L11: Gastritis

Question 1

mechanisms protecting gastric mucosa :

Answer 1

-mucin secreted by foveolar cells
-bicarbonate ion secretion by surface epithelial cells
-rich vascular supply to gastric mucosa
-elaboration of prostaglandin
-epithelial regenerative capacity

Question 2

etiology of acute gastritis :

Answer 2

-stress/trauma
-uremia
-treatment with cancer chemotherapeutic drugs

Question 3

examples of acute gastric ulcers:

Answer 3

-stress ulcers
-curling ulcers: severe burn/trauma
-Cushing ulcer: -intracranial disease

Question 4

etiology of chronic gastritis

Answer 4

-chronic infection by H.pylori
-autoimmune (in association with pernicious anemia)
-toxic (alcohol and cigarette smoking)
-post surgical , especially following antrectomy with reflux of bilious duodenal secretions

Question 5

less common etiologies for chronic gastritis ;
-radiation
-granulomatous conditions (crohn disease)
-miscellaneous -amyloidosis , graft vs host disease
-uremia

Question 6

what is the most common cause for chronic gastritis ?

Answer 6

H. pylori infection — may progress to pan-gastritis resulting in multifocal atrophic gastritis–which has chances of malignant transformation

Question 7

H.pylori can be typically found :

Answer 7

in the antrum

Question 8

autoimmune gastritis happens due to

Answer 8

antibodies forming against parietal cells and intrinsic factor that can be detected in serum and gastric secretions

Question 9

characteristics of autoimmune gastritis :

Answer 9

-reduced serum pepsinogen I concentration

-antral endocrine cell hyperplasia

-vitamin b12 deficiency

-defective gastric acid secretion (achlorhydria)

Question 10

autoimmune gastritis is often seen with other autoimmune conditions such as:

Answer 10

-type 1 diabetes
-Addison’s disease
-Hashimoto’s thyroiditis

Question 11

Autoimmune gastritis has a high risk of :

Answer 11

gastric carcinoma and endocrine tumors :carcinoid tumors)

Question 12

peptic ulcer disease is a complication of :

Answer 12

chronic gastritis

Question 13

most common site for peptic ulcers:

Answer 13

in the gastric antrum and first portion of duodenum

• can also occur in esophagus and gastric mucosa within Meckel diverticulum

Question 14

common co factors in peptic ulcer formation other than gastric acid and H.pylori :

Answer 14

-chronic NSAID use
-cigarette smoking
-high-dose corticosteroids

Question 15

duodenal ulcers are most frequent in:

Answer 15

-alcoholic cirrhosis
-COPD
-chronic renal failure

Question 16

H.pylori causes 100% of duodenal ulcers and 80% of gastric ulcers

Answer 16

treatment :
H2 blockers
Antacids
proton pump inhibitors