Gastrointestinal System - Stomach Flashcards
Epithelial bening tumor ?
Gastric adenoma
153
Epithelial malignant tumor ?
Gastric adenocarcinoma
small cell carcinoma
carcinoid tumor
mesenchymal/non-E benign ?
leiomyoma
lipoma
neurofibroma
granular cells tumors
GI stromal tumors = GIST
154
Gastric adenocarcinoma type ?
papillary
tubular
mucinous
USA
undifferentiated
signet ring cell
adenosqumous
Mesenchymal malignant tumor ?
leiomyosarcoma
kaposi sarcoma
schwannoma
malignant stromal tumor
ulcer definition?
loss of epithelial layer – if extend into submucosa/muscularis layer
ulcer of stomach ?
peptic U
stress-curling-cushing ulcer
ulcerative gastric carcinoma
types of PUD ?
D + S
PUD defination ?
PUD refers to chronic mucosal ulceration affecting the duodenum / stomach and always associated with H pylori NSAID & cigarettes
158
common sites of peptic ulcer ?
D-1st part
stomach = antrum
margins of a gastro-jejunostomy - marginal ulcer
gastro-esophageal junction
throughout the GIT in zollinger E S
risk factors of peptic ulcer ?
H pylori infection
90% DU
70% GU
Cigarettes
NSAID
COPD
Alcoholic cirrhosis
ZES
endocrine cell hyperplasia
CMV - Herpes
illicit drugs - cocaine
disease caused by H pylori >
PUD
Chronic gastritis
Gastric carcinoma
Gastric lymphoma- MALToma
defense mechanism of Gastro-deuodenal mucosa ?
surface mucosa secretion
bicarbonate secretion into mucus
inc mucosal blood flow
apical surface membrane transport
epithelial regenerative capacity
elaboration of prostaglandin
159
pathogenesis of PUD ?
1.impairment of defense mechanism
2.inc damaging forces
Inc damaging forces example ?
gastric hyperacidity
peptic enzymes
H pylori infection
NSAID
aspirin
cigarettes
alcohol
duodenal gasttrioc reflux
Gross of PUD ?
161
Location of PUD ?
DU - 1st part
GU - lesser curvature in the region of pyloric antrum
Shape of PUD ?
round to oval
sharply punched out lesion
margin of PUD ?
Slightly elevated
depth of PUD ?
superficial U - confined to mucosa
deep U - penetrating in to the muscular layer
base of PUD ?
smooth and clean due to peptic digestion of the exudates
Microscopic of PUD >
NIGS
N =necrotic fibrinoid debris
I =non-specific inflammatory infiltrate
G = granulation tissue
S= scar tissue
gross feature of benign peptic ulcer ?
small
regular
shaprly demarcate d- piuched out
Brunners gland location ?
Duodenum
malignant ulcer gross feature >
large
irregular
thickened
N + H
dekhe kivabe Benign & Malignant ulcer alada korbe >
Gross dekhe
163
Bening ulcer site ?
lesser curvature
malignant ulcer site ?
greater curvature of pylorous and antrum
complications of PUD ?
bleeeding
perforation
obstruction
malignant transformation
which PUD has more chance of maligant transformation ?
Chronic gastric ulcer
164
Clinical features of PUD ?
GU - weight loss + never pain occurs at night
DU - weight gain + night epigastric pain - hunger pain
N-V-bloating-heart burn - water brash
IDA
melaena
acute perforation
how to difference DU vs GU by pT History ?
weight loss - GU
weight gain - DU
common S/S in GU ?
Vomiting common
haematemesis common
no night pain
food pain pattern
90% of gastric carcinoma is ???
Adenocarcinoma
sites of adenocarcinoma >
pylorus antrum, 50-60%
cardia
body fundus
Laurns classification ?
Intestinal type
diffuse type
Gross of Gastric carcinoma ?
exophytic
flat / depressed
excavated
linitis plastica ??
large areas of infiltration
diffuse rugal flattening
and rigid thickened wall may impart a leather bottle appearance
more common micro feature ?
Intestinal type
intestinal type by laurns classification features ?
expanding growth
bulky tumor - columnar + gland forming cells
abundant mucin present
diffuse features >
infiltrative growth
signet ring cells
excessive mucin
168
signet ring cell count >80%
Dx ?
signet ring cell carcinoma
signet ring cell > 50%
Dx ??
diffuse adenocarcinoma
how to identify signet ring cell ?
large cytoplasmic mucin vacuoles &
peripherally displaced crescent shaped thin nuclei
linitis plastica like appearance
ar kothay ?
breast + lung cancer that metastasize stomcah
krukenberg tumor defination ?
A metastatic gastrointestinal neoplasia
to the Ovaries
Sister mary joseph nodule >
gastric tumor that metastasize to the peri-umbilical region to form a SC nodules
169
virchows node ?
involvement of left supraclavicular lymph node mainly by metastatic carcinoma of stomach
risk factors of Gastric carcinoma ?
smoked foods
cigarettes
alcohol
H pylori
gastric adenoma
GU
partial gastrectomy
achlorhydria
Blood group-A
family Hx
E cadherin mutation
Hereditory non-polyposis colon cancers syndrome
H pylori VS autoimmune gastritis ?
156+157
common ulcers of GIT ?
PU
TB ucler
Typhoid ulcer
malignant U
bacillary dysentry U
amorbic D U
158
