Pathology of Stomach

Question 1

what can cause acute gastritis?

Answer 1

burns, shock, trauma, head injury

Question 2

what can cause chronic gastritis?

Answer 2

autoimmune, bacterial (H pylori), chemical (e.g. NSAID use)

ABC

Question 3

what are features of autoimmune chronic gastritis?

Answer 3

anti-parietal and anti-intrinsic factor antibodies

atrophy and intestinal metaplasia in body of stomach

Question 4

what are features of bacterial (H pylori associated) chronic gastritis?

Answer 4

early acute inflammatory response (neutrophils release things which damage epithelial cells)
IL8 critical
increased risk of duodenal and gastric ulcers and cancers
lamina propria plasma cells produce anti-H pylori antibodies

Question 5

what are features of chemical chronic gastritis?

Answer 5

due to NSAIDs, alcohol. bile reflux
direct injury to mucus layer by fat solvents
hyperplasia, congestion, little inflammation, may produce erosions, ulcers

Question 6

pathogenesis of duodenal ulcers?

Answer 6

increased attack by acid secretion and failure of mucosal defence
This produces gastric metaplasia and leads to H pylori infection, inflammation, epithelial damage and ulceration

Question 7

what are complications of peptic ulcers?

Answer 7

perforation, penetration, haemorrhage, stenosis, intractable pain

Question 8

name benign gastric tumours?

Answer 8

hyperplastic polyps, cystic fundic gland polyps - they are incidental findings, cause no problems

Question 9

what are malignant gastric tumours?

Answer 9

carcinomas (adenocarcinomas), lymphomas, GISTs

Question 10

infection with _____ runs parallel to incidence of gastric cancer?

Answer 10

H pylori
patients with H pylori have higher risk of cancer
H pylori is the major cause of chronic gastritis

Question 11

what are the two types of gastric adenocarcinoma?

Answer 11

intestinal, and diffuse

intestinal prognosis slightly better