gastritis, peptic ulcer disease and gastric neoplasia

Question 1

stomach inflammation that cam be either acute or chronic

Answer 1

gastritis

Question 2

chronic gastritis can be either non-atrophic or atrophic.

atrophic increases the risk of

Answer 2

gastric intestinal metaplasia and dysplasia and gastric cancer

Question 3

in gastritis the inflammation usually involves the entire stomach

Answer 3

yep

Question 4

what causes chronic gastritis

Answer 4

1. H. pylori infection

2. autoimmune gastritis

Question 5

microaerophilic gram negative spiral shaped bacteria with multiple polar flagella

• urease enzyme

Answer 5

H. pylori

Question 6

H. pylori infects the stomach in two ways

Answer 6

1. entire stomach- acute infection

2. isolated to antrum- strain that express the CagA protein

Question 7

H. pylori infection of all stomach results in a pH that is

Answer 7

higher which damages the parietal cell

Question 8

H. pylori isolated to antrum results in a pH that is

Answer 8

lower which leads to ulcer and hyperplasia of G cells with increased gastrin release

Question 9

urease testing

Answer 9

invasive test for identifying H. pylori.

Question 10

treatment of H. pylori

Answer 10

antibiotics and acid supression

Question 11

antibodies against parietal cells and intrinsic factor that block the H+/K+ ATPase leading to low acid

it also leads to the block of intrinsic factor thus we might see meagloblastic anemia

Answer 11

autoimmune gastritis

Question 12

diagnosis of autoimmune gastritis

Answer 12

measure serum parietal cell antibodies

Question 13

autoimmune gastritis can result in

Answer 13

type 1 gastric neuroendocrine tumros and risk for intestinal metaplasia which is a precursor to gastric adenocarcinoma

Question 14

how does HP cause ulcers?

Answer 14

1. destructive effect of HP on antral epithelial cells

2. excess HP induced acid productionleading to mucosal damage and spillover into duodenal bulb causing mucosal damage

Question 15

How do NSAIDs cause ulcers?

Answer 15

1. topical effect- they are able to diffuse across epithelial cells and accumulate leading to toxicity
2. COX inhibition causing inhibition of prostanglandin synthesis which inhibits mucosal protective effects and mucosal blood flow

Question 16

which NSAIDs is less likely to develop a gastric ulcer

Answer 16

those that block Cox2

Question 17

pearl of NSAID and ulcer

Answer 17

NSAID induced ulcer may cause no symptoms except bleeding

Question 18

gnawing epigastric abdominal pain, N/V, coffee ground emesis

Answer 18

peptic ulcer symptoms

Question 19

why is a checkup necessary for peptic ulcers after treatment?

Answer 19

confirm eradication of H.pylori

Question 20

gastric ulcers need a endoscopy follow up for

Answer 20

assure healing and absence of malignancy

Question 21

zollinger -ellison syndrome

Answer 21

rare cause of ulcer disease due to the hypersecretion of acid by neuroendocrine tumor secreting gastrin

Question 22

tumor arise how in zollinger ellison syndroem

Answer 22

gastrinoma triangle

Question 23

malignant potential in neoplastic polyps

Answer 23

high 40-60% of polyps show malignant change

Question 24

fundic gland polyps are located at ______ and develops in setting of

Answer 24

fundic gland polyps are located at fundus and gastric body and develops in setting of high gastrin levels

Question 25

most common cause of cancer death worldwide with risk factors include H.pylori, adenomatous gastric polyps, cigarette smoking

Answer 25

gastric adenocarcinoma

Question 26

signet ring

Answer 26

gastric adenocarcinoma