010715 stomach dis 4 Flashcards
(24 cards)
shape of H pylori
spiral shaped
where does H pylori colonize exchlusively
gastric type epithelium
effects of H pylori colonization
stimulates inflammatory responses
hallmark of H pylori
neutrophilic infiltration
along with lymphocytes, plasma cells, macrophages
where does early stage h pylori gastritis occur
confined to ANTRUM
mechanism of h pylori in causing ulcers in its early stage
inhibits D cell somatostatin secretin so gastrin secretion is increased
acid secretion is increased, causing ulcers
late stage of chronic h pylori gastritis occurs where
inflammation expands to CORPUS/FUNDUS
mechanism of h pylori in causing ulcers in the late stage
in corpus/fundus, destroys parietal cells
decreased acid production causes gastrin increase
how to diagnose h pylori infec?
serology (false positive b/c persists even after eradication)
endoscopic gastric mucosa biopsy
urea breath test
stool antigen test
false negative with recent antibiotics or PPI therapy
adverse effects of h pylori infection
peptic ulcer
enteric infections
malnutrition (iron and B12 deficiency)
gastric neoplasia (adenocarcinoma, MALT lypmphoma, carcinoid)
autoimmune gastritis
inherited form is associated with immune response in oxyntic mucosa against parietal cells and IF
histology of autoimmune gastritis
lymphocytic inflam with destruc of parietal cells
atrophic metaplastic gastritis
could be in body and fundus or antrum:
autoimmune
vs
H pylori
gastritis vs gastropathy
gastritis: INFLAM associated mucosal injury (infectious, autimmune)
gastrophathy: epithelial cell damage and regeneration with MINIMAL OR NO ASSOCIATED INFLAM (bile, alcohol, aspirin, NSAIDs, ischemia)
ulcer
destructive breach of mucosa that extends below muscularis mucosa
erosion
destruction superficial to muscularis mucosa
peptic ulcer disease-what are some causes?
90% due to
aspirin/NSAIDs (can directly cause rapid cell death and superficial mucosal injury in addition to reduced prostaglandin)
H pylori
surreptitious or unaware NSAID use
complications of peptic ulcer disease
acute GI hemorrhage chronic GI blood loss or iron def anemia perforation, peritonitis, pancreatitis gastric outlet obstruction gastointestinal fistula malabsoprtion
symptoms of peptic ulcer dis
chronic dyspeptic epigastric pain acute severe pain--indicates perforation nausea anorexia, weight loss hematemesis melena recurrent postprandial vomiting (obstruction) diarrhea (fistula)
or no symptoms
dyspepsia
discomfort in upper abdomen
anion gap acidosis can occur with
NSAID s
ulcers can cause edema causing obstruction-true or false?
true
salicylate
aspirin
octreotide scan
to look for carcinoids and other tumors, sarcoidosis
