wk 3 12 - pathology of stomach

Question 1

3 causes of chronic gastritis (ABC)

Answer 1

autoimmune
bacterial - helicobacter pylori main
chemical

Question 2

likely cause of acute gastritis

Answer 2

severe shock (burns,trauma, chemical )

Question 3

autoimmune chronic gastritis is due to production of what antibodies

Answer 3

due to immune anti-parietal (acid cells) and anti-intrinsic factor (B12 broken down before reaching sml bowel) antibodies

Question 4

b12 deficiency leads to

Answer 4

anaemia

neurone exposure - b12 required for myelin

Question 5

how does helicobacter pylori inhabit the gastric area

Answer 5

lives between epithelial cell surface and mucous barrier

Question 6

h.pylori excits

Answer 6

acute inflam response

if not cleared - chronic

Question 7

3 causes of chemical gastritis

Answer 7

NSAIDs (non-steroidal anti-infalm) (ibuprofen)
Alcohol
bile reflux

Question 8

effect of chemical gastritis

Answer 8

direct injury to mucus layer by fat solvents
epithelial regeneration, hyperplasia, congestion, little inflammation
ulcers

Question 9

chemical gastritis looks histologically

Answer 9

similar to small bowel - villi structure

Question 10

define peptic ulceration

Answer 10

discontinuity of epitheliium

breach in gi mucosa - due to acid and pepsin attack

Question 11

t/f peptic ulceration is more likely to be chronic gastritis

Answer 11

true

Question 12

main sites of chronic peptic ulcers

Answer 12

duodenum (1st)
stomach (body - antrum junction)
oesophago-gastric junction
stomach ulcers

Question 13

leads to chronic duodenal ulcers

Answer 13

high sustained secretion of acid

H.pylori - too much acid, dumped into duodenum, comes more like gastric antrum. (inflam, epi damage, ulceration

Question 14

other than acid production, what else is another key factor for chronic peptic ulcers

Answer 14

failure of mucosal defence

Question 15

characteristics of peptic ulcers on microscope

Answer 15

layered
necrotic fibrinopurulent debris
inflamed granulation tissue
scar tissue

Question 16

complication of peptic ulcers

Answer 16

perforation 
penetration 
haemorrhage
stenosis
intractable pain

Question 17

3 main gastric malignant tumours

Answer 17

carcinoma
lymphoma
gastrointestinal stromal tumours

Question 18

pernicious anaemia

Answer 18

autoimmune gastritis

Question 19

4 conditions which may lead to gastric adenocarcinoma

Answer 19

pernicious anaemia
partial gastrectomy
Lynch syndrome
menetrier’s disease

Question 20

gastric adenocarcinoma can be either an intestinal type or diffuse type, explain difference

Answer 20

intestinal - exophytic/ polypoid mass

diffuse - expands, infiltrates wall

Question 21

difference in look of peptic ulcers and gastric adenocarcinoma

Answer 21

adeno - crater like
-pus,exudate blood

peptic - punched out

difference important, peptic - benign

Question 22

gastric adenocarcinoma spreads haematogenically, where does it go tob

Answer 22

liver

Question 23

h.pylori associated with what cancer, how

Answer 23

gastric lymphoma

continous inflammation induced aclonal b-cell proliferation
if unchecked evolves into high grade b cell lymphoma