Sketchy Path: Gastric Dysmotility Flashcards
Gastroparesis definition
Delayed gastric emptying without obstruction
Gastric cart is broken
What is the major pathophys cause of gastroparesis?
Dysfunction of the Vagus Nerve leading to imapired peristalsis of food
(Vegas Sign cut wires at the arcade)
Besides idiopathic, what are the major causes of gastric dysmotility?
Diabetes (Kid on cart eating candy jar) Medications like CCB and TCA (Med booth next to cart with mortar and pestle) Autoimmune Disease-Scleroderma
What are the first line treatments for gastroparesis?
Metoclpramide
Short frequent meals
Menetreir’s Disease
Hypertrophy of the rugal folds due to hyperplasia of mucus-secreting cells inhibits peristalisis of food through the stomach
(Ramen noodles shop with rugae like noodles on sign)
Menetreir’s Disease is consider what type of gastropathy?
Protein Losing
Noodle bowl tipping over with meat flying out
What are the common presenting symptoms of Menerier’s Disease?
Weight Loss Muscle Wasting Hypoalbumenemia Peripheral Edema (thin girl walking by) Melena (Black pool dripping from bowls) Nausea (Kid looking nauseous)
What is the most common stomach cancer?
Adenocarcinoma
(Giant crab under donburi sign)
HIGH in east Asian countries
What type of gastric adenocarcinoma is more common?
Intestinal
hanging intestines
What is the biggest risk factor for the development of intestinal type gastric adenocarcinoma? What causes this RF?
Chronic Atrophic Metaplastic gastritis
(Grandfather Clock and simmering stomach pot)
H pylori and Autoimmune gastritis
(H pylori fan blades and Ab chopstick)
What virus increases the risk of gastric lymphoma cancer?
EBV
Ebstein Barr sign
What colonic disease increases the risk of gastric cancer?
FAP
Family of mushroom polyps sign
Intestinal Type adenocarcinoma tends to develop where? What are the characteristics?
Lesser curvature of stomach (Lesser curvature of the cauliflower bowl) Bulky ulcerations (hot sauce on cauliflower bowl)
What causes the major difference between diffuse and intestinal adenocarcinoma?
Diffuse type lacks E-cadherin protein resulting in decrease intercellular growth connections which leads cancer incapable of making a bulky mass- instead these cancers invade surrounding structures
(Crabs in tank without the “claw adhering” rubber-band can escape and diffusely spread along shop)
Diffuse adenocarcinoma leads to disorganized cell growth and invasion throughout stomach of fibrous tissue this is termed? Causes the stomach to develop what?
Desmoplasia
linitis plastica - lacks peristalsis
(plastic stomach shaped bottle)
What characteristic cells are seen in diffuse adenocarcinoma?
Signet Ring Cells
Ring jewelry on passerby
What special metastasis of diffuse adenocarcinoma is important? Where is it too?
Krukenberg Tumor to the ovaries
Also have Virchow Node which is above the clavicle and sister mary joesph nodules which is periumbilical
The stomach is the most common metastasis sight for which types of cancer?
Non-Hodkin Lymphomas -besides lymph nodes
Gastric Lymphoma RF ?
H Pylori
Chronic Gastritis
Gastric lymphomas are most commonly what types?
Marginal B cell
(Archers near margin of chest board)
Large B Cell Lymphoma
(LARGE B cell archer on board)
GI stromal tumors of the stomach are usually derived from what cell?
Intersitial cells of Cajal
Cajal arcade hall - pacemaking game
What gene is mutated in GI stromal tumors
Activating mutation of tyrosine kinase C-KIT
GIST tumors have what two types of cells on histology?
Spindle cells
Epitheloid Cells
What drug is sometimes useful in shrinking the size of GIST tumors?
Imatinib
tyrosine kinase inhibitor
