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Test 8 > Path 4 Stomach > Flashcards

Path 4 Stomach Flashcards

1
Q

Parietal/Chief cell location

A

Fundus

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2
Q

Bicarbonate supply

A

Vasculature and Surface epithelium (protection)

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3
Q

Omphalocele

A

Herniation of bowel into umbilical cord (covered by peritoneum)

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4
Q

Gastroschisis

A

Herniated bowels with no peritoneum

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5
Q

Pyloric Stenosis

A
  • Projectile vomiting

- Tx Myotomy

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6
Q

Acute Gastritis Histology

A
  • Neutrophils in lamina propria

- Intact surface epithelium

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7
Q

Causes of acute ulceration

A

NSAIDs and severe physiologic stress

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8
Q

Normal prostaglandin function in stomach

A
  • Enhance bicarb secretion
  • Inhibit acid secretion
  • Promote mucin synthesis
  • Increase vascular perfusion
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9
Q

Stress ulcer

A

Post-shock, severe trauma

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10
Q

Curling ulcer

A
  • Post-severe burns

- Proximal duodenum

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11
Q

Cushing ulcer

A
  • Intracranial disease (stimulate vagus -> gastric acid secretion)
  • Stomach, duodenum/esophagus
  • Often perforate
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12
Q

ICU prophylaxis

A

H2-R blocker
PPIs
Prostaglandin analogs

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13
Q

Acute v Chronic Gastritis histology

A

Acute - Edema, Neutrophils in lamina propria

Chronic - Lymphoplasmacytic cells

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14
Q

Active Chronic Gastritis

A

Chronic gastritis with superimposed active inflammation

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15
Q

Acute v Chronic Gastritis clinical

A

Acute has much more prominent signs (vomiting)

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16
Q

Chronic Gastritis causes

A

H. Pylori, Autoimmune

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17
Q

H. Pylori infection location

A

Gastric Antrum

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18
Q

H. Pylori virulence factors (4)

A
  • Flagella
  • Urease (produce ammonia)
  • Adhesins
  • Cytotoxin A
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19
Q

H. Pylori infection result

A

Increased acid production

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20
Q

H. Pylori infection histology

A

Lymphoplasmacytic infiltrate in lamina propria

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21
Q

H. Pylori Dx

A

Endoscope & Biopsy
Serology
Urea breath test

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22
Q

Autoimmune Gastritis cause

A

Ab against Parietal cells, Intrinsic Factor

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23
Q

Autoimmune Gastritis mechanism

A

Loss of parietal cells -> achlorydia -> hypergastrinemia -> G-cell hyperplasia

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24
Q

Autoimmune Gastritis comorbidity (2)

A
  • Pernicious anemia

- Destruction of adjacent chief cells -> decreased pepsinogen

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25
H. Pylori v Autoimmune chronic gastritis histology
Lymphoid aggregates only with H. Pylori
26
Autoimmune gastritis spared locations
Antrum & cardia
27
Autoimmune gastritis unique finding
Megaloblastic epithelial cells (pre-metaplastic)
28
Autoimmune gastritis v. H. Pylori endoscope
Smooth mucosa v. Nodular Erythema
29
Autoimmune gastritis hyperplasia
Endocrine cells (pre-neuroendocrine tumor)
30
Gastrin changes in H. Pylori
Decreased or normal
31
Gastrin changes in Autoimmune gastritis
Increased
32
Reactive Gastropathy
Secondary to chemical injury, NSAID use, bile refulx
33
Eosinophilic Gastritis
Secondary to allergies, soy, drugs, parasites
34
Lymphocytic Gastritis
- Ideopathic | - Associated with Celiac disease (women)
35
Granulomatous Gastritis
Secondary to Crohns, Sarcoidosis, Infections
36
Peptic Ulcer Disease common location
Proximal duodenum
37
PUD main causes
- H. Pylori | - NSAIDs, corticosteroids
38
PUD syndrome cause
Zollinger-Ellison syndrome - | Gastrinoma (intestine or pancreas) -> Parietal cell hyperplasia
39
PUD problems
Hemorrhage, Perforation (Xray free air under diaphragm)
40
PUD clinical
- Post prandial pain | - Iron deficiency anemia
41
Intestinal complications of chronic gastritis
- Metaplasia (goblet cells) | - Atrophy
42
Inflammatory/Hyperplastic Polyps
- Due to chronic gastritis | - Dysplastic if large
43
Fundic Gland Polyps causes (2)
- FAP (Familial Adenomatous Polyposis) | - PPIs (reduced acidity -> increased gastrin secretion -> glandular hyperplasia)
44
Fundic Gland Polyp histology
Cystically dilated glands (parietal, chief), no inflammation
45
Hyperplastic Polyp histology
Dilated, irregular glands, acute chronic inflammation
46
Gastric Adenoma cause
Chronic gastritis with Atrophy and Intestinal Metaplasia
47
Gastric Adenocarcinoma
- 90% of all gastric cancers | - 20x in Japan (Nitrosamines)
48
Gastric Adenocarcinoma predisposing factors (3)
- Lower socioeconomic groups - Multifocal mucosal atrophy - Intestinal metaplasia
49
2 type of Gastric Adenocarcinoma
- Intestinal Type (well differentiated glands, ulcerated mass) - Diffuse type (Signet-ring cells, no glands, no mass)
50
Linitica plastica
Leather bottle - Diffuse Type gross appearance
51
Intestinal type genes
FAP | B-catenin mutation
52
Diffuse type genes
BRCA2 | E-cadherin (CDH1 gene)
53
Common to both gastric adenocarcinomas
Neoplastic progression supported by chronic inflammation
54
Gastric adenocarcinoma metastasis sites (3)
- Virchow's node (left supraclavicular) - Sister Mary Joseph nodule (periumbilical, intestinal type) - Krukenberg tumor (bilateral ovaries, diffuse type)
55
Gastric adenocarcinoma dermatology
- Acanthosis nigricans | - Leser-Trelat sign
56
MALT lymphoma
- Marginal zone B-cell lymphoma - Associated with H. pylori - Lymphoepithelial lesion (monoclonal lymphocytic infiltrate)
57
Carcinoid Tumor
- Neuroendocrine tumor, mostly in small intestine | - Secrete Histamine, Somatostatin, Serotonin
58
Carcinoid histology
Salt-and-pepper chromatin
59
Gastrointestinal Stromal Tumor (GIST)
Benign muscularis tumor
60
GIST immunohistochemistry
- C-KIT | - Imatinib inhibits c-KIT, used for Tx

Test 8 (21 decks)

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