GASTRITIS

Question 1

Define gastritis.

Answer 1

Inflammatory condition of the stomach resulting from damage to gastric mucosa.

Question 2

What type of glandular cells are found in the wall of the body of the stomach?

Answer 2

Parietal

Chief

Question 3

What type of glandular cells are found in the wall of the antrum of the stomach?

Answer 3

Mucin producing cells

Question 4

How might someone with suspected acute gastritis present?

Answer 4

Dyspepsia (indigestion)
Heartburn
Nausea
Vomiting
Epigastric pain

Severe:
Haematemesis
Melaena

Question 5

What is the pathophysiology of gastritis?

Answer 5

Reduced protection of mucosa or direct epithelial damage
Acid diffusion
Infiltration of neutrophils
Oedema and congestion

Question 6

What are some of the risk factors for gastritis?

Answer 6

Alcohol
Smoking
NSAIDs including aspirin
Chemotherapy
H. pylori
HSV
CMV (cytomegalovirus)
Trauma, burns

Question 7

What are the complications of gastritis?

Answer 7

Erosion and haemorrage
Ischemia
Necrosis
Ulceration
Perforation
Shock
Death

Question 8

What is chronic gastritis?

Answer 8

Sustained inflammatory response to gastric mucosal damage.

Question 9

What are the immediate complications of chronic gastritis?

Answer 9

Intestinal metaplasia

Glandular atrophy

Question 10

What is the system most commonly used to classify gastritis?

Answer 10

Updated Sydney system

Question 11

What are the three components of the Sydney System for classifying gastritis?

Answer 11

Aetiology
Topography
Morphology

Question 12

What are the non-infectious aetiological causes of gastritis?

Answer 12

Autoimmune - (including pernicious anaemia)
NSAIDs
Alcohol
Bile reflux
Chemotherapy
Radiation
Allergy to gluten
Foreign Bodies
Crohn’s disease
Systemic diseases

Question 13

What are the infectious aetiological causes of gastritis?

Answer 13

Helicobacter pylori
Helicobacter heilmannii
Treponema pallidum
Micobacteria

CMV
Herpes virus

Candida
Histoplasma capsulatum
Giardia lamblia
Cryptosporidium
Strongyloides stercoralis
Anisakidae

Question 14

What are the three topographical locations for classifying gastritis?

Answer 14

Antral
Body
Pangastritis

Question 15

What percentage of the population are colonised by H. pylori?

Answer 15

Up to 80%

Question 16

What virulent proteins do some strains of H. pylori have, which makes them more likely to cause gastritis and gastric ulcers and also cancer?

Answer 16

CagA

VacA

Question 17

What is autoimmune gastritis?

Answer 17

Chronic gastritis as a result of autoantibodies against the gastrin receptor, ATPase and intrinsic factor (pernicious anaemia), leading to atrophy of the stomach.

Question 18

What are the complications of autoimmune gastritis?

Answer 18

Achlorhydria
Pernicious anaemia
Adenocarcinoma
Carcinoid

Question 19

What other hereditary diseases is autoimmune gastritis associated with?

Answer 19

Hashimoto thyroiditis
Type I diabetes mellitus
Addison disease
Primary hypoparathyroidism
Graves disease
Myasthenia gravis
Lambert-Eaton syndrome

Question 20

What are most of the signs and symptoms of autoimmune gastritis attributable to?

Answer 20

The vitamin B12 defiency

Question 21

How does the body respond to the drop in acid production in autoimmune gastritis?

Answer 21

Increased production and secretion of gastrin leading to hypergastrinemia.

Question 22

What cells continue to be stimulated by the excessive levels of gastrin in the blood in a patient with autoimmune gastritis? What happens as a result?

Answer 22

Enterochromaffin-like cells (ECL)

Hyperplasia of these cells

Question 23

What type of gastric tumour is particularly associated with chronic gastritis involving H. pylori?

Answer 23

MALT lymphoma