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Pathoma COPY :}}}} > GI: Stomach > Flashcards

GI: Stomach Flashcards

1
Q

What is gastroschisis

A

congenital malformation of anterior abdominal wall leading to exposure of abdominal contents

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2
Q

what is omphalocele

A
  • persistent herniation of bowel into umbilical cord
  • failure of herniated intestines to return to body cavity during development
  • contents covered by peritoneum and amnion of the umbilical cord
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3
Q

What is pyloric stenosis

A

congenital hypertrophy of pyloric smooth muscle

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4
Q

pyloric stenosis commonly occurs in who

A

male

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5
Q

when does pyloric stenosis present

A

2 weeks after birth

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6
Q

name 3 clinical symptoms for pyloric stenosis

A
  1. projectile nonbilious vomiting
  2. visible peristalsis
  3. Olive-like mass in abdomen
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7
Q

how is pyloric stenosis treated

A

myotomy

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8
Q

What is acute gastritis

A

acidic damage to stomach mucosa

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9
Q

what causes acute gastritis

A

imbalance b/w mucosal defenses and acidic environment

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10
Q

what are defenses of the stomach

A
  • mucin layer produced by foveolar cells
  • bicarbonate secretion by surface epithelium
  • normal blood supply ( provides nutrients and picks up leaked acid)
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11
Q

what are 6 risk factors for acute gastritis

A
  1. severe burn ( Curling ulcer) - hypovolemia leads to decreased blood supply
  2. NSAIDS( decrease PGE2)
  3. Heavy alcohol consumption
  4. chemotherapy
  5. increased intracranial pressure ( Cushing ulcer) - increased stimulation of vagus nerve leads to increased acid production
  6. shock - multiple (stress) ulcers may be seen in ICU patients
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12
Q

acid damage in acute gastritis result in

A

superficial inflammation
erosion ( loss of superficial epithelium)
ulcer ( loss of mucosal layer)

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13
Q

What is chronic gastritis

A

chronic inflammation of stomach mucosa

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14
Q

what are 2 types of chronic gastritis

A
  1. chronic autoimmune gastritis

2. chronic H. pylori gastritis

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15
Q

what is chronic autoimmune gastritis

A
  • antibodies against parietal cells and/or intrinsic factor (diagnostic)
  • pathogenesis is mediated by T cells ( Type IV hypersensitivity)
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16
Q

what are clinical features for chronic autoimmune gastritis

A
  • atrophy of mucosa with intestinal metaplasia
  • achlorhydria with increased gastrin levels and antral G-cell hyperplasia
  • megaloblastic (pernicious) anemia due to lack of intrinsic factor
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17
Q

chronic autoimmune gastritis is an increased risk for what

A

gastric adenocarcinoma ( intestinal type)

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18
Q

Where are gastric parietal cells located in the stomach

A

body and fundus

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19
Q

what is the most common form of gastritis

A

chronic H. pylori gastritis

20
Q

what is chronic H. pylori gastritis

A

due to H. pylori-induced acute and chronic inflammation

- h. pylori ureases and proteases along with inflammation weaken mucosal defenses

21
Q

what is the most common site for chronic H. pylori gastritis

A

antrum

22
Q

how do patients present with chronic H. pylori gastritis

A

epigastric abdominal pain

23
Q

chronic H. pylori gastritis increases the risk for what

A
  1. ulceration ( peptic ulcer disease)
  2. gastric adenocarcinoma ( intestinal type)
  3. MALT lymphoma
24
Q

how is chronic H. pylori gastritis treated

A

triple therapy: resolves gastritis/ulcer and reverses intestinal metaplasia

25
Q

what tests confirm eradication of H. pylori

A

negative urea breath test

lack of stool antigen

26
Q

what is peptic ulcer disease

A

solitary mucosal ulcer involving proximal duodenum (90%) or distal stomach ( 10%)

27
Q

what can cause peptic ulcer disease in duodenal

A

H. pylori

rare due to ZE syndrome

28
Q

how would a patient clinically present with peptic ulcer disease in duodenum present

A

epigastric pain that improves with meals

29
Q

what is diagnostic of peptic ulcer disease in duodenum

A

endoscopic biopsy shows ulcer with hypertrophy of Brunner glands

30
Q

peptic ulcer disease in duodenum is usually located where and what are complications

A
  • usually in anterior duodenum

- when present in posterior duodenum: rupture may lead to bleeding from the gastroduodenal artery or acute pancreatitis

31
Q

what is the most common cause of gastric ulcers

A

H. pylori

other: NSAIDs and bile reflux

32
Q

how does a patient present with gastric ulcers

A

epigastric pain that worsen with meals

33
Q

where is gastric ulcer usually located

A

lesser curvature of antrum

34
Q

when gastric ulcer rupture what are risks

A

bleeding from left gastric artery

35
Q

Are duodenal ulcers malignent

A

almost never

36
Q

physically describe benign gastric peptic ulcers

A

small ( less than 3 cm)
sharply demarcated (“punched-out”)
surrounded by radiating folds of mucosa

37
Q

physically describe malignant gastric peptic ulcers

A

large and irregular with heaped up margins

38
Q

what is done for definitive diagnosis for gastric ulcers

A

biopsy

39
Q

what is gastric carcinoma

A

malignant proliferation of surface epithelial cells ( adenocarcinoma)

40
Q

what are 2 categories of gastric carcinoma

A
  1. intestinal

2. diffuse types

41
Q

What is the most common type of gastric carcinoma? what does it physically look like? location?

A

intestinal

  • large, irregular ulcer with heaped up margins
  • lesser curvature of the antrum ( similar to gastric ulcer)
42
Q

What are risk factors for gastric carcinoma ( intestinal)

A
  1. intestinal metaplasia (due to H. pylori and autoimmune gastritis)
  2. nitrosamines ( in smoked foods - Japan)
  3. blood type A
43
Q

characterize the diffuse type gastric carcinoma

A
  • signet ring cells that diffusely infiltrate the gastric wall
  • desmoplasia results in thickening of stomach wall ( linitis plastica)
44
Q

What type of gastric carcinoma is not associated with H. pylori, intestinal metaplasia, and nitrosamines

A

diffuse type gastric carcinoma

45
Q

what are late clinical symptoms of gastric carcinoma

A
  • weight loss
  • abdominal pain
  • anemia
  • early satiety
    rarely presents as: acanthosis nigricans or Leser-Trelat sign
46
Q

what lymph nodes can be involved in gastric carcinoma

A

left supraclavicular node ( Virchow node)

47
Q

distant metastasis for gastric carcinoma go where

A
  1. liver
  2. periumbilical region ( Sister Mary Joseph Nodule) - intestinal type
  3. Bilateral ovaries ( Krukenberg tumor) - diffuse type

Pathoma COPY :}}}} (38 decks)

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