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GI/GU Illness > Stomach and Peptic Ulcer Disease > Flashcards

Stomach and Peptic Ulcer Disease Flashcards

1
Q

What are the mucosal defences of the stomach? (6)

A
  1. mucous
  2. phospholipids
  3. bicarb
  4. epithelial cells
  5. blood flow
  6. prostaglandin E2 and I2
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2
Q

What is pyloric stenosis?

A

congenital concentric narrowing of the pyloric sphincter and narrowing of the pyloric canal

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3
Q

What is the pathology of pyloric stenosis?

A

muscular hypertrophy of pyloric circular muscle coat

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4
Q

What are the symptoms of pyloric stenosis?

A

projectile vomiting in the 2nd or 3rd week of life

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5
Q

What are the causes of chronic gastritis? (3)

A
  1. helicobacter pylori infection
  2. autoimmune
  3. chemical damage
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6
Q

What is acute gastritis?

A

acute mucosal inflammation, without glandular loss or atrophy usually of a transient nature

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7
Q

What are the associations of acute gastritis? (9)

A
  1. NSAID use
  2. alcohol
  3. smoking
  4. chemotherapy
  5. uraemia
  6. systemic infections
  7. stress
  8. ischaemia
  9. neurotrauma
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8
Q

What are the gross features of acute gastritis? (3)

A
  1. shiny oedema
  2. hyperaemia and intramucosal haemorrhage - red
  3. multiple superficial erosions
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9
Q

What are the histological characteristics of chronic gastritis? (5)

A
  1. presence of chronic mucosal leucocytic infiltrate
  2. lymphocytes
  3. plama cells
  4. +/- neutrophils
  5. +/- epithelial changes
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10
Q

What is chronic gastritis associated with? (3)

A
  1. h pylori
  2. autoimmunity
  3. reflux
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11
Q

What is the most common cause of chronic gastritis?

A

h pylori

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12
Q

What virulence factors does h pylori use for colonisation?

A
  1. Urease
  2. flagella
  3. adhesins
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13
Q

What virulence factors does H pylori use for immune escape?

A
  1. flagella
  2. CagA
  3. VacA
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14
Q

What is the histology of chronic gastritis caused by h pylori? (4)

A
  1. HLOs on surface epithelium
  2. chronic inflammation
  3. lymphoid follicle formation
  4. MALT
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15
Q

What are the host factors that influence H pylori gastritis? (3)

A
  1. blood group A
  2. cytokine
  3. receptor gene polymorphisms
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16
Q

What are the two patterns of h pylori associated gastritis?

A
  1. antral gastritis

2. pangastritis

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17
Q

What is the most common pattern of h pylori associated gastritis?

A

antral gastritis

18
Q

What are the risks of h pylori associated gastritis? (3)

A
  1. peptic ulcer disease
  2. gastric carcinoma risk
  3. Maltoma
19
Q

What does the body generate antibodies against in autoimmune gastritis?

A
  1. parietal cells

2. intrinsic factor

20
Q

When does chemical/reactive chronic gastritis occur?

A
  1. post surgery cholecystectomy, by-pass
  2. bile acids are an irritant
  3. NSAIDS
  4. alcohol
21
Q

What are the characteristics of chemical/reactive gastritis? (3)

A

1, oedema

  1. vasodilation
  2. scant leucocytes
22
Q

What is the definition of a gastric ulcer?

A

a breach in the mucosa of the alimentary tract that extends through the muscularis mucosa into the submucosa or deeper

23
Q

What is the definition of peptic ulceration?

A

a breach in the mucosal lining of the alimentary tract as a result of acid and pepsin attack

24
Q

What are the sites of peptid ulcer disease? (2)

A
  1. first part of duodenum

2. stomach

25
Q

What is the cause of peptic ulcer disease? (6)

A
  1. shift in balance from mucosal defence to mucosal damage
  2. h pylori
  3. hyperacidity
  4. decreased prostaglandins
  5. irritants
  6. genetic factors
26
Q

What are the causes of acute peptic ulcers? (2)

A
  1. stress

2. extreme hyperacidity

27
Q

What is the gross appearance of chronic peptic ulcers? (6)

A
  1. 80% solitary
  2. 1-3cm
  3. round to oval
  4. sharply punched out
  5. straight walls
  6. overhang base
28
Q

Where do duodenal ulcers usually occur? (2)

A
  1. 90% first part

2. anterior wall

29
Q

Where do gastric ulcers usually occur?

A
  1. predominantly on lesser curvature
30
Q

What are the complications of peptic ulcer disease? (5)

A
  1. perforation - peritonitis
  2. penetration - adjacent organ
  3. haemorrhage
  4. stenosis/stricture
  5. malignant change
31
Q

What are the clinical features of peptic ulcer disease? (2)

A
  1. dyspepsia

2. epigastric pain

32
Q

What is a polyp?

A

protuberant mass of tissue

33
Q

What are the majority of mesenchymal tumours?

A

gastrointestinal stromal tumours

34
Q

What cells are affected by gastrointestinal stromal tumours?

A

interstitial pacemaker cells of cajal

35
Q

What are the mutations associated with gastrointestinal stromal tumours? (2)

A
  1. C-Kit

2. PDGFRA tyrosine kinase mutations

36
Q

What are adenomas?

A

benign glandular epithelial neoplasms

37
Q

What are the majority of malignant gastric tumours?

A

adenocarcinomas

38
Q

What are the different types of gastric adenocarcinomas?

A
  1. intestinal type - glands

2. diffuse - signet ring single cells

39
Q

What is intestinal gastric adenocarcinoma associated with?

A
  1. h pylori
  2. autoimmune gastritis
  3. intestinal metaplasia
  4. low acid
  5. altered flora
  6. carcinogens
  7. preserved food
  8. high prevalence areas
40
Q

What is diffuse gastric adenocarcinoma associated with?

A
  1. low prevalence areas
41
Q

What do gastric lymphomas present with? (3)

A
  1. weight loss
  2. dyspepsia
  3. abdominal pain
42
Q

What are the types of gastric lymphomas?

A
  1. high grade diffuse large B cell lymphomas

2. low grade B cell lymphomas - MALTOMAS

GI/GU Illness (15 decks)

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