Gastroenterology - Gastric Diseases Flashcards
Which part of the stomach expands for food?
fundus and body
What are the components of the mucosa layer of the stomach?
- superficial epithelium
- lamina propria
- gastric glands
- neuroendocrine cells
- muscularis mucosa
Which cells make up the gastric glands of the stomach?
mucous neck cells
parietal cells
chief cells
What is the lamina propria of the stomach made up of?
loose connective tissue
immune system cells
nutritional support
What is produced by the gastric neuroendocrine cells?
- enterocromafin (serotonin, histamine)
- somatostatin
- gastrin
What is the submucosa of the stomach made up of?
- dense connective tissue: structural support
- blood vessels
- lymphatics
- Meissner’s plexus
What is the muscularis of the stomach made up of?
- layers of perpendicular smooth muscle
- Auerbach’s (myenteric) plexis
Which enzyme is responsible for protein digestion?
Fat digestion?
protein - pepsin
fat - gastric lipase
What influences/controls motility of the GIT?
- migrating motility complex
- neural and hormonal stimulus
- pressure/distension (mechanoreceptors)
- nutritional content of food
What is acute gastritis?
inflammation of the stomach lining
What is the pathology associated with GDV?
- compression of CVC > impaired venous return > hypovolemic shock
- gastric wall necrosis
- splenic torsion or avulsion
- congestion of viscera
- endotoxic shock
- DIC
What are the clinical signs associated with GDV?
- acute, non-productive retching
- pytalism
- abdominal distension
- collapse
What is found on physical exam of a dog with GDV?
- abdominal distension
- tachycardia, poor pulses
- hypothermia
- depression
How is GDV diagnosed?
radiographs
- right lateral view most important
- “popeye arm”
How is GDV treated?
- aggressive fluid therapy
- decompression
- surgery ASAP
What is the treatment for food bloat?
- fluid support
- withhold food
- walk frequently
- pain management
- +/- lavage or surgery
What are the possible causes of mucosal barrier injury?
- disruption of normal gastroprotection
- decreased blood flow
- hypersecretion of acid
- decreased mucous or bicarbonate
What conditions can cause secondary gastric ulcers/erosion?
- neoplasia
- hypovolemic shock/hypotension
- trauma
- medication (NSAIDs)
- uremic gastritis
What are the clinical signs associated with gastric ulceration/erosion?
vomiting, hematemesis, melena, retching, inappetence
How is gastric ulceration/erosion diagnosed?
- radiographs with contrast
- ultrasound
- endoscopy for confirmation
- MDB and fecal
How is gastric ulceration/erosion treated?
- treat primary disease
- mucosal protectants
- proton pump inhibitors
- pain management
- blood transfusion
- nutrition
What type of bacteria is Helicobacter pylori?
spiral
gram negative
How is Helicobacter gastritis treated?
Clorithromycin
Amoxicillin
Metronidazole
Which parasites can cause gastric disease?
- Toxocara
- Physalloptera
- Ollulanus tricuspi
Describe gastric pythiosis
- chronic vomiting
- thickened gastric outflow tract
- pyogranulomatous inflammation
- cause by fungus: P. insidiosum
What are the clinical signs associated with gastric esophageal reflux?
- chronic vomiting
- lip licking, hard swallow, pytalism, halitosis, esophagitis
What is the usual cause of gastric esophageal reflux?
secondary to gastric or small intestinal disease
How is gastric esophageal reflux treated?
- proton pump inhibitor
- treat primary disease
- sucralfate
What is the main clinical signs of inflammatory gastritis?
chronic vomiting
How is inflammatory gastritis diagnosed?
endoscopy or surgical biopsy
- infiltrate of inflammatory cells in mucosa and lamina propria
How is lymphoplasmacytic and eosinophilic gastritis treated?
- symptomatic therapy (antacid and antiemetics)
- empiric deworming (Fenbendazole or Pyrantel pamoate)
- diet trial
- immune modulation
What pathology is found with atrophic gastritis?
- marked mononuclear cell infiltrate
- thinning of gastric mucosa
- atrophy of gastric glands
- replacement by fibrous tissue
- impaired ingestion
What pathology is found with hypertrophic gastropathy?
- diffuse or focal hypertrophy of mucosa and/or muscularis
- inflammatory infiltrates
What is pyloric stenosis?
- muscular thickening of pyloric sphincter
- delayed gastric emptying
What pathology and clinical signs are found with gastrinoma?
- thickened gastric wall
- hypertrophy of pylorus
- gastric ulceration
- reflux esophagitis
- chronic vomiting
- +/- diarrhea
What is gastrinoma?
- tumor in pancreas of the APUD cells
- hypersecretion of gastric acid
How is gastrinoma diagnosed?
- gastrin levels
- low pH of gastric juice with a high gastrin level
- ultrasound, CT, scintigraphy
- biopsy
How is gastrinoma treated?
- surgical removal
- proton pump inhibitor
- Octreotide to inhibit gastrin
