Lecture 15 - Pathology of Stomach Diseases

Question 1

Parietal and Chief cells are mostly located in the ____ and ____ of the stomach, while G cells are mostly located in the _____.

Answer 1

Fundus

Corpus

Antrum

Question 2

Congenital _____ _____ is the only congenital disease of the stomach. It tends to affect _____ (which race?) more and _____ (which sex?) more. Interestingly, it usually affects the ______ (which child of a family?), presenting by the end of the ______ month after birth, and resulting in _________ vomiting. Remember that TE fistula presented immediately after birth with excessive drooling and breath sounds in the abdomen.

Answer 2

Congenital Pyloric stenosis

Whites

Men

First born

First month

Projectile

Question 3

Erosion –> lesion into the _____ layer of the stomach.

Superficial Ulcer –> lesion into the ______ layer.

Penetrating ulcer –> lesion into the ______ _____.

Perforating Ulcer –> full thickness lesion that can end up affecting the _____ if the ulcer is on the posterior aspect of the stomach. Think about how these patients will present.

Answer 3

Mucosal layer

Submucosal layer

Muscularis Propria

Pancreas

Question 4

Patients who have had partial gastrectomy are at greater risk of developing _______ (acute or chronic?) gastritis.

Answer 4

Chronic

Question 5

Chronic gastritis can lead to the formation of lymphoid nodule or follicles, and it can cause intestinal _______ (meaning the mucosa/epithelium of the stomach becomes more like intestinal tissue with goblet cells).

Answer 5

Metaplasia

Question 6

Acute gastritis has multiple foci that are ______ (randomly or organizationally?) dispersed throughout the stomach.

Answer 6

Randomly

Question 7

Gastritis caused by NSAIDs is more appropriately called Reactive Gastropathy. Why does it make sense to call it that?

Answer 7

There is villiform change of the stomach, so it resembles intestinal tissue, but there is NO inflammation.

Question 8

Peptic Ulcers usually affects the proximal ______ or distal ______. Less frequently, it can occur in the distal esophagus (usually in patients with _____).

_____ is considered the major cause, along with hyperacidity, NSAIDs, smoking, and other factors.

Answer 8

Duodenum

Stomach

GERD

H. pylori

Question 9

Zollinger-Ellison Syndrome results from non ___-___ tumors of the pancreatic or ectopic pancreatic islets that lead to hypersecretion of _____ –> this causes multiple ____ ____ in various, non-traditional locations (so not in the proximal duodenum or distal stomach).

Answer 9

Beta-cell

Gastrin

Peptic Ulcers

Question 10

_____ gastritis appears as loss of gastric cells and HYPOacidity –> this can lead to ______ anemia.

Answer 10

Atrophic gastritis

Pernicious

Question 11

Mentrier’s disease is characterized by huge, ceribriform folds in the _______ (proximal, mid, or distal?) stomach that stop at the _____. Hyperplasia of neck glands causes mucus hypersecretion, and there is focal cyst formation with atrophy of ____ and ____ cells. Keep in mind this typically occurs in males between the ages of _____ and ____.

Answer 11

Proximal stomach

Antrum

Chief

Parietal

30

50

Question 12

______ is the most common stomach cancer, followed by Lymphoma. Keep in mind _____ _____ is the most common cause.

Answer 12

Adenocarcinoma

H. pylori

Question 13

Two of the hallmarks of cancerous ulcers are the edge and shape. How do they compare to peptic ulcers?

Answer 13

Cancerous ulcers typically have a RAISED edge and are not smoothly defined circular shapes. Peptic ulcers are flush (no raised edge) and are well defined.