Stomach Pathoma Flashcards
What is acute gastritis?
Acute mucosal inflammation of the stomach due to increased acid production or decreased mucosal protection.
What are the major causes of acute gastritis?
NSAIDs (↓ PGE2 → ↓ mucus & HCO3⁻ production), Alcohol (direct mucosal damage), Burns (Curling ulcer: hypovolemia → mucosal ischemia), Brain injury (Cushing ulcer: ↑ vagal tone → ↑ acid secretion), Chemotherapy, shock, severe stress.
What are the two types of chronic gastritis?
Chronic autoimmune gastritis & chronic H. pylori gastritis.
What is the pathogenesis of chronic autoimmune gastritis?
Autoantibodies against parietal cells & intrinsic factor → loss of acid production (achlorhydria) & vitamin B12 deficiency (pernicious anemia).
What part of the stomach is affected in chronic autoimmune gastritis?
The body and fundus of the stomach (where parietal cells are located).
What is the pathogenesis of chronic H. pylori gastritis?
H. pylori urease & proteases weaken mucosal defenses, leading to chronic inflammation.
What part of the stomach is affected in chronic H. pylori gastritis?
The antrum (initial site of infection).
What are complications of chronic H. pylori gastritis?
Peptic ulcer disease (PUD), gastric adenocarcinoma (intestinal type), MALT lymphoma.
How is chronic H. pylori gastritis treated?
Triple therapy: PPI + clarithromycin + amoxicillin/metronidazole.
What are the two most common locations of peptic ulcers?
Proximal duodenum (90%) & distal stomach (10%).
What are the differences between duodenal & gastric ulcers?
Duodenal ulcer: caused by H. pylori (95%), pain decreases with meals. Gastric ulcer: caused by H. pylori (75%) & NSAIDs, pain worsens with meals.
What are the complications of peptic ulcer disease?
Bleeding (gastroduodenal artery in duodenal ulcer; left gastric artery in gastric ulcer), perforation (pneumoperitoneum), gastric outlet obstruction.
What are the two types of gastric carcinoma?
Intestinal type & diffuse type.
What is the risk factor for intestinal-type gastric adenocarcinoma?
H. pylori infection, nitrosamines, smoked foods, chronic gastritis, blood type A.
What are the key histological features of diffuse-type gastric carcinoma?
Signet ring cells (mucin-filled cells with peripheral nuclei), linitis plastica (thickened stomach wall).
What is the most common site of metastasis for gastric carcinoma?
Liver.
What are other metastatic sites & associated findings in gastric cancer?
Virchow node (left supraclavicular lymph node), Sister Mary Joseph nodule (periumbilical metastasis in intestinal type), Krukenberg tumor (bilateral ovarian metastasis, seen in diffuse type).
What is Leser-Trélat sign?
Sudden appearance of multiple seborrheic keratoses, seen in gastric cancer (paraneoplastic syndrome).
What is the prognosis of gastric carcinoma?
Poor prognosis due to late presentation (weight loss, abdominal pain, early satiety, anemia).
