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Year 2 Gastrointestinal > Pathology of the stomach > Flashcards

Pathology of the stomach Flashcards

1
Q

an ulcer penetrates past what layer?

A

muscularis mucosa (into submucosa or deeper)

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2
Q

what is the pathogenesis of acute gastritis?

A

disruption of defenses
stimulation of acid secretion
neutrophilic infiltration of mucosa in acute h pylori infection

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3
Q

what is the morphology of MILD acute gastritis?

A

hyperemia and edema

neutrophils ABOVE basement membrane

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4
Q

what is the morphology of SEVERE acute gastritis?

A

entire mucosal thickness, erosion, hemorrhage

does NOT cross muscularis mucosae

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5
Q

definition: chronic gastritis

A

mucosal atrophy and intestinal metaplsia due to chronic mucosal inflammatory changes

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6
Q

how does h pylori bind to surface epithelial cells?

A

bacterial adhesins

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7
Q

what is the role of urease in h pylori infection?

A

buffers gastric acid for more favorable environment

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8
Q

patients with what features are more likely to develop duodenal ulcer disease?

A

antral predominant gastritis

increased acid and gastrin

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9
Q

gastric carcinoma is more likely to be a result of h pylori infection in what area of the stomach?

A

body

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10
Q

autoimmune gastritis is characterized by antibodies made to what cells / molecules?

A

paritetal cells and intrinsic factor

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11
Q

is achlorydia possible in autoimmune gastritis?

A

yes

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12
Q

is achlorydia associated with h pylori infection?

A

no (never)

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13
Q

where do peptic ulcers arise?

A

stomach, duodenum, anywhere in GI tract

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14
Q

what is present in almost all duodenal ulcer patients?

A

h pylori

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15
Q

what ILs are produced in h pylori infection?

A

IL-6, IL-8

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16
Q

which IL is responsible for recruiting neutrophils in h pylori infection?

A

IL-8

17
Q

what is zollinger ellison syndrome? how does it usually manifest?

A

endocrine tumor producing gastrin (gastrinoma)

usually presents with peptic ulcers

18
Q

98% of peptic ulcers are located in what part?

A

1st portion of duodenum or stomach

19
Q

what must be done to rule out carcinoma for peptic ulcers?

A

biopsy

20
Q

what are the four zones of malignant ulcers?

A

necrosis of base and margins
inflammatory infiltrate
granulation tissue
scar (fibrosis)

21
Q

what are the complications of peptic ulcer disease?

A

bleeding
perforation - most important
obstruction
intractable pain

22
Q

patients with severe burns and trauma could develop what type of acute gastric ulcer? what is the major complication?

A

curling ulcers

bleeding

23
Q

patients with CNS conditions that increase intracranial pressure could develop what type of acute gastric ulcer?

A

cushing ulcers

24
Q

which types of polyp are precancerous? which type of cancer can develop?

A

adenomatous polyps

gastric adenoma

25
Q

what accounts for 90-95% of malignancy occurring in the stomach?

A

primary gastric carcinoma

26
Q

what are the two types of gastric carcinoma? what are the histologic characteristics of each?

A

intestinal - colonic adenocarcinoma with desmoplastic response

diffuse - signet ring cells

27
Q

what is the most important factor in intestinal type gastric carcinoma?

A

h pylori infection

28
Q

what is the most important prognostic indicator for gastric carcinoma?

A

depth of invasion

29
Q

what is linitis plastica?

A

thickened wall in stomach - desmoplasia with signet ring cells

30
Q

is diffuse type gastric carcinoma aggressive or non-aggressive?

A

aggressive

31
Q

which primary gene is mutated in colon cancer?

A

APC

32
Q

where is the virchow node? what is the significance?

A

sentinal supraclavicular node

metastasis site for gastric carcinoma

33
Q

where is the sister mary joseph nodule? what is the significance?

A

periumbilical area

metastasis site for gastric carcinoma (intestinal type)

34
Q

where are krukenberg tumors? what is the significance?

A

ovaries

metastasis site for gastric carcinoma

35
Q

what are the cells associated with gastrointestinal stromal tumors (GISTs)?

A

cells of cajal - mesenchymal

36
Q

the majority of GISTs are positive for what markers?

A

c-KIT (CD117)

37
Q

GISTs will respond to what therapy?

A

tyrosine kinase inhibitor (imatinib - Gleevec)

Year 2 Gastrointestinal (38 decks)

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