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Gastrointestinal > Pathology of Stomach and Duodenum > Flashcards

Pathology of Stomach and Duodenum Flashcards

1
Q

inflammatory disorders of the stomach

A

acute gastritis
chronic gastritis
rare disordes

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2
Q

causes of acute gastritis

A 
irritant chemical injury
severe burns
shock
severe trauma 
head injury
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3
Q

causes of chronic gastritis

A

autoimmune
bacterial (H. pylori)
chemical

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4
Q

rare causes of an imflmmatroy disorder of the stomach

A

lymphocytic
eosinophilic
granulomatous

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5
Q

describe autoimmune chronic gastritis

A

rare
anti-parietal and anti-intrinsic antibodies
increased risk of malignant

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6
Q

pathology of autoimmune chronic gastritis

A

atrophy and intestinal metaplasia in body of stomach

pernicious anaemia, microcytic - due to vitamin B12 deficiency

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7
Q

describe bacterial associated chronic gastritis

A

common
bacteria inhibits niche between epithelial cell surface and mucous barrier, exciting early acute inflammatory response
if not cleared –> chronic active inflammation ensues
IL8 critical

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8
Q

describe H.pylori

A

gram negative curvilinear rod

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9
Q

complications of H.pylori gastritis

A 
lamina propria plasma cells produce anti H/pylori antibodies
increases risk of;
duodenal ulcer
gastric ulcer
gastric carcinoma 
gastric lymphoma
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10
Q

causes of chemical gastritis

A

Non-steroidal anti-inflammatory drugs
alcohol
bile reflux

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11
Q

pathology of chemical gastritis

A

direct injury to mucus layer by fat solvents
marked epithelial regeneration, hyperplasia, congestion and little inflammation
may produce erosions r ulcers

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12
Q

what is peptic ulceration

A

breach in the GI mucosal as a result of acid and pepsin attack;
increased acid production
failure of mucosal defence

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13
Q

what are chronic peptic ulcers

A

ulceration is long-standing and often deep

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14
Q

sites of chronic peptic ulcers

A

duodenum - 1st part
stomach - body and antrum
oesophagi-gastric junciton
stomach ulcers

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15
Q

describe chronic duodenal ulcers

A

increased/inappropriately sustained acid secretion

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16
Q

consequence of excess acid in duodenum

A 
produces gastric metaplasia, leading to (synergism); 
H.pylori infection
inflammation
epithelial damage 
ulceration
17
Q

morphology of peptic ulcers

A

edges clear cut, punched out

18
Q

microscopic changes in peptic ulcers

A

layered appearance
floor or necrotic fibrinopurulent debris
base of inflamed granulation tissue
deepest layer is fibrotic scar tissue

19
Q

complication of peptic ulcers

A 
perforation
penetration 
haemorrhage
stenosis
intractable pain
20
Q

benign gastric tumours

A

hyperplastic polyps

cystic funds gland polyps

21
Q

malignant gastric tumours

A

adenocarcinomas
lymphomas
GI stromal tumurs (GISTs)

all gastric tumours regarded malignant until proven otherwise!

22
Q

most common cause of gastric adenocarcinomas

A

H.pylori infection

23
Q

pathogenesis of gastric adenocarcinoma

A 
in order;
H.pylori infection 
chronic gastritis 
intestinal metaplasia/atrophy
dysplasia
carcinoma
24
Q

rare causes of gastric adenocarcinoma

A

pernicious anaemia
partial gastrectomy
HNPCC/Lynch syndrome
menetrier’s disease

25
Q

subtypes of gastric adenocarcinoma

A

intestinal - exophytic/polypoid mass (better prognosis)
diffuse - expands/infiltrates stomach wall

can be mixed subtypes

26
Q

describe a bengin peptic ulcer

A

mimics cancer

more punched out, lacks raised rolled edge

27
Q

metastases of gastric adenocarcinoma

A

local - other organs, peritoneal cavity and ovaries (Kruckenberg)
lymph nodes
haematogenous (liver)

28
Q

what is a gastric lymphoma

A

maltoma;

derived from mucosa associated lymphoid tissue (MALT)

29
Q

causes of gastric lymphoma

A

H.pylori infection

30
Q

pathology of gastric lymphoma

A

continuous inflammation inducing evolution into clonal B cell proliferation - low grade lymphoma
if unchecked, evolves into high grade B-cell lymphoma

Gastrointestinal (71 decks)

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