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GI II Exam 1 > Stomach Path II > Flashcards

Stomach Path II Flashcards

1
Q

hypertrophic gastropathy

A

menetrier and zollinger ellision

can mimic cancer

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2
Q

menetrier disease

A

excessive TGF-alpha secretion
-unknown cause

protein losing enteropathy

weight loss, diarrhea, peripheral edema

body and fundic involvement

increased risk of adenocarcinoma

premalignant**

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3
Q

nausea, vomiting, loss of appetite, weight loss, hypoalbuminemia, edema, age 30-60yo

A

menetrier disease

increased risk for adenocarcinoma

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4
Q

tx of menetrier

A

high protein diet

cetuximab - M-Ab against EGFR

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5
Q

menetrier prognosis

A

children - goes away

adults - doesn’t go away

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6
Q

zollinger ellison syndrome

A

gastrin secreting tumor
-gastrinoma

chronic diarrhea and multiple peptic ulcers

increase in number of parietal cells

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7
Q

tx zollinger ellison

A

block acid production and remove tumor

majority malignant**

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8
Q

ZES path

A

non-beta islet cell gastrin tumor of pancreas stimulating acid secretion of stomach

auto dom - MEN-1

pancreas, duodenum, or abdominal lymp nodes

majority malignant

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9
Q

diagnosis of ZES

A

secretin stimulation test
fasting gastrin levels - 3 occasions
gastric acid secretion and pH - > 15mEq/hour

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10
Q

octreotide

A

best drug for ZES tx

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11
Q

fundic gland polyps

A

proton pump inhibitor related - secondary to increased gastrin

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12
Q

gastric adenomas

A

benign

proliferative dysplastic epithelium

in chronic gastritis with atrophy and intestinal metaplasia

risk or carcinoma if >2cm

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13
Q

corkscrew shaped foveolar glands

A

hyperplastic gastric polyp

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14
Q

epithelial dysplasia

A

gastric adenoma

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15
Q

3rd most common cause of cancer death worldwide

A

carcinoma of stomach

80% with h. pylori infection

majority from surface of glandular epithelial of stomach - adenocarcinoma

aggressive

decreasing incidence in US

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16
Q

gastric cancers

A

going down in incidence in US

the intestinal type **

17
Q

adenocarcinoma in stomach

A

two types

intestinal type - non-signet

diffuse type - signet ring

18
Q

intestinal type adenocarcinoma

A

non-signet ring

decline in incidence

h. pylori association

APC/WNT pathway

masses that ulcerate

antrum/pylorus

19
Q

diffuse type adenocarcinoma

A

signet ring

no decline in incidence

no association with h pylori

E-cadherin mutation

throughout stomach

20
Q

WNT-APC pathway

A

control of beta-catenin levels

which goes to nucleus promoting cell division and cell cycle progression

mutation in APC - colon polyps - no destruction of beta-catenin - cells progress to cycle uncontrolled

21
Q

E-cadherin mutation

A

signet ring
-diffuse type

cells don’t stick together - diffuse

as well as lobular ca of breast

22
Q

sister mary joseph

A

nodule on umbilicus

stomach carcinoma

23
Q

irish node

A

axillary

stomach carcinoma

24
Q

virchows node

A

left supraclavicular

stomach carcinoma

25
Q

advanced stomach carcinoma

A

to muscularis propria and beyond

26
Q

linitis plastica

A

gastric wall thick and folds lost

diffuse type

mutation in CDH1 - loss of E-cadherin

27
Q

elevated mass with heaped up borders and central ulceration

A

intestinal type carcinoma

28
Q

usual gastric carcinoma

A

intestinal type

  • non-signet
  • has h pylori association

most common antrum

29
Q

intestinal type

A

has holes**

both mucin positive

30
Q

signet type

A

no holes**

mucin in cytoplasm
-signet ring like shape**

both mucin positive

31
Q

B cell MALT

A

5% gastric malignancies

32
Q

most common site of extra-nodal lymphoma

A

stomach

MALToma - h pylori

high grade DLBCL

33
Q

MALToma

A

t (11;18)
t(1;14)
t(14;18)

all constitutive activation of NF-kappaB

promotes B cell growth

often h pylori related

CD19 and CD20 positive - B cell markers

34
Q

2nd most common gastric lymphoma

A

DLBCL

35
Q

GIST

A

gastrointestinal stromal tumor

from interstitial cells of cajal - pacemaker cells

smooth m/neural

most common mesenchymal tumor**

Male age 60yo

36
Q

mutation in GIST

A

c-KIT - CD117 mutation majority

also some PDGFRA mutation

37
Q

gleevac

A

imatinib - tx of CML and GIST

same genetic defect - philly chromosome

ABL-BCR tyrosine kinase mutation

38
Q

spindle cell feature

A

GIST

GI II Exam 1 (29 decks)

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