wk 3 12 - pathology of stomach Flashcards
3 causes of chronic gastritis (ABC)
autoimmune
bacterial - helicobacter pylori main
chemical
likely cause of acute gastritis
severe shock (burns,trauma, chemical )
autoimmune chronic gastritis is due to production of what antibodies
due to immune anti-parietal (acid cells) and anti-intrinsic factor (B12 broken down before reaching sml bowel) antibodies
b12 deficiency leads to
anaemia
neurone exposure - b12 required for myelin
how does helicobacter pylori inhabit the gastric area
lives between epithelial cell surface and mucous barrier
h.pylori excits
acute inflam response
if not cleared - chronic
3 causes of chemical gastritis
NSAIDs (non-steroidal anti-infalm) (ibuprofen)
Alcohol
bile reflux
effect of chemical gastritis
direct injury to mucus layer by fat solvents
epithelial regeneration, hyperplasia, congestion, little inflammation
ulcers
chemical gastritis looks histologically
similar to small bowel - villi structure
define peptic ulceration
discontinuity of epitheliium
breach in gi mucosa - due to acid and pepsin attack
t/f peptic ulceration is more likely to be chronic gastritis
true
main sites of chronic peptic ulcers
duodenum (1st)
stomach (body - antrum junction)
oesophago-gastric junction
stomach ulcers
leads to chronic duodenal ulcers
high sustained secretion of acid
H.pylori - too much acid, dumped into duodenum, comes more like gastric antrum. (inflam, epi damage, ulceration
other than acid production, what else is another key factor for chronic peptic ulcers
failure of mucosal defence
characteristics of peptic ulcers on microscope
layered
necrotic fibrinopurulent debris
inflamed granulation tissue
scar tissue
complication of peptic ulcers
perforation penetration haemorrhage stenosis intractable pain
3 main gastric malignant tumours
carcinoma
lymphoma
gastrointestinal stromal tumours
pernicious anaemia
autoimmune gastritis
4 conditions which may lead to gastric adenocarcinoma
pernicious anaemia
partial gastrectomy
Lynch syndrome
menetrier’s disease
gastric adenocarcinoma can be either an intestinal type or diffuse type, explain difference
intestinal - exophytic/ polypoid mass
diffuse - expands, infiltrates wall
difference in look of peptic ulcers and gastric adenocarcinoma
adeno - crater like
-pus,exudate blood
peptic - punched out
difference important, peptic - benign
gastric adenocarcinoma spreads haematogenically, where does it go tob
liver
h.pylori associated with what cancer, how
gastric lymphoma
continous inflammation induced aclonal b-cell proliferation
if unchecked evolves into high grade b cell lymphoma
