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DIT Gastro > Gastro 4 - Upper GI Path > Flashcards

Gastro 4 - Upper GI Path Flashcards

1
Q

What are the causes of acute gastritis?

A

NSAIDs and aspirin. Alcohol. Burns (Curling ulcer). Brain injury (Cushing ulcer).

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2
Q

What can chronic gastritis due to H.pylori cause in the long run?

A

MALT-lymphoma. Gastric cancer.

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3
Q

Stomach biopsy reveals neutrophils above the basement membrane, loss of surface epithelium, and fibrin-containing purulent exudate. What upper GI problem is this?

A

Acute gastritis.

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4
Q

Stomach biopsy reveals lymphoid aggregates in the lamina propria, columnar absorptive cells, and atrophy of glandular structures. What upper GI problem is this?

A

Chronic gastritis.

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5
Q

Diffuse thickening of gastric folds, elevated serum gastrin levels, biopsy reveals glandular hyperplasia w/o foveolar hyperplasia. What upper GI problem is this?

A

Zollinger-Ellison syndrome.

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6
Q

What is a peptic ulcer?

A

Gastric acid erodes thru mucosa into submucosal tissue.

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7
Q

What are the symptoms of a gastric ulcer?

A

Upper abdominal and epigastric pain after eating. Weight loss. 70% associated w/ H.pylori infection. Increased risk of gastric cancer.

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8
Q

What are the symptoms of duodenal ulcer?

A

Pain relieved by eating. Pain returns several hours after eating. Weight gain. 90% due to H.pylori. Ulcers have clean, smooth borders. May have hypertrophy of Brunner glands. May rarely caused by Zollinger-Ellison syndrome.

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9
Q

What are the complication of gastric ulcer?

A

Pain. Weight loss or gain. Hemorrhage (somatostatin, octreotide; decreases splachnic blood flow). Can perforate (especially duodenal ulcers), causing peritonitis.

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10
Q

What is the treatment of ulcers itself?

A

Triple therapy: PPI + clarithromycin + amoxicillin (or metronidazole). If resistant to clarithromycin, use Quadruple therapy: PPI + bismuth + metronidazole + tetracycline.

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11
Q

Calcium carbonate is an OTC antiacid. Why is it bad to use it chronically?

A

It can cause hypercalcemia, stimulating G cells to produce gastrin, leading to rebound excessive acid.

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12
Q

What can Magnesium hydroxide cause in chronic use?

A

Diarrhea, leading to hypokalemia. It is a smooth muscle relaxer.

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13
Q

What are the symptoms of chronic use of aluminum hydroxide?

A

Constipation. Hypophosphatemia. Proximal muscle weakness. Seizures. Osteodystrophy.

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14
Q

What are four H2 blockers?

A

Cimetidine. Famotidine. Nizatidine. Ranitidine. They all end in -dine, as in lets dine together.

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15
Q

What is the mechanism of H2 blockers?

A

Directly inhibit H2 histamine receptors on parietal cells.

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16
Q

What are the cumbersome side effects of Cimetidine?

A

Inhibits cytochrome P450. Anti-androgen effects: impotence, decreased libido, gynecomastia. Decreases methemogloblin levels. Thrombocytopenia.

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17
Q

What are three Proton pump inhibitors (PPIs)?

A

Omeprazole. Esomeprazole. Pantoprazole. All end in -prazole.

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18
Q

What is the mechanism of action of proton pump inhibitors (PPIs)?

A

Inhibit the H+/K+ ATPase.

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19
Q

When do we use Proton Pump inhibitors (PPIs)?

A

Severe GERD. Zollinger-Ellison syndrome. Erosive esophagitis. Peptic ulcers. Gastritis. H.pylori infection.

20
Q

Why is bismuth useful in GERD?

A

Binds to tissue at base of ulcer and forms protective barrier.

21
Q

Why is Misoprostol useful in GERD? Why is it deadly in pregnancy?

A

“Prost”: A prostaglandin analog. Aids in generation of gastric mucus barrier by trapping bicarb and protecting the mucus barrier. Side effect in pregnancy: It increases Utetine tone, causing an abortion. Can cause diarrhea.

22
Q

What is Menetrier Disease?

A

A precursor to gastric cancer (Adenocarcinoma), causes hypertrophy of the mucus producing cells. Atrophy of parietal cells. Decreased in acid production. Causes enteric protein loss, causing hypoalbuminemia, causing edema.

23
Q

What is the most common type of cancer of the GI track?

A

Adenocarcinoma. Except in the esophagus.

24
Q

What are the risk factors of gastric cancer?

A

H.pylori. Chronic gastritis. Nitrosamines. Men over 50. Japanese people in Japan.

25
Q

What is a Virchow node?

A

When a gastric cancer has metastasized to the left supraclavicular node.

26
Q

What is a Sister Mary Joseph nodule?

A

When a gastric cancer has metastasized to the periumbilical node.

27
Q

What is a Krukenberg tumor?

A

When a gastric cancer has metastasized to the ovary.

28
Q

What is acanthosis nigricans associated with?

A

Metabolic syndrome. Visceral malignancies like stomach cancer.

29
Q

What is Signet ring cell?

A

Classic for gastric Adenocarcinoma and Lobular carcinoma in situ of the breast. Mucinous material in cytoplasm pushes the nucleus to the periphery.

30
Q

What is the most common condition requiring surgery in the 1st month of life?

A

Pyloric stenosis.

31
Q

What electrolyte imbalance do we see in prolonged Pyloric stenosis?

A

Hypochloremic. Metabolic alkalosis. Hypokalemia.

32
Q

What does Ondansetron and Granisetron do?

A

They are serotonin 5HT3 receptor antagonists that is used in cancer patients undergoing chemotherapy for nausea and vomiting. Also post-op nausea/vomiting. Pregnancy.

33
Q

What are the 2 most common underlying causes of hospital admission for a bleeding peptic ulcer?

A

H.pylori. NSAIDs.

34
Q

Which antiacid may cause diarrhea?

A

Magnesium hydroxide.

35
Q

Which antiacid may causes constipation?

A

Aluminum hydroxide.

36
Q

Which antiacid may cause hypercalcemia?

A

Calcium carbonate.

37
Q

Which antiacid may causes hypokalemia?

A

Magnisum hydroxide. Aluminum hydroxide. Calcium carbonate.

38
Q

A patient taking NSAIDs for the management of her gout develops anemia, has pain w/ eating, and is positive on occult blood test. What drug would most directly address the mechanism behind this patient’s current problem?

A

Mesoprostol.

39
Q

Where is Virchow’s node located?

A

Left supraclavicular lymph node.

40
Q

RFF: Mucin-filled cell w/ a peripheral nucleus.

A

Signet ring cells.

41
Q

RFF: Most common type of stomach cancer.

A

Adenocarcinoma.

42
Q

RFF: Ovarian metastasis from gastric cancer.

A

Krukenburg tumor.

43
Q

RFF: Gastric ulcerations and high gastrin levels.

A

Zollinger-Ellison syndrome.

44
Q

RFF: Acute gastric ulcer associated w/ elevated ICP or head trauma.

A

Cushing ulcer.

45
Q

RFF: Acute gastric ulcer associated w/ severe burn.

A

Curling ulcer.

DIT Gastro (17 decks)

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