pathology of gastritis and gastroduodenal ulceration

Question 1

what are the causes of a gastroduodenal ulcer?

Answer 1

mucosal ischaemia 
increased acid production
stress
Helicobacter pylori infection
drugs eg Aspirin
alcohol
gastroduodenal reflux - bile salts

Question 2

describe and explain how mucosal ischaemia results in gastroduodenal ulceration

Answer 2

reduced blood supply to the stomach causes ischaemia
this causes gastric mucosa cells to die and ulceration forms
this allows the acid to enter the epithelial layer and damage neighbouring cells, causing damage to spread

Question 3

give a cause of mucosal ischaemia of the stomach

Answer 3

drop in BP eg due to shock (causes vasoconstriction in the stomach to redirect the blood flow to vital organs eg the heart)

Question 4

what class of drugs are used to reduce acid secretion of the stomach?

Answer 4

PPIs eg lansoprazole

Question 5

How does aspirin cause gastric ulcer formation?

Answer 5

inhibits prostaglandin synthethase ie COX 2 so reduces the synthesis of prostaglandins

Question 6

How does H. pylori infection increase acid secretion?

Answer 6

increases acid production

H. pylori secreted chemicals that cause acute inflammation and attract neutrophils which cause more damage

Question 7

What type of change in the epithelium is seen with gastritis and ulcerformation?

Answer 7

intestinal metaplasia

Question 8

how do gastric ulcers look macroscopically?

Answer 8

well demarcated ulcer, cancers are not well demarcated

fibrosis may be seen

Question 9

what is are potential complications of gastric ulcers?

Answer 9

the ulcer erodes into arteries causing haemorrhage
the ulcer erodes into the muscle wall, causing peritonitis
the ulcer could erode into the pancreas leading to pancreatitis