Sketchy Path: Gastric Dysmotility Flashcards

1
Q

Gastroparesis definition

A

Delayed gastric emptying without obstruction

Gastric cart is broken

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2
Q

What is the major pathophys cause of gastroparesis?

A

Dysfunction of the Vagus Nerve leading to imapired peristalsis of food
(Vegas Sign cut wires at the arcade)

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3
Q

Besides idiopathic, what are the major causes of gastric dysmotility?

A
Diabetes
(Kid on cart eating candy jar)
Medications like CCB and TCA
(Med booth next to cart with mortar and pestle)
Autoimmune Disease-Scleroderma
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4
Q

What are the first line treatments for gastroparesis?

A

Metoclpramide

Short frequent meals

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5
Q

Menetreir’s Disease

A

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)

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6
Q

Menetreir’s Disease is consider what type of gastropathy?

A

Protein Losing

Noodle bowl tipping over with meat flying out

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7
Q

What are the common presenting symptoms of Menerier’s Disease?

A
Weight Loss
Muscle Wasting
Hypoalbumenemia 
Peripheral Edema 
(thin girl walking by)
Melena
(Black pool dripping from bowls)
Nausea
(Kid looking nauseous)
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8
Q

What is the most common stomach cancer?

A

Adenocarcinoma
(Giant crab under donburi sign)
HIGH in east Asian countries

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9
Q

What type of gastric adenocarcinoma is more common?

A

Intestinal

hanging intestines

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10
Q

What is the biggest risk factor for the development of intestinal type gastric adenocarcinoma? What causes this RF?

A

Chronic Atrophic Metaplastic gastritis
(Grandfather Clock and simmering stomach pot)
H pylori and Autoimmune gastritis
(H pylori fan blades and Ab chopstick)

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11
Q

What virus increases the risk of gastric lymphoma cancer?

A

EBV

Ebstein Barr sign

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12
Q

What colonic disease increases the risk of gastric cancer?

A

FAP

Family of mushroom polyps sign

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13
Q

Intestinal Type adenocarcinoma tends to develop where? What are the characteristics?

A
Lesser curvature of stomach (Lesser curvature of the cauliflower bowl)
Bulky ulcerations (hot sauce on cauliflower bowl)
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14
Q

What causes the major difference between diffuse and intestinal adenocarcinoma?

A

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)

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15
Q

Diffuse adenocarcinoma leads to disorganized cell growth and invasion throughout stomach of fibrous tissue this is termed? Causes the stomach to develop what?

A

Desmoplasia
linitis plastica - lacks peristalsis
(plastic stomach shaped bottle)

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16
Q

What characteristic cells are seen in diffuse adenocarcinoma?

A

Signet Ring Cells

Ring jewelry on passerby

17
Q

What special metastasis of diffuse adenocarcinoma is important? Where is it too?

A

Krukenberg Tumor to the ovaries

Also have Virchow Node which is above the clavicle and sister mary joesph nodules which is periumbilical

18
Q

The stomach is the most common metastasis sight for which types of cancer?

A

Non-Hodkin Lymphomas -besides lymph nodes

19
Q

Gastric Lymphoma RF ?

A

H Pylori

Chronic Gastritis

20
Q

Gastric lymphomas are most commonly what types?

A

Marginal B cell
(Archers near margin of chest board)
Large B Cell Lymphoma
(LARGE B cell archer on board)

21
Q

GI stromal tumors of the stomach are usually derived from what cell?

A

Intersitial cells of Cajal

Cajal arcade hall - pacemaking game

22
Q

What gene is mutated in GI stromal tumors

A

Activating mutation of tyrosine kinase C-KIT

23
Q

GIST tumors have what two types of cells on histology?

A

Spindle cells

Epitheloid Cells

24
Q

What drug is sometimes useful in shrinking the size of GIST tumors?

A

Imatinib

tyrosine kinase inhibitor