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8 PATH 2 > LAB 4 > Flashcards

LAB 4 Flashcards

1
Q

What are the 3 major stimulators of HCl production by parietal cells?

A

1) Neuronal Factor - vagal
2) Endocrine Stimulator - gastrin
3) Local stimulator - Histamine

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2
Q

What does Histamine stimulate?

A

Parietal cells

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3
Q

What is a natural reservoir of histamine?

A

MAST CELLS, and lesser degree = Basophil

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4
Q

Where are mast cells and basophils?

A

Everywhere in the vessels and in the subendothelial layers

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5
Q

Spicy foods leads to :

A

Degranulation of mast cells and increase in histamine release

= HIGH GI INFECTION (hot areas spicy food)

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6
Q

What is produced by parietal cells?

A

Intrinsic factor of Castle

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7
Q

WHat does intrinsic factor of castle account for?

A

Absorption of V B12

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8
Q

Aka of Vit b12

A

Extrinsic factor

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9
Q

WWhere does absorption of Vit b12 occur?

A

In the ileum because ileum contains receptors for intrinsic factor

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10
Q

Without _______ Vit b12 would not be absorbed?

A

Intrinsic factor

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11
Q

Without Vit B12 _______ occurs

A

Megaloblastic anemia

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12
Q

What causes a B12 deficiency?

A

Pernicious anemia

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13
Q

What is the process of Megaloblastic Anemia?

A

Enlarged and rigid membrane of RBC’s preventing the flow through the capillaries

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14
Q

Normal RBCs are _____

A

Smaller and able to fold and change shape

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15
Q

General name of cells with large size =

A

Macrocyte

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16
Q

What is the process of developing large mature cells?

A

Macrocytosis

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17
Q

What is a Megaloblast?

A

Large immature cell

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18
Q

What does the site of Megaloblasts mean?

A

This is an issue with the hematopoeitic system

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19
Q

What type of Hypersensitivity is Megaloblastic anemia?

A

Type 2 hypersensitivity (subtype = antibody mediated cellular dysfunction) reaction leads to lack of receptors.

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20
Q

What is the nervous system Involvment of megaloblastic anemia?

A

Subacute combined degeneration of spinal cord

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21
Q

What happens to the WBCs, thrombocytes, platelets in macrocytosis?

A

THEY ALL BIG

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22
Q

What is a pathognomonic finding of Macrocytosis?

A

More than 2 lobes in neutrophils = Hypersegmented

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23
Q

What else may lead to / cause Megaloblastic anemia?

A

Folic acid deficiency

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24
Q

Will folic acid deficiency lead to a nervous system pathology?

A

NO, unless a FETUS

= Results in demyelination of NS

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25
Q

What are the primary manifestations of folic acid deficiency?

A

Cheilosis

Cheilitis

Glossitis

(Also with B2, 3, 6, 9)

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26
Q

Chief cells aka

A

Zymogen cells

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27
Q

Why do chief cells aka zymogen cells only produce pepsinogen and not pepsin?

A

Safety mechanism to prevent cell digestion

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28
Q

G cells produce =

A

GASTRIN

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29
Q

2 types of stomach cancers that occupy 90% of all stomach tumors:

A

Intestinal Type Adenocarcinoma

Diffuse Carcinoma

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30
Q

What is Intestinal type Adenocarcinoma?

A

Projectile tumor - esophytic - projects above the level of the wall of empty organ into lumen exophytic

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31
Q

What are the predisposing factors to Intestinal type Adenocarcinoma?

A

Food containing nitrites (carcinogen)- > nitrosamines

Smoked foods (Polycyclic hydrocarbon production)

Pickled veggies and excess salt

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32
Q

Intestinal Type Adenocarcinoma has infection with:

A

Helicobacter pylori

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33
Q

What can Intestinal type Adenocarcinoma develop?

A

Chronic gastritis

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34
Q

Most common pathology in human body =

A

Chronic gastritis

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35
Q

What are the 2 outcomes of Intestinal type Adenocarcinoma developing Chronic Gastritis?

A

Mucosal atrophy and Mucosal Metaplasia aka (Intestinal Metaplasia)

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36
Q

Mucosal Metaplasia aka

A

Intestinal Metaplasia

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37
Q

What is Mucosal Metaplasia aka intestinal Metaplasia?

A

Appearance of intestinal type mucosa in stomach wall mucosa

Precancerous, goblet cell Involvment

38
Q

What is there a loss of during Intestinal type Adenocarcinoma (possibly chronic gastritis)?

A

Loss of parietal cells (due to pernicious anemia)

39
Q

Is there altered anatomy of Intestinal type Adenocarcinoma (possibly development of chronic gastritis?)

A

Altered anatomy (distal gastrectomy = antrum and pyloric - antropyloric area (G cells)

40
Q

Distal gastrectomy in Intestinal type Adenocarcinoma leads to ?

A

Hypoacidity / anacidity

41
Q

What is a predisposing factor for gastric carcinoma?

A

Hypoacidity

42
Q

What is key about Intestinal Type Adenocarcinoma?

A

There is a LACK OF LATENT PERIOD *

43
Q

What does it mean in Intestinal Type Adenocarcinoma when there is a “lack of LATENT PERIOD?”

A

Moving of malignant tumors beyond initial location - period when tumor is able to be removed safely without metastasis (~ 1 year - the faster you find it, the more likely you are to survive)

  • Time frame from focal to systemic disease
44
Q

Diffuse Carcinoma:

A

Flat tumor within stomach wall -> Linitis Plastica ***

45
Q

What is “Linitis Plastica” associated with Diffuse carcinoma ?**

A

Malignant tumors within empty organ wall without projection into the lumen

46
Q

WHat are the risk factors for Diffuse Carcinoma?

