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P&T Block 3 Pulm & GI > L80 > Flashcards

L80 Flashcards

1
Q

How do you distinguish between antrum // fundus + body on histo?

A

Antrum:

- More glands w/ pale mucin

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2
Q

What is gastropathy vs gastritis?

A

Gastropathy: changes to mucosa w/ little or mild inflammation
Gastritis = INFLAM

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3
Q

Histo features of gastritis caused by chemicals (bile, etc)

A

Fovea on top are longer - look more like vili

+ Lymphocytes in lamina propria

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4
Q

What is iron pill gastritis? What does it look like on histo?

A

Inflam b/c you’re taking iron pills
Likely chronic gastritis
SEE IRON ON HISTO

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5
Q

Where in the stomach does H pylori infect? How does gastritis caused by this look on histo?

A

Antrum - but can be anywhere

See BUGS on histo

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6
Q

Explain metaplasia in relation to H pylori infection

A

In short term, its a way to fight the infection = good
BUT won’t ever be enough to eradicate infection
Long term metaplasia = increases risk of cancer

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7
Q

Why does H pylori increase risk for lymphoma?

A

Lymphoma = gut lymph centers where immune system is trying to fight this bacterial infection

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8
Q

Lymphoma on histo

A

Lymphoepithelial lesion

Aka lymphocytes are destroying glands in stomach

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9
Q

Another name for pernicious anemia

A

AI gastritis
Abs vs IF + parietal cells
T cells go to these Abs to do damage
= chronic inflammation

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10
Q

What parts of stomach does AI gastritis effect?

A

Body and fundus - aka where normal acid and IF is made

Gets replaced with antral-like mucosa

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11
Q

What diseases can result from untreated AI gastritis // pernicious anemia?

A

Macrocytic anemia
Peptic ulcer disease
Cancer

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12
Q

Explain the connection between AI gastritis and euro-nendocrine tumors

A 
No acid
More gastrin to try to increase acid
Gastrin works on ECL cells = overgrowth
Linear hyperplasia
Nodular hyperplasia = tiny tumors
Neuro endocrine tumors
- Mostly benign -> can be monitored for growth
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13
Q

Stain for neuroendocrine tumors

A

W/ synapthophysin and chromogranin!!! Duh!!!

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14
Q

H pylori or AI gastritis: which has decreased acid

A

AI

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15
Q

H pylori or AI gastritis: which has decreased gastrin

A

HP

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16
Q

H pylori or AI gastritis: which can form adenocarcinoma?

A

Both

17
Q

H pylori or AI gastritis: which can form lymphoma?

A

HP

18
Q

H pylori or AI gastritis: which can form neuro-endocrine tumors?

A

AI

19
Q

H pylori or AI gastritis: which is associated with other auto-immune disorders?

A

AI… duh

20
Q

Crohn’s is a SI disease - can it present with upper GI symptoms?

A

YEP - pain, N & V

21
Q

Triad for ZE syndrome

A

Hypergastrin
High acid in stomach
Duodenal ulcers - vili burned off due to acid

22
Q

Which area of the stomach undergoes hyperplasia in ZE?

A

Fundus

**Look for this on histo

23
Q

What is an antral heterotopia polyp?

A

Polyp @ body or fundus of stomach
Made of antral-like mucosa
Clinical NO CONSEQUENCE

24
Q

What is a pancreatic hetertopia polyp?

A

Normal pancreatic tissue in stomach
Submucosal
NO CONSEQUENCE

25
Q

What is a hyperplastic polyp?

  • Tissue type
  • Associated diseases
  • Cancerous?
A

= Overgrowth of fovea epi
See dilated glands underneath
Associated with gastritis
If >2cm, worry about cancer

26
Q

What is a fundic gland polyp?

  • Cancerous?
  • 2 causes
A

Benign stomach polyp
Due to:
- Long term PPI
- Familal adenomaous polyposus

27
Q

What is polyposis?

- Cancerous?

A

Many gastric polyps
HUGH cancer risk: APC mutations
- Do a colonoscopy

28
Q

What is gastric dysplasia?

  • Is it a polyp?
  • Cancerous?
A

FLAT lesion
Reaction to something going on the in the stomach
Can regress
OR can progress to cancer

29
Q

What do you call a low grade glandular polyp?

A

Adenoma

> 2cm = worry about cancer

30
Q

2 types gastric adenocarcinoma

A

Intestinal (less bad)

Diffuse (bad bad)

31
Q

2 features of intestinal type gastric adenocarcinoma?

A

Glands cohesive

Still a discrete cancer mass

32
Q

Describe diffuse type gastric adenocarcinoma

A

“Thickening” of entire stomach
Signet righ
NOT cohesive - probably infiltrating
DEAD WITHIN 6 MOs :(

33
Q

How stage gastric cancer?

A 
Direct spread
- Through muscularis proproa?
- Through serosa?
LN Mets
Distant mets
34
Q

What predictive marker can be used for stomach cancer treatment

A

Her2/neu

Trastuzimab

35
Q

What are the 3 types of neuroendocrine tumors in the stomach? Why are they called tumors instead of carcinoma?

A 
Classified by the condition associated with the tumor
Type 1 = AI gastritis
2 = ZE
3 = sporadic
Tumors b/c hard to predict behavior
36
Q

36 yo pt has 30lb unintentional weight loss. Endoscopy show no discrete mass, but generalized abnormality of the stomach. Biopsy show single infiltrative cells. What is the cancer? What are the risk factors?

A

Diffuse type adenocarcinoma

No know risk factors

37
Q

What is gastric antral vascular ectasia?

  • Where in stomach
  • Patho
  • Other disease association
A

Watermelon stomach
@ antrum
Dilated capillaries w/ FIBRIN thrombi
AI association

38
Q

What is caliber persistant artery?

  • Symptoms
  • Treat
A

Large artery going all way to stomach surface
Look for pts w/ recurrent bleeding and no other symptoms
Stop bleeding endoscopically

P&T Block 3 Pulm & GI (31 decks)

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