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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
What are the primary manifestations of folic acid deficiency?
Cheilosis Cheilitis Glossitis (Also with B2, 3, 6, 9)
26
Chief cells aka
Zymogen cells
27
Why do chief cells aka zymogen cells only produce pepsinogen and not pepsin?
Safety mechanism to prevent cell digestion
28
G cells produce =
GASTRIN
29
2 types of stomach cancers that occupy 90% of all stomach tumors:
Intestinal Type Adenocarcinoma Diffuse Carcinoma
30
What is Intestinal type Adenocarcinoma?
Projectile tumor - esophytic - projects above the level of the wall of empty organ into lumen exophytic
31
What are the predisposing factors to Intestinal type Adenocarcinoma?
Food containing nitrites (carcinogen)- > nitrosamines Smoked foods (Polycyclic hydrocarbon production) Pickled veggies and excess salt
32
Intestinal Type Adenocarcinoma has infection with:
Helicobacter pylori
33
What can Intestinal type Adenocarcinoma develop?
Chronic gastritis
34
Most common pathology in human body =
Chronic gastritis
35
What are the 2 outcomes of Intestinal type Adenocarcinoma developing Chronic Gastritis?
Mucosal atrophy and Mucosal Metaplasia aka (Intestinal Metaplasia)
36
Mucosal Metaplasia aka
Intestinal Metaplasia
37
What is Mucosal Metaplasia aka intestinal Metaplasia?
Appearance of intestinal type mucosa in stomach wall mucosa | Precancerous, goblet cell Involvment
38
What is there a loss of during Intestinal type Adenocarcinoma (possibly chronic gastritis)?
Loss of parietal cells (due to pernicious anemia)
39
Is there altered anatomy of Intestinal type Adenocarcinoma (possibly development of chronic gastritis?)
Altered anatomy (distal gastrectomy = antrum and pyloric - antropyloric area (G cells)
40
Distal gastrectomy in Intestinal type Adenocarcinoma leads to ?
Hypoacidity / anacidity
41
What is a predisposing factor for gastric carcinoma?
Hypoacidity
42
What is key about Intestinal Type Adenocarcinoma?
There is a LACK OF LATENT PERIOD *
43
What does it mean in Intestinal Type Adenocarcinoma when there is a “lack of LATENT PERIOD?”
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
Diffuse Carcinoma:
Flat tumor within stomach wall -> Linitis Plastica ***
45
What is “Linitis Plastica” associated with Diffuse carcinoma ?****
Malignant tumors within empty organ wall without projection into the lumen
46
WHat are the risk factors for Diffuse Carcinoma?
UNDEFINED* - Infection with H. Pylori and chronic gastritis are OFTEN ABSENT
47
Diffuse Carcinoma is slightly increased with association to
BLOOD GROUP A
48
Latent period of Diffuse Carcinoma:
VERY SHORT - WHen you see symptoms it’s TOO LATE
49
Stomach Polyp pic*** :
Most common benign tumor of the stomach
50
What is special about the stomach polyp ?
It is PEDUNCULATED ** tumor
51
Describe the “pedunculated tumor” that is STOMACH POLYP:
Just the stroma of the tumor - wide found ratio of the colorectal area (flat polyp common in colorectal area)
52
Describe what makes up the Stomach polyp, what that means:
Stroma and Parenchyme - The parenchyme locates on TOP of tumor. This is the benign tumor
53
What can a stomach poly lead to?
Can move and lead to obstruction of pyloric canal due to mobility of the tumor itself
54
Do Stomach Polyps become malignant? ***
RARELY (4-30%), but COLORECTAL Polyps undergo malignancy in 40% of cases ****
55
Any tissue cannot be anywhere, have to be attached to something -
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
Benign tumor of stomach =
Leiomyoma = RARE
57
WHat is the tissue of origin for Leiomyoma?
Smooth Muscle cells (Leio = smooth muscle)
58
Most common Leiomyoma:
Uterine aka fibroids, 30-50% of women in world
59
What is sarcoma derived Leiomyoma?
Mesoderm - smooth muscle - mesoderm = LEIOMYOSARCOMA = malignant
60
Benign tumor from skeletal muscle =
Rhabdomyoma
61
Carcinoma =
Endo/ectoderm derived malignant
62
Malignant tumor form from skeletal muscle =
Rhabomyosarcoma
63
What is the most common leiomyoma?
Fibroid (leiomyoma of uterus - 30-50% of women, doesn’t metastasize)
64
WHat are characteristics of carcinomas of intestinal type?
Found in X ray, located close to canal leads to block of the pyloric or cardiac sphincters
65
What is Carcinoma of intestinal type manifested by?
Vomiting and hunger, etc.
66
If Carcinoma of intestinal type is by cardiac sphincter what must be done?
Have to remove part of the esophagus as well - All are exophytic
67
Diffuse Stomach Carcinoma =
Smooth -> Linitis Plastica *****
68
Typical Scirrhosis cancers =
Tumor which is “MOSTLY” made of STROMA* = > 50%
69
What is the most common Scirrhous cancer?
BREAST
70
Difference between stroma and Parenchyme =
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
T/F, tumors can be made by stroma or parenchyme in differing ratios?
TRUE
72
Diffuse stomach carcinoma with ENTIRE stomach involved =
LEATHER BOTTLE STOMACH ***
73
What is Leather Bottle Stomach ?***
Increased rigidity of the stomach - Cannot be distended, tight and rigid
74
What is typical example of scirrhous cancer?
Breast cancer (breast Adenocarcinoma)
75
What is typical of Scirrhous cancer (breast cancer) = Breast Adenocarcinoma?
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
Which type of malignant tumors are opposite of Scirrhous tumor ?
Made of well developed parenchyma and very little stroma = Sarcoma
77
In breast sarcoma, what happens?
Breast enlarges from inside | Parenchyme affected
78
How does Stomach Carcinoma metastasize?
Lymphatics
79
Sarcomas typically spread through ? ****
BLOOD
80
Carcinomas usually spread through ? ****
Lymph
81
What is Lymphadenopathy? **
Metastasis to lymph node first - remove these first then radiation to remove rest of tumor
82
If lymph nodes are painful =
Lymphadenitis
83
Where will you find Mets of the stomach?
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
Where will you find Mets if it goes through the veins?
LUNGS based on circulation of blood due to the blood being slowed/stopped in capillaries
85
Where will you find Mets if it goes through arteries?
Good blood supply = Brain kidney spleen
86
Secondary ovarian carcinoma aka
BROKEN BACK TUMOR
87
Secondary ovarian Carcinoma aka Broken Back tumor Mets through :
The abdominal cavity to the ovaries (stomach cancer spread through abdominal cavity)
88
Which anemia does not have hypersegmented neutrophils?
Iron deficiency (pernicious, megaloblastic, folic acid def. all do)
89
Chronic cystitis :
Hematopoietic
90
Lt -> RT shunt increase BP ______
In upper extremities , decreases in lower extremities = COARCTATION OF AORTA**
91
Floated can help a B12 def but B12 cannot help ______
A folate deficiency ***

8 PATH 2 (10 decks)

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