Pathoma: Stomach Flashcards
Gastroschisis results from __________.
congenital malformation of the abdominal wall, leading to exposure of abdominal contents that are NOT covered by amniotic sac (as is found in omphalocele)
Omphalocele results from __________.
persistent herniation of the bowel into the umbilical cord, resulting in exposure of the intestines covered by the amnion of the umbilical cord
Pyloric stenosis results from ____________.
hyperplasia of smooth muscle AFTER birth (generally two to three weeks after)
You can sometimes see the ____________ in babies with pyloric stenosis on physical exam.
excess gastric peristalsis
What are the main causes of acute and chronic gastritis?
Acute: increased acid production or decreased mucus production
Chronic: autoimmune gastritis and H. pylori gastritis
Foveolar cells produce ______.
mucus
Normal blood supply to the gastric mucosa is important for two reasons: ___________.
supplying mucus-producing cells with nutrients and washing away any acid that seeps into the blood
Why do people get ulcers with severe burns?
Because burns cause hypovolemia, which leads to decreased blood supply to the gastric mucosa
Why does chemotherapy increase risk for acute gastritis?
Because it limits the turnover of protective mucosal cells
Cushing’s ulcer result from __________.
increased ICP, which increases vagal stimulation on parietal cells
What is the difference between erosion and ulceration?
Erosion: destruction of epithelium
Ulceration: destruction of mucosal layer
Parietal cells are predominantly found in the __________.
body and the fundus
Autoimmune gastritis mostly affects the __________.
parietal cells in the body and the fundus
True or false: autoimmune gastritis results from antibodies against parietal cells.
False. It is a T-cell mediated response, and the antibodies are just a byproduct of the contents released into the blood.
Achlorhydria is a symptom of ___________.
autoimmune gastritis
Increased gastrin level with G-cell hyperplasia is a consequence of _____________.
autoimmune gastritis
Which cancer is more likely in someone with autoimmune gastritis?
Gastric adenocarcinoma, because gastric epithelium transitions to intestinal metaplasia in response to proximity to lymphocytes.
The most common site of H. pylori colonization is __________.
the antrum
Which part of the lymph node is likely to develop cancerous proliferation in response to chronic inflammation?
The marginal zone (this is the type found in MALTomas)
90% of the time, ______ presents in the proximal duodenum.
PUD
Zollinger-Ellison syndrome results from __________.
gastrinomas (usually presents with multiple ulcers)
Epigastric pain that improves with meals is a symptom of PUD. Why?
Because the duodenum secretes bicarb upon eating, which relieves the symptoms; this is in contrast to gastric ulcers, which become more painful with eating
Hypertrophy of Brunner’s glands is a consequence of ____________.
PUD (because they’re trying to overcome the excess acid)
What artery runs posterior to the duodenum?
Gastroduodenal artery (can bleed if duodenal ulcers are posterior)
Bile reflux can cause ______.
gastric ulcers
What artery is most likely to rupture with gastric ulcers?
The left gastric artery, because most gastric ulcers are on the lesser curvature of the stomach
Benign ulcers present with ____________.
a “punched-out” look with NO heaping of the surrounding mucosa
Gastric carcinoma is an __________ carcinoma.
adenocarcinoma
Gastric adenocarcinoma most often presents on the ____________ side of the stomach.
lesser curvature (because of the common location of ulcers)
What two lifestyle factors increase risk of gastric adenocarcinoma?
Nitrosamines in smoked food
Blood type A
True or false: H. pylori increases risk of diffuse carcinoma.
False.
Desmoplastic thickening (linitus plastica) is a consequence of ___________.
diffuse type gastric carcinoma (because of the frequency of invasion)
__________ can present with acanthosis nigricans.
Gastric carcinoma
There are two dermatologic findings that present with gastric carcinoma: ___________ and acanthosis nigricans.
Leser-Trélat sign (lots of seborrheic keratoses)
Gastric carcinoma frequently spreads to the __________ lymph node.
leftsupraclavicular
Diffuse-type gastric carcinomas spread to the __________ in Krukenburg tumor.
bilateral ovaries (“some KrooK stole my ovaries”)
