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BHP Exam 3 > GI 1 > Flashcards

GI 1 Flashcards

1
Q

Intrinsic factor is critical for the absorption of what?

A

vitamin B12

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2
Q

Lack of intrinsic factor leads to what disease?

A

pernicious anemia

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3
Q

Intrinsic factor is produced by what cells of the stomach?

A

parietal cells

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4
Q

What does the gastric mucosa protect from?

A

from auto-digestion from stomach acid

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5
Q

Five properties of the gastric mucosa that protects against stomach acid?

A 
Secretion (3)
1. mucous
2. bicarbonate
3. prostaglandins
Physical (2)
4. epithelial barrier
5. mucosal blood flow to remove acid
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6
Q

What is produced that leads to immune gastritis?

A

Antibodies against parietal cells

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7
Q

Autoimmune gastritis particularly affects what area of stomach?

A

body

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8
Q

Autoimmune gastritis most common in what age group, atrophy occurs over what timeframe?

A

Elderly, 2-3 decades of atrophy

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9
Q

Autoimmune gastritis leads to what other diseases? (2)

A

Pernicious anemia

Megaloblastic, macrocytic anemia

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10
Q

Intestinal metaplasia can result from what condition of the stomach?

A

Chronic gastritis

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11
Q

Intestinal metaplasma is characterized by what epithelial changes? Where are these cells usually found?

A

Gastric epithelium replaced by goblet cells and mucous cells.

Goblet cells - small intestine
Mucous cells - pyloric antrum

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12
Q

What is the cause of peptic ulcers?

A

imbalance between gastroduodenal mucosal defense mechanisms and damaging gastric acid & pepsin

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13
Q

Three places peptic ulcers are found

A
  1. esophagus
  2. stomach
  3. proximal duodenum
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14
Q

What is the size and shape of a peptic ulcer?

A

1 to 7 cm
sharply defined
nonelevated margins
smooth base

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15
Q

What is the histological makeup of the peptic ulcer?

A

FIbrous scar with granulation tissue, inflammation, and necrotic slough that extends into the muscularis propria

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16
Q

What are most gastric malignancies?

A

adenocarcinoma

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17
Q

Gastric adenocarcinoma associated with infection with what?

A

H. pylori

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18
Q

Gastric adenocarcinoma associated with what surgery?

A

Higher risk with partial gastrectomy

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19
Q

Gastric adenocarcinoma have what risk associated with peptic ulcers?

A

NO direct risk

20
Q

Gastric carcinoma predilection for what age/gender?

A

2 to 1 male

mean age 55

21
Q

Gastric carcinoma more common in what geographical locations (4) ? Why? (2)

A

Japan, South America, Chile, Eastern Europe

Environment and dietary factors

22
Q

Are gastric carcinomas increasing or decreasing in the US?

A

decreasing

23
Q

What is the most common site of gastric carcinoma?

Rare in what area?

A

Distal stomach along lesser curvature of the antrum or prepyloric region
Rare in fundus.

24
Q

What area in the stomach has increasing incidence of gastric carcinoma, due to what?

A

Cardia, secondary to GERD

25
Q

What is the diffuse infiltrative type of gastric carcinoma?

A

Sheets of discohesive cells with vacuoles of mucin displacing nuclei to one side (signet-ring cell)

Creates “linitis plastica” or leather bottle stomach (shrinkage)

26
Q

What is the Virchow node? Role in gastric carcinoma spread?

A

The supraclavicular node, lymphatic spread of gastric carcinoma

27
Q

What is a form of hematogenous spread of gastric carcinoma bilaterally to ovaries?

A

Krukerberg tumor

28
Q

Prognosis of gastric carcinoma?

A

poor, 28% five-year survival rate

29
Q

Two main growth patterns of gastric carcinoma?

A

intestinal and diffuse infiltrative

30
Q

Most common bacterial enteric pathogen & one that causes infective enterocolitis?

A

Campylobacter jejuni

31
Q

Pseudomembranous colitis caused by what pathogen

A

Clostridium difficile

32
Q

Tissue effects of pseudomembranous colitis?

A

Enterotoxin causes superficial, gray mucosal exudate, fibrinous necrosis and loosely adherent mucosal debris (pseudomembrane)

33
Q

Pseudomembranous colitis symptoms?

A

Fever, toxicity, abdominal pain and diarrhea

34
Q

Pseudomembranous colitis main predisposing factors?

A

broad-spectrum antibiotics therapy
GI surgery
GI ischemia
GI burn

35
Q

Malabsorption syndrome diagnosis criteria (4)

A

One or more is missing:

  1. Intraluminal digestion
  2. Terminal digestion
  3. Transepithelial transport
  4. Lymphatic transport
36
Q

Most common cause of malabsorption syndrome in western hemisphere?

A

celiac disease

37
Q

Celiac disease is what?

A

Atrophy of small intestine villi

38
Q

Celiac disease etiology - genetic?

A

Familial linkage with HLA-DQ2, HLA-DQ8

39
Q

Celial disease etiology - immune?

A

Immune response to gliadin, a glycoprotein component of gluten; serum antibodies also observed

40
Q

Celial disease - 3 diagnosing signs

A

Biopsy of small intestine mucosa
Loss of villous architecture and crypts
Flattened, mosaic pattern

41
Q

Crohn’s disease is most common in what site? Can occur where?

A

terminal ileum, may involve any part of GI tract

42
Q

What lesion pattern is seen in Crohn’s diseaes?

A

discontinuous pattern/skip lesions

43
Q

What are the signs of established Crohn’s disease? (4)

A

Cobblestone pattern and fissured ulcers
Stricture formation
Regional nodes enlarged
“Skip” lesions with areas of normal bowel

44
Q

Histopathology of Crohn’s disease?

A

Transmural inflammation with submucosal edema
Ulcers that extend deep into the bowel and form fissures
Fibrous scarring
Noncaseating granulomas

45
Q

Complications of Crohn’s disease (8)

A 
(SPADE BB)
Stricture formation
Perforation of bowel
Adhesions to other loops of bowel, bladder, abdominal wall
Deep ulcers --> fistulae and sinuses
Eye, skin, joint, liver complications
Bowel cancer
Bleeding from ulcers

BHP Exam 3 (7 decks)

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