Stomach/ Esophagus

Question 1

• G cell releases? D cell?
• Gastric emptying decreases with? (3)
  1. ) 2 types of gastritis? Location? Acid production?
  2. ) Thickened Gastric Folds: Increased mucus? Hypersecretory acid state?
  3. ) Gatropathy means? Causes? (5)
• PG’s do what? PGE2? I2? Both part of?
  4. ) PUD: Causes? (3) GU gender? DU?
  5. ) Stress ulcers usually where?
• Neoplasm: Unrelated to H. pylori but is with PPI? AC related to? Stromal GIST CD117 + treat with? NE tumors lead to? Lymphoma type/ cause?

Answer 1

• gastin; somatostatin
• Acid, fat, increased osmolarity
  1. ) Autoimmune (body); Infectious (Antrum) ; higher acid means less severe
  2. ) Menetriers; Zollinger Ellison
  3. ) Non inflamm; NSAIDs, ethanol, stress, cocaine, bile reflux
• Mucus/bicarb secretion; protect gut; homeostasis; COX 1
• H pylori, smoke, NSAIDS; equal; M>F
• Gastric polyps; H pylori; GISTs –> gleevac; ZE; MALT/ h.pylori

Question 2

• Malignant stomach cancers? (4)
• Autoimmune associated with? (2)
• Stomach polyps:
  a. ) Hyperplastic: Malig? Assoc with? Prolif of?
  b. ) Fundic: Malig? Assoc with? Prolif of?
  c. ) Dysplastic: Malig? Assoc with? Prolif of?
• 2 types of AC in stomach/look? Risk factors? Age? Look?
• GIST malignancy of? Where?
• Carcinoid from?
• Common metastatic? (2)

Answer 2

• AC, GIST, Carcinoid, Lymphoma
• Achlorhydria/hypergastinemia
  a. ) No; Chronic gastritis; Foveolar epi/lp
  b. ) No; FAP; cystic dilation/ fundic glands
  c. ) Yes; Adenoma; Epi
  1. ) Intestinal: M>F; Older; H. Pylori, Tobacco, FAP, HNPCC; ulcer with heaped up edges
  2. ) Diffuse: M=F; younger; NO precursor lesion; CDH1 mutation; Linitis plastica/ signet ring cells
• Cajal, Musc. Propia nerve plexus
• Enterochromaffin
• Melenoma/ Breast

Question 3

• Esophagus layers? (4)
• 4 causes of esophagitis?
• 5 causes of reflux?
• 2 Infectious agents?
• Eisino esoph looks like?
• 2 types of esophageal obstruction? related to?
• Severe wretching leads to?
• Barrett esophagus progression? (4)
• AC: More where? More common in? Assoc with? (3)
• SCC: More where? Assoc with? (3)

Answer 3

• Squamus mucosa, Musc. Mucosa, Sub mucosa, Musc. Pro
• Chemical, infection, immune, radiation
• Trans. LE relax, hiatal hernia, low LES tone, intra ab pressure, delayed emptying
• HSV/ Candidia
• Rings
• Functional (Nm); Structural (Blocked)
• Mallory Weiss Tears
• GERD –> BE/meta –> Dysplasia –> AC
• US; Males; GERD, Tobacco, Radiation
• Worldwide; Alcohol, tobacco, diet

Question 4

• Oropharynx obstruction presents with? Causes? (3) Test?
• Oro propulsive all same but add? 6 causes? Test?
• Esophagus obs: Present with? (3) 4 causes? 2 tests?
• Esophagus prop: Present with? (2) 4 causes? 3 tests?
• Treatment for eisino esoph? (3)
• 3 types of achlasia? Due to?
• oral phase? pharyngeal phase?
• PSS: Due to?

Answer 4

• Choke, cough, nasal reurg., aspir; Cancer, Zenker, Radiation; Barium swallow
• Transfer dysphagia; Stroke, MS, ALS, Park, MG, MD; BS
• Solid vomit, regurg; Stricture, rings, EoE, Compression; EGD Esophragrams
• Solid and liquid; Achlasia, Spasm, Sclero, Cancer; Manom.
• Drugs, dilation, diets
• Classic = no change in pressure; 2 = pressure over entire 3= spastic; loss of inhibitory neurons in my plexus
• voluntary; involuntary
• Small vessel vasculitis –> SM atrophy/gut wall fibrosis