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GI II Block 1 > Stomach Path > Flashcards

Stomach Path Flashcards

1
Q

Protective Features of the Stomach (5)

A 
Mucus secretion
Bicarbonate in mucus
Mucosal blood flow
Epithelial cells
Prostaglandin production
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2
Q

Damaging Factors in Stomach

Normal (2) and Pathological (6)

A

Gastric acids
Peptic enzymes

H. pylori
NSAIDs
Tobacco
Alcohol
Ischemia
Duodenal-Gastric Reflux
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3
Q

Acute Gastritis

Etiology, Morphology (4) and Presentation (4)

A

Imbalance between protective and damaging factors in the stomach

Neutrophilia
Active inflammation
Erosions
Hemorrhage

Epigastric pain
N/V
Hematemesis
May be asymptomatic

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4
Q

Chronic Gastritis

Etiologies (4) and Clinical Features (3)

A

H. pylori (most common)
Autoimmune Gastritis (IF Abs)
Peptic ulcer disease
Crohn disease

Epigastric pain
N/V
Symptoms less severe but more persistent than acute

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5
Q 
Stress Related Gastric Bleeding
Associated Ulcers (2), Pathogenesis (2) and Presentation (2)
A 
Curling Ulcers (burns)
Cushing Ulcers (intracranial diseases)

Initiated by local ischemia
Vagal stimulation of acid secretion (Cushing)

Bleeding requiring transfusion
Gastric Perforation

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6
Q

Non-Stress Related Gastric Bleeding

Etiologies with Descriptions (2)

A

Dieulafoy Lesion
Erosion of large submucosal arteries

Gastric Antral Vascular Ectasia (GAVE)
Longitudinal stripes of edematous erythematous mucosa
May see fecal blood and iron deficiency anemia

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7
Q

H. pylori Gastritis

Description (2), Epidemiology, Virulence Factors (4) and Diagnosis (3)

A

Antral gastritis with increased or normal acid production

Most infections seen in people older than 60

Flagella, Urease, Adhesins and Cag-A (toxin)

Urea breath test
Fecal Ag
H. pylori Abs on serology

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8
Q

Autoimmune Gastritis

Characteristics (4), Morphology (3) and Presentation (3)

A

Abs to Parietal cell H/K ATPase and Intrinsic Factor
Reduced serum pepsinogen
Achlorhydria
Hypergastrinemia

Diffuse atrophy in body/fundus
Rugal folds gone
Endocrine cell hyperplasia

Vitamin B12 Deficiency (pernicious anemia)
Subacute combined degeneration of spinal cord
Glossitis

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9
Q 
Peptic Ulcer Disease
Risk Factors (3), Morphology, Complications (3)
A

H pylori infection
NSAIDs
Smoking

Solitary sharply punched out lesion

Perforation into peritoneum
Hemorrhage
Iron deficiency anemia

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10
Q

Gastric Polyps Clincal Features

Fundic (2) and Adenoma (3)

A

Fundic Gland Polyps
Seen in Familial Adenomatous Polyposis
Caused by long term PPI use

Gastric Adenoma
Seen in Familial Adenomatous Polyposis
Mostly males 50-60
Precursor lesion for adenocarcinoma

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11
Q

Intestinal-Type Gastric Adenocarcinoma

Epidemiology, Precursor Lesions (2), Initial Presentation Features (2) and High Risk Areas (4)

A

Rates have dropped as H pylori infections have decreased

Gastric Dysplasia
Gastric Adenoma

Mostly discovered after already metastasized
Males aged 50-60

Japan, Costa Rica, Chile, Eastern Europe

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12
Q 
Intestinal-Type Gastric Adenocarcinoma
Genetic Associations (3), Morphology, Prognostic Factors (2)
A

Mutations that increase WNT signaling
Loss of function in APC
Gain of function in genes encoding Beta-Catenin

Bulky tumors formed of glandular structures

Depth of invasion
Extent of nodal/distant metastasis

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13
Q 
Diffuse Gastric Adenocarcinoma
Genetic Associations (2), Morphology and Clinical Features (3)
A

Silencing of CDH1 causing loss of E Cadherin
BRCA2 mutation

Signet ring cells

Equal male-female incidence
No precursor lesion
No geographic tendencies

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14
Q 
Small Intestinal Carcinoid Tumors
Hormones Elaborated (3), Clinical (3) and Morphology (3)
A

Serotonin, Substance P, PPYY

Mostly asymptomatic
Can cause obstruction or metastasize

Intramural or submucosal
Small polypoid lesions
Yellow or tan

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15
Q

MALT Lymphoma

Presentation (4), Pathogenesis (2) and Morphology

A

Dyspepsia
Epigastric pain
Hematemesis
Melena

H. pylori infections
t(11;18)(q21;q21) translocations

Diagnostic lymphoepithelial

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16
Q 
Gastrointestinal Stromal Tumors
Clinical Features (4), Pathogenesis (3), Cell Types (2), 
Peds Disorder Features (3)
A

Most common GI mesenchymal tumor
Symptoms due to mass effect
Anemia
Peak at age 60

Gain of function in KIT oncogene
Activation mutation in PDGFRA
Arise from interstitial cells of Cajal

Spindle cells
Epithelioid cells

Carney Triad: GIST, Neurofibromatosis, Pulmonary condroma

17
Q 
Duodenal Ulcers
Clinical Features (3) and Drug Associations (2)
A

Elevated gastric acid
Gnawing pain hours after meals and at night
Pain initially relieved by eating/drinking

Glucocorticoids
NSAIDs

18
Q

Gastric Ulcers

Location, Clinical Features (3), Drug Associations (2)

A

Antrum of stomach

Normal gastric acid levels
Burning pain right after eating
Must perform EGD to rule out malignancy

NSAIDs
Salicylates

GI II Block 1 (12 decks)

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