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GI > Pathoma - Stomach > Flashcards

Pathoma - Stomach Flashcards

1
Q

Gastroschisis

A

congenital malformation of abdominal wall (exposes gastric contents to outside)

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2
Q

Gastroschisis vs Omphacele

A

omphalocele contents inside “bubble” (peritoneum and amnion)

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3
Q

Omphalocele

A

persistent herniation into umbilical cord

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4
Q

Omphalocele - clinical presentation

A

contents covered by peritoneum and amnion of cord

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5
Q

Pyloric stenosis

A

tightening of pyloric sphincter

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6
Q

Pyloric stenosis - clinical presentation

A

presents 2 weeks after birth:
projectile vomit
olive-like mass in abdomen

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7
Q

Pyloric stenosis - treatment

A

myotomy

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8
Q

Acute gastritis

A

acidic damage to mucosa (imbalance between acidic environment and mucosal defense)

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9
Q

Mucosal defenses

A

epithelial cells, mucous, bicarbonate, blood supply

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10
Q

Acute gastritis - risk factors

A

Severe burns (hypovolemia-> dec BF to stomach)
NSAIDS
Alcohol (direct mucosal damage)
Chemotherapy (killing cells that are turning over)
Decreased ICP (Cushing ulcer)- increased vagal stimulation->ACh stimulation
Shock

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11
Q

Prostaglandin effects on stomach

A

decrease acid production, increase mucous/bicarb production, increase BF to stomach

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12
Q

which hormones/NT’s increase acid production?

A

Gastrin, ACh, histamine

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13
Q

Outcomes of acidic damage

A

Superficial inflammation
Erosion (loss of epithelium)
Ulceration (loss of mucosal layer)

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14
Q

Chronic gastritis - types

A

Chronic autoimmune gastritis

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15
Q

Chronic autoimmune gastritis

A

autoimmune destruction of parietal cells (Type IV hypersensitivity)

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16
Q

CAG - location

A

body and fundus of stomach

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17
Q

CAG - labs

A

Ab’s against parietal cells or intrinsic factor
Achlorhydria
Increased gastrin levels
anemia (megaloblastic)

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18
Q

CAG - clinical presentation

A

Atrophy of mucosa
Achlorhydria w/ increased gastrin levels (G cell hyperplasia in antrum
Megaloblastic anemia (IF Ab’s)

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19
Q

CAG - complications

A

increased risk of gastric adenocarcinoma (inflammation->intestinal metaplasia)

20
Q

What histological finding suggests intestinal metaplasia

A

goblet cells

21
Q

Chronic H. pylori gastritis

A

90% of chronic gastritis, due to inflammation from H.pylori bacteria

22
Q

How does H. pylori weaken mucosal defenses?

A

ureases, proteases and inflammation

23
Q

H. pylori gastritis - location

A

antrum

24
Q

H. pylori gastritis - clinical presentation

A

epigastric abdominal pain

(+) urease breath test

25
Q

H. pylori gastritis - complications

A

inc risk of: ulceration, gastric adenocarcinoma, MALT lymphoma

26
Q

H. pylori gastritis - treatment

A

Triple therapy (PPI + amoxicillin + clarithromycin)

27
Q

Peptic ulcer disease

A

solitary mucosal ulcer

28
Q

PUD - location

A

proximal duodenum (90%) or distal stomach

29
Q

Duodenal ulcer - cause

A

almost always H. pylori

rarely Zollinger-Ellison Syndrome (gastrinoma)

30
Q

Duodenal ulcer - clinical presentation

A

epigastric pain that IMPROVES W/ MEALS

31
Q

Duodenal ulcer - diagnosis

A

ulcer w/ hypertrophy of Brunner glands on endoscopic biopsy

32
Q

Duodenal ulcer - complications

A

rupture of ulcer (anterior or posterior wall- anterior more common)

33
Q

Possible complications of POSTERIOR duodenal wall rupture from ulcer?

A

bleeding from gastroduodenal artery

acute pancreatitis

34
Q

Gastric ulcer - cause

A

60% H. pylori
NSAIDS
bile reflux

35
Q

Gastric ulcer - clinical presentation

A

epigastric pain that WORSENS W/ MEAL

36
Q

Gastric ulcer - location

A

lesser curvature of antrum

37
Q

possible complications from rupture of gastric ulcer

A

bleeding from left gastric artery

38
Q

DDX for ulcers

A

consider cancer
very rarely malignant in duodenum
gastric ulcer- can cause gastric carcinoma

39
Q

Gastric carcinoma

A

malignant proliferation of surface columnar epithelium (adenocarcinoma)

40
Q

GC: instestinal type

A

large, irregular ulcer w/ heaped-up margins

41
Q

GC: intestinal type - location

A

lesser curvature of antrum

42
Q

GC: intestinal type - risk factors

A

intestinal metaplasia, nitrosamines (smoked food), Type A blood

43
Q

GC: diffuse type

A

signet ring cells invade gastric wall (diffusely)

44
Q

GC: diffuse type - response to signet cell invasion

A

Desmoplasia (->thickening of stomach wall) (linitis plastica)

45
Q

GC: clinical presentation

A

weight loss, abdominal pain, anemia, early satiety

rare: acanthosis nigricans or Leser Trelat sign (seborrheic keratoses on skin)

GI (9 decks)

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