Gastritis/gastropathy

Question 1

Gastritis

Gastropathy

Answer 1

Epithelial cell damage & regeneration w mucosal inflamm

Damage/regenration with minimal inflammation

Question 2

Pathology

Acute gastritis mcc

if untreated, H pylori canc cause

Answer 2

Imbalance of acid secretion and protective physiochemical barrier (mucus, bicarb, phospholipids)

H pylori- edema/hyperemia of gastric mucosa, neutrophils above BM (no lymphocytes)

Hypochlorhydria, Type B chronic gastritis

Question 3

Chronic gastritis areas of involvement

characterized by

Answer 3

antrum initially, then spreads to body and fundus

subepithelial lymphocytes + neutrophils, with atrophy

Question 4

MALT

Type A chronic gastritis characterized by

Gastropathy characterized by

Answer 4

chronic inflammation by H pylori, leads to development of B cell tumor

Inflammatory infiltrate with lymphocytes and macrophages, no PMNs

edema and vascular congestion

Question 5

CM of gastritis/gastropathy

Answer 5

Dyspepsia/epigastric pain

Mucosal erosion, ulceration, hemorrhage

Question 6

Dx gastropathy

Answer 6

Endoscopy with biopsy

Question 7

Gastropathy

Acute gastritis

Type A chronic gastritis

Type B chronic gstritis

Pathology

Answer 7

Intact suface epithelium, edema of lamina propria
Few PMNs/lymphs

Intact/erosive SE w edema of LP
Dense PMNs above BM

Diffuse mucosal atrophy in body/fundus
Lymphocytes/macros

Multifocal mucosal atrophy, antrum
PMNs and lymphocytes present

Question 8

Initial management

Gastropathy

Acute and Type B

Type A

Managements

Answer 8

Remove NSAIDs, aspirin, alcohol

Cessation of offending agents, acid suppression

H pylori eradication

B12 supplementation