Gastric Pathology

Question 1

Eosinophilic gastritis

etiology

Answer 1

often not isolated, associated with eosinophilic esophagitis

must rule out other causes of eosinophilia

Question 2

Zollinger-Ellison Syndrome

Answer 2

gastrin-secreting tumor of small bowl or pancreas usually

presents as ulcer or diarrhea

Question 3

Presentation of autoimmune gastritis

Answer 3

usually B12-related

Question 4

5-HIAA test

Answer 4

serum test for metabolite of 5-HT

test for neuroendocrine tumors

Question 5

Patients presenting with epigastric pain 1-3 hours after eating, relieved by consuming more food may have…

Answer 5

peptic ulcer disease

food helps buffer burning from acid

Question 6

Autoimmune gastritis

etiology

diagnostic test

Answer 6

CD4+ T-cell mediated destruction of parietal cells

(type IV hypersensitivity)

BUT test by looking for antibodies

**strange, because that seems like it would be type II then, but the Ab just happen to be produced as well, although they are non-pathogenic

Question 7

H. heilmanni

Answer 7

related to H. pylori, can cause same conditions

found in animal vectors, don’t let dogs lick your face!

Question 8

Chronic reactive gastropathy

causes

Answer 8

NSAIDs

ASA

bile reflux

EtOH

Question 9

Most common gastric cancer

Answer 9

adenocarcinoma

Question 10

Peptic Ulcer disease

causes

Answer 10

H. pylori

NSAIDs

Zollinger-Ellison syndrome

GERD

Question 11

Very common condition of stomach related to chronic NSAID use

Answer 11

chronic reactive gastropathy

Question 12

Carcinoid syndrome

Answer 12

due to neuroendocrine (carcinoid) tumor

secreting NTs

Sx: cutaneous flushing, sweating, bronchospasm, colicky abdominal pain, diarrhea, right-sided valvular fibrosis

Question 13

Idiopathic retroperitoneal fibrosis

Answer 13

ureteral obstruction → renal failure

IgG4-associated autoimmune disease

Question 14

Sister Mary Joseph umbilican nodule

Answer 14

firm umbilical nodule

often due to adenocarcinoma of stomach metastisis to umbilicus

Question 15

Recurrent ulcers

how to test for Zollinger-Ellison syndrome

Answer 15

serum gastrin levels

Question 16

Complication of chronic gastritis

Answer 16

intestinal metaplasia of stomach → dysplasia → gastric adenocarcinoma

Question 17

New name for carcinoid tumors

Answer 17

neuroendocrine tumors

that’s great!

many secrete 5-HT causing carcinoid syndrome

that makes sense, because 5-HT is neurotransmitter

Question 18

Transudate

vs

Exudate

Answer 18

transudate: from increased capillary permiability
exudate: from inflammatory process

Question 19

GIST tumors are most often found

Answer 19

in stomach

Question 20

Ascites: 90% caused by

Answer 20

cirrhosis

then

cancer

Question 21

Granulomatous gastritis

associations

Answer 21

Chron’s, sarcoid, mycobacerial and fungal infections

basically anything that can cause granulomas to form

Question 22

Dieulafoy’s Lesion

Answer 22

large-diamter mural arteriole penetrating into submucosa

one of few causes of:

massive upper GI bleeding

Question 23

Menetier’s Disease

etiology

Answer 23

TNF-α secretion in stomach

marked diffuse gastric hyperplasia

enteropathy and hypoproteinemia

CMV in children

association with gastric adenocarcinoma

Question 24

Virchow’s node

Answer 24

left supraclavicular node

may be first sign of

gastric adenocarcionma