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GI II Exam 1 > Stomach Path I > Flashcards

Stomach Path I Flashcards

1
Q

parietal cells

A

HCl and IF

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2
Q

chief cells

A

protelytic enzymes

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3
Q

stomach ulceration

A

smooth border - better

rough border - likely malignant

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4
Q

acute gastritis

A

acute mucosa inflammation

-neutros present - w/ or w/out ulceration

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5
Q

acute hemorrhagic gastritis

A

erosive with bleeding

  • with NSAIDs, aspirin
  • alcoholic
  • heavy smoker
  • stress
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6
Q

stress ulcer

A

tx with PPIs
-pt with shock, burns, sepsis, trauma, critically ill

curling - burns/trauma
cushings - intracranial bleed

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7
Q

erosion

A

stressed situation

-not an ulcer

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8
Q

h. pyloric

A

inhibition of gastric bicarb transporters

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9
Q

curling ulcer

A

severe stress situations

-burns, trauma, sepsis, etc.

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10
Q

cushing ulcer

A

intracranial injury - disrupted vagal activity

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11
Q

chronic gastritis

A

presence of chronic mucosal inflammatory changes
-atrophy and metaplasia

majority - h. pylori infection

autoimmune - pernicious anemia - < 10%

also with drugs, alcoholi, toxins

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12
Q

giemsa and steiner silver stain

A

h. pylori

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13
Q

CagA

A

toxin of h. pyloric - may be involved in ulcer or cancer development

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14
Q

chronic inflammation of antrum

A

almost always h. pylori

increased acid production

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15
Q

entire stomach chronic inflammation

A

alcohol, smoking, etc.

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16
Q

h. pylori virulence

A

1 flagella
2 urease
3 adhesins
4 toxins - CagA

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17
Q

duodenal ulcers

A

increased risk with h pylori chronic gastritis

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18
Q

active chronic gastritis

A

PMNs

-hallmark of ongoing h. pylori infection

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19
Q

swallow urea with carbon-14 tag - do breath test

A

if positive - h. pylori

-takes up C-14 and CO2 given off has this tagged carbon

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20
Q

mucosal atrophy in chronic gastritis

A

marker for increased cancer risk

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21
Q

tx h pylori

A

PPIs and antibiotics

22
Q

h pylori diagnosis

A

detection of organism in biopsy

often in antrum

23
Q

autoimmune gastritis

A

spares antrum

  • includes hypergastrinemia - achlorydia
  • defective gastric acid secretion

aka atrophic

24
Q

autoimmune gastritis path

A

Abs to parietal cells and IF - detected in serum and gastric secretions

CD4 T cells against parietal cell components** - H/K ATPase

chief cells also get destroyed

25
Q

pernicious anemia

A

with autoimmune gastritis if severe

26
Q

oxyntic mucosa

A

acid producing

27
Q

autoimmune gastritis histo

A

glandular atrophy and inflammatory infiltrates

destroys acid producing mucosa in body nd fundus

may see intestinal metaplasia

28
Q

autoimmune gastritis

A

60yo female

often with other autoimmune disease - hashimotos, DM, addison, graves, etc.

29
Q

atrophic glossitis

A

smooth beefy tongue

-with B12 deficiency

30
Q

reactive gastropathy

A

chemical injury
NSAID use
bile reflux
trauma

31
Q

eosinophilic gastritis

A

allergy, parasites, h. pylori

32
Q

lymphocytic gastritic

A

celiac

33
Q

granulomatous gastritis

A

crohn, mycobacteria, fungi, CMV, h. pylori

34
Q

trichobezoar

A

hair ball in stomach

35
Q

peptic ulcer

A

chronic solitary lesions in part of GI tract exposed to lots of acid

usually with chronic gastritis - association with h. pylori and NSAID use

36
Q

ulcer

A

by definition through the muscularis mucosa

37
Q

erosion

A

limited to mucosa

38
Q

PUD clinical

A

duodenal, male, h. pylori related

also esophagus with GERD or meckel diverticulum with gastric mucosa

pretty common

39
Q

zollinger ellison syndrome

A

uncontrolled release of gastrin by tumor

get lots of acid - can cause ulcers

40
Q

hypercalcemia

A

stimulate gastrin production and increased acid secretion

41
Q

classic peptic ulcer

A

sharply punched out defect

heaped up margins - in cancer

42
Q

pneumoperitoneum

A

air within abdominal cavity

43
Q

tx of PUD

A

antibiotics - h pylori
PPI
surgery if severe bleeding/perforation

44
Q

melena

A

black tarry stools

stool in contact with acid - in upper GI bleeds

45
Q

hematochezia

A

bright red blood in stool

-lower GI bleed

46
Q

coffee grounds

A

slow bleeding/oozing

47
Q

red blood/clots

A

active ongoing bleeding

48
Q

bile stained

A

no bleeding above treitz ligament

49
Q

clear

A

competent pylorus - but bleeding could still be occuring

50
Q

confirmation of bleeding location

A

upper GI endoscopy

  • EGD
  • diagnostic and therapeutic
  • inject epi or electro coag techniques

can biopsy with EGD - determine h. pylori infection

GI II Exam 1 (29 decks)

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