Stomach Flashcards
Gastritis is defined by inflammation of gastric epithelium True/False?
True
Peptic ulcer is type of chronic inflammation True/False?
False .The correct is
Is a chronic ulcer
In acute gastritis the inflammation accompanied by ….. and this …. Is an important cause of ….
Haemorrhage into gastric mucosa and erosion ,sever erosive process is , of gastrointestinal bleeding
Numerate the causes of Acute gastritis !
1) Heavy use of NSANDs like aspirin
2) Excessive Alcohol consumption
3) Heavy smoking
4) Treatment with caner chemotherapeutic drug
5) Uraemia
6) Sever stress(surgery,trauma,burns)
7) Mechanical Trauma(nasogastric intubation)
8) Suicide attempts to acids and alkali
Acute erosive gastritis ,how is it marked?
This is marked by:
1) mucosal oedema
2) inflammatory infiltrate of neutrophils
3) possibly by chronic inflammatory cell
Chronic gastritis of characterised by hematemesis ,melena and fatal blood lose True/False?
False .The correct is
It is acute gastritis
Define the chronic gastritis
Is defined by chronic mucosal inflammatory changes leading eventually to mucosal atrophy and epithelial metaplasia
What are causes of Chronic gastritis ?
1) Helicobacter pylori
2) Autoimmune gastritis
The inflammatory changes in chronic gastritis consist of ….. and ….. infiltrate in lamina propria ,occasionally accompanied by ….. of …..of gastric pit
Lymphocytic and Plasma cell ,
Neutrophilic inflammation, neck region
Chronic gastritis ,in autoimmune variant loss of chief cell is dominant True/False?
False .The correct is
Parietal cells
What is the cause on gastric lymphoma?
H.pylori induced proliferation of lymphoid tissue within gastric mucosa has been implicated as a precursor of gastric lymphoma
Define the gastric ulceration !
Is defined as breach in mucosa of the alimentary-tract that extend through the muscular-is mucosa into the sub mucosa or deeper
Gastric Ulcer include ….&….
Peptic ulcer (chronic ulcer) Stress ulcer (acute ulcer)
Peptic ulcer occur in oesophagus True/False?
False .The correct is
Al least 98% of it occur either in first part of duodenum or in stomach
Numerate the causes of Chronic ulcer
1) Mucosal exposure to aggressive action of acid-peptic juice
2) Very strong casual association with H.pylori infection
Describe the host mechanism that preventing the gastric mucosa from being digested like a piece of meat
1) Secretion of mucous by surface epithelial cell
2) Secretion of bicarbonate into the surface mucous creating a buffered surface micro environment.
3) Secretion of acid-peptic juice from gastric pit as jet through surface mucous layer entering the lumen directly without contact surface epithelial cells
4) Rapid rate of epithelial regeneration
5) Mucosal elaboration of prostaglandin ,which help maintain mucosal blood flow
Explain the possible mechanism by which H.pylori cause gastric ulcers ?
1)H.pylori doesn’t invade the tissue ,but induces an intense inflammatory response by induce production of pro inflammatory cytokines like interleukin which recruits and activates the neutrophils
2)Several bacterial products like ureas are causing epi. Cell injury and induction of inflammation.
Bacterial protease and phospholipase breakdown glycoproteins-lipid complexes in the gastric mucous ,thus weakening the first line of m. defence
3)H.pylori enhance gastric acid secretion and impairs duodenal bicarbonate production thus reducing normal luminal ph in the duodenum
4)Several H.pylori proteins are immunogenic ,and they evoke immune response in mucosa .Both activated T & B cells can be seen in chronic gastritis caused by H.pylori
In patients who don’t have H.pylori infection NSAIDs are the major causes of peptic ulcer disease .Explain the mechanism !
1)Suppression of prostaglandin synthesis
2)Inhibition of prostaglandin synthesis increase secretion of HCL and reduce the HCO3-
and mucin production
3)Loss of mucin degrades the mucosal barrier that normally prevents acid from reaching the epithelium
4)By not clear mechanism ,some NSAIDs also impair angiogenesis,thus impeding the healing of ulcers
Most peptic ulcer cause ….,….,….but significant minority first come to light with complications such as ….or….
Epigastric gnawing ,burning ,boring pain ,haemorrhage ,perforation
The pain of peptic ulcer tends to be worse at evening and occurs usually 2-3 hours after meals True/False?
False .The correct is
At night ,1-3 hours after meals
Classically how the pain of peptic ulcer is relived ?
By ingestion of alkalis and food
Stomach and jejunum are the common site for stress ulcers True/False?
False .The correct is
Stomach and duodenum
Numerate the causes of stress ulcer.
1)Severe trauma including major surgical procedures ,sepsis or grave disease of any type
2)Extensive burns(the ulcers is then referred to curling ulcers).
3)Traumatic or surgical injury of CNS or intracerebral
haemorrhage(the ulcer is then referred to cushing ulcer).
4)Chronic exposure to gastric irritant drugs ,particularly NSAIDs and corticosteroids
Answer By True or False
1) The acute ulcer is appearing usually polypoid and medium lesions
2) Its base is frequently stained dark brown due to acid digestion of extruded blood
1)False .The correct is
Circular and small (less than 1 cm in diameter)
2)True
Numerate the types of gastric polyps!
1)Hyper-plastic polyp (80%-85%)
2)Fundic polyp (about 10%)
3)Adenomatous polyp (about 5%)
All three types associated with chronic gastritis
Carcinoma represent 80%-85% of gastric carcinoma True/False?
False .The correct is
90%-95%
Gastric carcinoma include …..&…..&…..
1) Carcinoma which represents 90%-95%
2) Lymphomas and carcinoids (4%-3%)
3) Mesenchymal spindle cell tumours (2%)
According the morphology of gastric carcinoma it classified into …..&…..&….
1) Exophytic
2) Flat or depressed
3) Excavated
Which form of gastric carcinoma cause linitis plastica ?
Flat or depressed form
Histologic appearance of gastric cancer include …..&…..
1) Intestinal variant
2) Diffuse variant
Explain the early spread of gastric carcinoma !
The earliest lymph node metastasis may sometimes involve the supraclavicular lymph node (Virchow’s node)
Another somewhat of unusual intraperitoneal spread in women is to the both ovaries giving rise to so called Krukenberg tumour
Advanced gastric carcinoma is symptomatic and involve sometimes abdominal discomfort or weight loss True/False ?
False .The correct is
Asymptomatic