A

UNDEFINED*

  • Infection with H. Pylori and chronic gastritis are OFTEN ABSENT
47
Q

Diffuse Carcinoma is slightly increased with association to

A

BLOOD GROUP A

48
Q

Latent period of Diffuse Carcinoma:

A

VERY SHORT

  • WHen you see symptoms it’s TOO LATE
49
Q

Stomach Polyp pic*** :

A

Most common benign tumor of the stomach

50
Q

What is special about the stomach polyp ?

A

It is PEDUNCULATED ** tumor

51
Q

Describe the “pedunculated tumor” that is STOMACH POLYP:

A

Just the stroma of the tumor - wide found ratio of the colorectal area (flat polyp common in colorectal area)

52
Q

Describe what makes up the Stomach polyp, what that means:

A

Stroma and Parenchyme

  • The parenchyme locates on TOP of tumor. This is the benign tumor
53
Q

What can a stomach poly lead to?

A

Can move and lead to obstruction of pyloric canal due to mobility of the tumor itself

54
Q

Do Stomach Polyps become malignant? ***

A

RARELY (4-30%), but

COLORECTAL Polyps undergo malignancy in 40% of cases **

55
Q

Any tissue cannot be anywhere, have to be attached to something -

A

Housing of the function of the cell = stroma - can be made from the same material no matter what tissue is inside

The specific cells that determine function of cells - Parenchyma

56
Q

Benign tumor of stomach =

A

Leiomyoma = RARE

57
Q

WHat is the tissue of origin for Leiomyoma?

A

Smooth Muscle cells (Leio = smooth muscle)

58
Q

Most common Leiomyoma:

A

Uterine aka fibroids, 30-50% of women in world

59
Q

What is sarcoma derived Leiomyoma?

A

Mesoderm - smooth muscle - mesoderm = LEIOMYOSARCOMA = malignant

60
Q

Benign tumor from skeletal muscle =

A

Rhabdomyoma

61
Q

Carcinoma =

A

Endo/ectoderm derived malignant

62
Q

Malignant tumor form from skeletal muscle =

A

Rhabomyosarcoma

63
Q

What is the most common leiomyoma?

A

Fibroid (leiomyoma of uterus - 30-50% of women, doesn’t metastasize)

64
Q

WHat are characteristics of carcinomas of intestinal type?

A

Found in X ray, located close to canal leads to block of the pyloric or cardiac sphincters

65
Q

What is Carcinoma of intestinal type manifested by?

A

Vomiting and hunger, etc.

66
Q

If Carcinoma of intestinal type is by cardiac sphincter what must be done?

A

Have to remove part of the esophagus as well

  • All are exophytic
67
Q

Diffuse Stomach Carcinoma =

A

Smooth -> Linitis Plastica *****

68
Q

Typical Scirrhosis cancers =

A

Tumor which is “MOSTLY” made of STROMA* = > 50%

69
Q

What is the most common Scirrhous cancer?

A

BREAST

70
Q

Difference between stroma and Parenchyme =

A

Stroma = housing of soft tissue made of CT;

Parenchyme = the “Contents” -> the functional tissue of an organ as distinguished from the connective and supporting tissue

71
Q

T/F, tumors can be made by stroma or parenchyme in differing ratios?

A

TRUE

72
Q

Diffuse stomach carcinoma with ENTIRE stomach involved =

A

LEATHER BOTTLE STOMACH ***

73
Q

What is Leather Bottle Stomach ?***

A

Increased rigidity of the stomach

  • Cannot be distended, tight and rigid
74
Q

What is typical example of scirrhous cancer?

A

Breast cancer (breast Adenocarcinoma)

75
Q

What is typical of Scirrhous cancer (breast cancer) = Breast Adenocarcinoma?

A

SHRINKING of the skin around nipple and nipple inverts (invagination/retraction of nipple)

  • Tissue is made of CT that then shrinks pulling skin inward - LATE STAGE
76
Q

Which type of malignant tumors are opposite of Scirrhous tumor ?

A

Made of well developed parenchyma and very little stroma = Sarcoma

77
Q

In breast sarcoma, what happens?

A

Breast enlarges from inside

Parenchyme affected

78
Q

How does Stomach Carcinoma metastasize?

A

Lymphatics

79
Q

Sarcomas typically spread through ? **

A

BLOOD

80
Q

Carcinomas usually spread through ? **

A

Lymph

81
Q

What is Lymphadenopathy? **

A

Metastasis to lymph node first - remove these first then radiation to remove rest of tumor

82
Q

If lymph nodes are painful =

A

Lymphadenitis

83
Q

Where will you find Mets of the stomach?

A

Liver! *

  • From entire GI tract to the liver first to check for detoxification through portal system (GI tract carries blood to the portal vein which carries blood into liver)
84
Q

Where will you find Mets if it goes through the veins?

A

LUNGS based on circulation of blood due to the blood being slowed/stopped in capillaries

85
Q

Where will you find Mets if it goes through arteries?

A

Good blood supply =

Brain kidney spleen

86
Q

Secondary ovarian carcinoma aka

A

BROKEN BACK TUMOR

87
Q

Secondary ovarian Carcinoma aka Broken Back tumor Mets through :

A

The abdominal cavity to the ovaries (stomach cancer spread through abdominal cavity)

88
Q

Which anemia does not have hypersegmented neutrophils?

A

Iron deficiency (pernicious, megaloblastic, folic acid def. all do)

89
Q

Chronic cystitis :

A

Hematopoietic

90
Q

Lt -> RT shunt increase BP ______

A

In upper extremities , decreases in lower extremities = COARCTATION OF AORTA**

91
Q

Floated can help a B12 def but B12 cannot help ______

A

A folate deficiency ***

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