Gastric Pathology Flashcards
what are normal mechanisms of mucosal injury?
h. pylori, NSAID, ASA, cigarettes, alcohol, gastric hyperactivity, GERD
How doe the mucosa protect itself?
mucus, bicard, blood flow, regeneration, apical surface membrance transport
What are the main causes of acute gastric ulceration?
h. pylori, NSAIDs, lots of alchohol, shock, trauma, sepsis, uremia, severe burns and intercranial ds.
The most common pathologic finding in H. Pylori gastritis
active chronic gastritis
Letting your dog lick your face is not only gross it can lead to this gastric infection
H. helmannii
These tests can indicate an active H. pylori infection
stool antigen, urea breath test, biopsy.
(serology not active infection- just exposure),
Key nugget of autoimmune gastritis
t-cell mediated destruction of parietal cells
Describe some of the key findings of gastritis
decreased acid secretion hyperplasia of G cells vit B12 def. reduced serum pepsinogen inflammatory mucusoal damage atrophy of gastric mucosa glossitis CNS
Normal things that cause chronic reactive gastropathy
NSAIDS, asprin, bile reflux, alcohol ingestion
list complications of H. pylori infection.
peptic ulcer disease, chronic gastritis, gastric tumors, adenocarcinoma, lymphoma
Two common causes of peptic ulcer disease
H. pylori or chronic use of NSAIDs
List complications of PUD
bleeding
perforation
obstruction
Keys of eosinophilic gastritis
eosinophils w/out known cause, probably an allergic rxn.
What causes granulomatous?
Secondary to Crohn’s, sarcoidodis, mycobaterial and fungal infections, foreign body
Describe what characterizes Lymphocytic gastritis
Intraepithelical lymphocytic inflammation (CD8+ T cells) 40% have celiac disase
Excessive secretion of TGF-alpha is called this
Menetrier’s Ds (hypertrophic ds)
Describe how one develops Zollinger-Ellison syndrome
Gastric secreting tumors of the pancreas or small bowel –> increased gastric acid production.
Polyps that represent exaggerated mucosal response to tissue injury and inflammation
hyperplastic polyp
What medication use can cause gastric polyps?
PPI’s cause cystic fundic gland polyp
This neoplastic polyp is mostly seen in people >50.
Gastric adenoma usually seen with chronic gastritis and interstinal metaplasia
These polyps occur in middle aged females and is thought to be a pseudotumor and involve mesenchymal proliferation
inflammatory fibroid polyp
A pt. presents in the 2nd or 3rd week of life with regurgitation and projectile vomiting.
Congenital hypertrophic pyloric stenosis, cured with surgical myotomy
What puts one at risk for Gastric adenocarcinoma?
chronic gastritis dietary carcinogens menetrier's ds no antioxidatns FAP
Describe 2 morphological types of adenocarcinoma.
intestinal - invasive mass or ulcer
diffuse - diffuse involvement and thickening of gastric wall - see signet-ring cells - can be young people
Keys of GIST tumor.
Most common to stomach
cells become interstitial cells of Cajal
85% have gain of function mutation for TK KIT
sporadic
Gleevec effective inhibitor TK.
Most common risk factor for gastric MALT lymphoma.
Treatment?
chronic inflammation from H. pylori.
can treat with antibodies and remove transcription activation if no translocations..
How do you diagnose carcinoid syndrome?
24 hour urinary 5-HIAA test (serotonin metabolite)
What would you see in a patient with carcinoid syndrome?
intermittent flushing, sweating, bronchospasm, abdominal pain, diarrhea, right sided valvular fibrosis
