chronic gastritis the parietal cells are destroyed….what do they secrete that is important for RBCs and what can this lead to?
secrete intrinsic factor for B12 absorption…without that you get macrocytic anemia which is called pernicious anemia
where does peptic ulcer disease occur?
stomach and duodenum
what are the three ways to have peptic ulcer diseases?
h pylori
NSAIDS
increased gastric acid
name the three pre epithelial defenses against ulcer disease
bicarbonate
mucus
prostaglandins
name the epithelial defense against ulcer disease
cellular resistance
name the post epithelial defense against ulcer disease
mucosal blood flow bringing nutrients and bicarb
in peptic ulcer disease…what does the ulcer usually look like?
smooth and flat sides
name the two locations in the stomach where ulcers usually occur?
lesser curvature of antrum and pre pyloric area
name the four zones/layers of a peptic ulcer
fibrinopurulent exudate
necrotic tissue
granulation tissue
fibrosis
how does an uncomplicated PUD present?
epigastric pain…nausea bloating…or asymptomatic
name three complications of an ulcer?
hemorrhage
perforation
obstruction
a perforation of an ulcer can lead to what?
perotinitis
why does an obstruction happen with an ulcer?
edema/scar contraction…muscle hypertrophy
what are the signs of an ulcer that has a hemorrhage?
melena, hematemesis
hematochezia
what is melena?
dark bloody stools
what is hematochezia?
bright red bloody stools
how does a perforation present with an ulcer?
toxic appearance/shock
what is zollinger ellison syndrome?
when you have over production of gastrin due to a gastrinoma that secretes it
where does the gastrinoma occur in zollinger ellison syndrome?
often in the pancreas
what happens in zollinger ellison syndrome due to the increased gastrin levels?
increased acid levels and then peptic ulcers
what is menetrier disease? what happens in it?
hyperplasia of the gastric pit mucous cells
hypertrophy of gastric walls
what is the shape of gastric walls in menetrier disease?
thick rugae in cerebriform pattern
with increased mucous production in mentrier disease…what is hindered from happening?
protein digestion
what two symptoms do people with menetrier disease have?
epigastric pain and edema
what are the two types of stomach adenocarcinomas?
diffuse and intestinal
an ulcerating malignancy has what shape in the stomach?
irregular with elevated sides and odd shape…very diff from peptic ulcer
what are the two lymph nodes to check for stomach malignancies
left supraclavicular and periumbilical
what is another name for the left supraclavicular lymph node
virchows node
what is another name for the periumbilical node?
sister mary joseph
what is an odd site for stomach cancer to metastasize to? what is this tumor called?
ovaries…Krukenberg tumor
what are two pre existing diseases that contribute to development of gastric adenocarcinoma
H pylor
chronic atrophic gastritis
an infiltrating cancer in the stomach has a special name…what is it?
linitis plastica
diffuse adenocarcinoma in the stomach arises from what cells? what is another name for them?
gastric mucous cells…signet cells
what happens in diffuse adenocarcinoma that causes linitis plastica?
diffuse desmoplasia or fibrosis
how does intestinal type adenocarcinoma of the stomach arise?
metaplastic intestinal epithelium dyplasia then adenocarcinoma
what are significant prognostic features of gastric adenocarcinoma? 2
depth of invasion
extent of nodal/metastases
what often causes gastric lymphoma? what cell is in charge of it?
H pylori infection brings B cells in to party and they cause overgrowth of the GALT
what does gastric lymphoma look like grossly? what about histo?
just like any other gastric gross patterns…have to do histo slide to see lots of GALT nodules
is gastric lymphoma a good or bad course of disease?
good to have…indolent course
