Histology

Question 1

What faulty sphincter is responsible for the symptoms of GERD?

Answer 1

Lower Esophageal Sphincter pressure is absent or with transient LES relaxation.

Question 2

Which layer of tissue is damaged by GERD? What is the consequence of this damage?

Answer 2

Esophageal superficial squamous epithelium. Stimulates the basal cell layer to proliferate –> hyperplasia.

Question 3

What does GERD backflow consist of?

Answer 3

Gastric acid, pepsin and bile

Question 4

What is Barrett’s esophagus? What are these patients at risk for developing?

Answer 4

Chronic gastric acid reflux (chronic GERD) causes change from stratified squamous to columnar. Patients are prone to develop adenocarcinomas (cancer that starts within the mucus glands of an organ).

Question 5

Gastrin adenomas of the pancreas is a symptom of _______. This leads to uncontrolled _______ output and subsequent severe ulcerations.

Answer 5

Zollinger-Ellison syndrome. HCl output.

Question 6

What is the relationship between helicobacter pylori and gastric acid? This bacteria is the major contributor to the pathogenisis of __________.

Answer 6

Unlike most other enteric organisms, H. pylori colonizes gastric mucous. Causes peptic and duodenal ulcer disease (PUD). Also causes chronic superficial gastritis.

Question 7

Peptic Ulcer Disease is aggravated by NSAIDS because …? Hint: Cox-1, Cox-2 and prostaglandins

Answer 7

COX-1 inhibition by NSAIDS results in decreased prostaglandin synthesis which results in impaired gastric mucosal defense and repair mechanisms.

Question 8

Prostglandins stimulate ____ and ______ from surface epithelial cells, which helps protect the lining of the stomach.

Answer 8

Mucus and bicarbonate

Question 9

Prostaglandins also help epithelial cells with ______ and _____ ; this process is mediated by growth factors such as _______.

Answer 9

Proliferation and regeneration. Growth factors include: TGF-B, EGF, HGF and trefoil factors (in stomach TTF1 and TFF2).

Question 10

A rare autosomal recessive disease with severe intractable diarrhea and malabsorption in neonates.

Hint: Brush border atrophy with accumulation of lysosomal granules and microvillus inclusions without crypt hypertrophy or immune cell filtrate.

Answer 10

Microvillus Inclusion Disease

This disease is always fatal unless treated with parenteral nutrition and intestinal transplants.