Stomach Flashcards
In what region do we seen generalized pain from the stomach?
Epigastric
What is the most common pathogen responsible for gastrointestinal infection?
Helicobacter pylori
What is the unique appearance seen with the vomit associated with a stomach infection?
Hematemesis, “coffee ground” appearance
What is the appearance of feces associated with a stomach infection?
Melena (black, tarry feces)
What are risk factors for gastritis?
Alcohol, NSAIDs, age, chemotherapy, radiation therapy
What leukocyte is present for the initial onset of acute gastritis?
Neutrophils
What is the clinical term for acute gastritis that progresses into mucosal erosion, ulceration, and hemorrhage?
Acute erosive hemorrhagic gastritis
What are risks for acute gastritis?
NSAIDs: ASA, ibuprofen, naproxen
Alcohol, smoking, irradiation, chemo, sepsis, physical trauma
Why are NSAIDs a risk factor for acute gastritis?
Inhibition of bicarbonate production
What are the medications used to treat acute gastritis?
PPIs, hydrogen receptor antagonists
How do the medications for acute gastritis work?
Decrease gastric activity
What is the condition of aspirin toxicity?
Salicylism
Is an acute peptic ulceration the same as a peptic ulcer?
NO
What are the two causes of acute peptic ulcerations?
Severe physiologic stress
NSAIDs
What is the recovery timeline for acute gastritis?
Heals within a few days to weeks
Acute peptic ulceration can occur in patients with what neural condition and why?
Intracranial disease due to increased ICP (via vagal nerve hypothesis)
Which is more severe: acute or chronic gastritis?
Acute gastritis
Hematemesis is rare in which kind of gastritis: acute or chronic?
Chronic
Which form of gastritis has upper abdominal “discomfort” and which has epigastric pain?
Acute - epigastric pain
Chronic - upper abdominal discomfort
Chronic gastritis is associated with what other GI condition?
Peptic ulcers
What are the two major complications associated with chronic gastritis?
Peptic ulcer disease
Gastric adenocarcinoma
70-90% of chronic gastritis cases involve which pathogen?
Helicobacter pylori
What are risk factors for chronic gastritis?
Poor childhood sanitation/hygiene
What is unique about the symptoms of chronic gastritis?
Most commonly asymptomatic (although chronic)
What are the effects of chronic gastritis on the body?
1 increased acid production
2 epithelial metaplasia leading to risk for gastric cancer
Autoimmune gastritis most commonly affects what population?
Elderly females over 60 years of age
What is autoimmune gastritis?
Gastric atrophy + chronic gastritis
Autoimmune gastritis attacks what specific GI cells and can lead to what overlying condition?
Attack parietal cells; pernicious anemia
What is pernicious anemia?
Difficulty producing RBC due to the inability to absorb vitamin B12 because of the loss of intrinsic factor
What are the locations for peptic ulcer disease?
1 proximal duodenum
2 gastric antrum (distal stomach)
What is the appearance associated with peptic ulcer disease?
Red granulation tissue as a solitary “punched-out” lesion and possible hemorrhage
What is the gender bias associated with peptic ulcer disease?
Males
Peptic ulcer disease is usually a result from what?
Chronic gastritis or hyperacidity
What is the most common pathogen involved with peptic ulcer disease?
Helicobacter pylori
Helicobacter pylori is present in what percent of PUD cases?
70-90%
Will all cases of a Helicobacter pylori infection result in PUD?
NO (only 5-10%) but remember that the majority of PUD cases DO involve H. pylori
How is smoking a risk factor for PUD?
Decreased GI blood flow
Decreased healing ability
When is the epigastric pain associated with PUD most present?
At night and 1-3 hours postprandial (after eating)
What can relieve epigastric pain due to PUD?
Alkaline substances
Is peptic ulcer disease a medical emergency?
YES (perforation/hemorrhage is possible)
Which type of ulcer is relieved after eating?
Duodenal
Which type of ulcer is worsened by eating?
Gastric
What characteristics are shared by both types of peptic ulcers?
Relieved by alkaline substances
Worse at night
Inconsistent pain patterns
What is the serious form of a gastric polyp?
Gastric adenoma
What forms of gastric polyps are common but not worrisome?
Inflammatory and hyperplastic polyp (75%)
Fundic gland polyp (15%)
Why are gastric adenomas worrisome?
30% transition into adenocarcinomas
What is the frequency of gastric adenomas?
10% (least common gastric polyp)
What is the only way to determine if a gastric polyp is worrisome?
Biopsy
What is the clinical term for an upper endoscopy?
Esophagogastroduodenoscopy
What type of cancer makes up 90% of all cases?
Gastric adenocarcinomas
What country is at a higher risk for gastric adenocarcinomas?
Japan (20X)
What are the risks for gastric adenocarcinomas?
Chronic inflammation (EBV or H. pylori) Dysplastic adenomas
What is unique about the type of cancer that is a gastric adenocarcinoma?
5% are ex-nodal lymphomas
The symptoms of gastric adenocarcinomas resemble what GI condition?
PUD
When an isolated form of gastric adenocarcinoma, what is the prognosis?
90% 5-year survivablitiy
