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Gastrointestinal - step > Pathology - stomach > Flashcards

Pathology - stomach Flashcards

1
Q

what are two types of gastritis

A

acute- erosive

chornic - non erosive

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2
Q

what causes acute gastritis?

A

disruption of the mucosal barrier - inflammation

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3
Q

what type of patient would display acute gastritis

A

OHics
chronic NSAID users
burn victims
brain injury victims

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4
Q

how do NSAIDs lead to the development of gastritis?

A

decrease PGE2 - decrease mucosal barrier

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5
Q

what are curling ulcers?

A

burn victims - acute gastritis

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6
Q

how do burns lead to ulcers?

A

decrased plasma volume - sloughing of gastric mucosa

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7
Q

what are cushing ulcers?

A

brain injury - acute gastritis

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8
Q

how does a brain injury lead to an ulcer?

A

increased vagal stimulation - increased Ach - increased H secretion

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9
Q

what type of patient typical for acute gastritis

A

OHis and patients taking daily NSAIDs (ie rheumatoid arthritis)

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10
Q

type A chronic gastritis due to:

A

autoimmune disorders
pernicious anaemia
abs to parietal cells
achlorhydria

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11
Q

what part of the stomach does type A chronic gastritis hit?

A

fundus and body

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12
Q

what part of the stomach does type B chronic gastritis hit?

A

antrum

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13
Q

what causes type B chronic gastritis?

A

H pylor infection

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14
Q

what type of cancer does type B chronic gastritis increase the risk of?

A

MALToma

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15
Q

autoimmune disease
abs to parietal cells
pernicious anaemia
achlorhydria

A

type A chronic gastritis

body and fundus of stomach

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16
Q

what is achlorhydria?n

A

no Cl in gastric secretions

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17
Q

hypertrophies ruga
excess mucos production
protein loss
parietal cell atrophy

A

menetrier disease

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18
Q

describe how menetrier disease looks on CT?

A

rugaue are so hypertrophied that they look like brain gyri

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19
Q

describe menetrier disease

A

gastric hyperPLASIA of mucosa leads to hyperTROPHY of rugae, increased mucous production, protein loss and atrophy or parietal cells – decreased acid production

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20
Q

who cares about menetrier disease

A

precancerous

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21
Q

describe the s and sxs of stomach disorders

A

hematemesis: most common due to PUD, can be from varices or acute gastritis
melena: hb exposed to acid turns black – bleed proximal to fourth part of the duodenum

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22
Q

what surrounds the fourth part of the duodenum?

A

the ligament of trietz

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23
Q

what does H pylori infection cause?

A

type B chronic gastritis
duodenal > gastric ulcers
gastric adenocarcinoma
MALToma

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24
Q

what types of gastric cancer exist

A

adenocarcinoma
lymphoid
carcinoid (rare)

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25
Q

where is most common site of carcinoid tumour in the git?

A

small intestine

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26
Q

what needs to happen for a carcinoid tumour to present as carcinoid syndrome?

A

mets to the liver

27
Q

describe prognosis of stomach cancer

A

early aggressive local spread with node/liver metastases

28
Q

where does stomach cancer met to?

A

liver and nodes

29
Q

weight loss
early satiety
acanthosis nigricans

A

stomach cancer

30
Q

what causes intestinal form of gastric cancer?

A 
H pylori
dietary nitrosamines/smoked foods
tobacco
achlorhydria
chronic gastritis
31
Q

where is intestinal gastric cancer most common?

A

japan

32
Q

incident of gastric cancer in USA?

A

decreasing

33
Q

where does intestinal gastric cancer occur in stomach?

A

lesser curvature

34
Q

what does intestinal gastric cancer look like?

A

ulcer with RAISED MARGINS

35
Q

H pylori and diffuse stomach cancer?

A

not related

36
Q

H pylori and intestinal stomach cancer?

A

related

37
Q

histopathos of diffuse stomach cancer please

A

SIGNET RING CELLS

38
Q

what is a signet ring cell?

A

diffuse stomach cancer

mucin filled cells with peripheral nuclei

39
Q

describe gross presentation fo diffuse stomach cancer

A

linitus plastic: wall is grossly thickened and leathery as signet celsl invade

40
Q 
cachexia
weight loss
epigastric pain
vomiting and melena
acanthosis nigricans
seborrhoeic keratosis
A

stomach cancer

41
Q

what is Leser-Trelat sign?

A

multiple outcroppings of seborrheic keratosis associated with gastric cancer

42
Q

name the lumps and bumps you’d see in gastric cancer

A 
virchows node (also esophageal, cervical, pancreatic)
sister mary joseph nodule
SEBORRHEIC KERATOSIS
acanthosis nigricans
krukenberg tu;mour
43
Q

what is vrichows node

A

gastric cancer, pancreatic, esophageal, cervical cancers

involvement of left supraclvicular node by mets from stomach

44
Q

what is sister mary joseph nodule

A

subcutaneous periumbilical metastasis with gastric cancer

45
Q

what is a krkenberg tumor

A

bilateral mets to ovaries
hematogenous spread
abundant mucin secreting signet ring cells

46
Q

bilateral ovaries with abundant mucin secreting signet ring cells

A

krukenberg tumour

gastric cancer

47
Q

which PUD: weight loss

A

pain with food - gastric

48
Q

which PUS: weight gain

A

duodenal - pain relived by food

49
Q

which PUD is associated with H pylori infection?

A

H pylori - intestinal gastric cancer, type B chronic gastricits, MALToma

gastric - 70%
duodeonal - 100%

50
Q

mechanism of gastric ulcer pelase

A

decreased mucosal protection against gastric acid

51
Q

mechanism of duodenal ulcer pelase

A

decreased mucosal protection
OR
increased gastric acid secretion

52
Q

risk fo carcinoma with gastric ulcer

A

some

53
Q

risk of carcinoma with duodenal ulcer

A

negligible

54
Q

which type of ulcer needs to be biopsied?

A

gastric not duodenal

55
Q

what happens in duodenal histology in duodenal ulcers

A

hypertrophy of brunner glands

56
Q

what type of ulcers associated with zollinger Ellison syndrome

A

duodenal

57
Q

what are complciatiosn of ulcers?

A

hemorrhage

perforation

58
Q

what type of PUD associated with hemorrhage

A

gastric

duodenal

59
Q

anterior ro posterior for hemorrhages associaedted with PUD?

A

posterior

60
Q

list vessels to worry about in hemorrhage of PUD

A

gastric - left gastric

duodenal - gastroduodenal

61
Q

which PUD worry about in perforation?

A

duodenal

62
Q

describe what youd see if duodenal PUD perforates?

A

may see free air under diaphragm with referred pain to shoulder via phrenic nerve

63
Q

anterior or posterior for perforation of PUD

A

anterior

64
Q

free air under diaphragm
H pylori infection
referred pain to the shoulder

A

perforation of duodenal PUD

Gastrointestinal - step (10 decks)

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