17-3 -- Stomach

Question 1

The Gastric Mucosa has many factors that protect it. List 5.

Answer 1

• Prostaglandins
• Mucous secretion and mucosal blood flow
• Bicarbonate secretion
• Epithelial barrier and regenerative capactiy

Question 2

The Gastric Mucosa has many factors that protect it. List 5.

Answer 2

• Prostaglandins
• Mucous secretion and mucosal blood flow
• Bicarbonate secretion
• Epithelial barrier and regenerative capacity

Question 3

The Gastric Mucosa has many factors that can damage it. List 3.

Answer 3

• Acid
• Peptic enzymes
• Injury - ex. H.pylori, NSAIDs, alcohol

Question 4

The Gastric Mucosa has many factors that can damage it. List 3.

Answer 4

• Acid
• Peptic enzymes
• Injury - ex. H.pylori, NSAIDs, alcohol

Question 5

Acute Gastritis

Answer 5

Inflammation of gastric mucosa when Neutrophils are present

Question 6

With Acute Gastritis, what inflammatory cell must be present?

Answer 6

Neutrophils

Question 7

Gastropathy

Answer 7

Inflammation of gastric mucosa when NO inflammatory cells present

Question 8

What causes Gastritis?

Answer 8

Damaging forces overwhelm the protective factors of the mucosa

Question 9

What can cause Acute Gastritis?

Answer 9

NSAIDs, alcohol, bile

Question 10

How do NSAIDs cause Acute Gastritis?

Answer 10

(-) COX = DECREASED prostaglandin synthesis

prostaglandin is a protective factor

Question 11

What histo signs will be present with Acute Gastritis?

Answer 11

Foveolar cell hyperplasia, edema

Neutrophils above the basement membrane

Question 12

2 types of Chronic Gastritis and what causes them?

Answer 12

Type A - autoimmune

Type B - H.pylori

Question 13

Type A Chronic Gastritis has what blood change?

Answer 13

Hypergastrinemia

Question 14

Type A Chronic Gastritis location and damage?

Answer 14

Body and fundus of stomach

= Diffuse mucosal damage

Question 15

Type A Chronic Gastritis has antibodies to?

Answer 15

Parietal cells and Intrinsic factor

= Decreased acid ==> Hypergastrinemia trying to compensate

Question 16

Achlorhydria

Answer 16

Decreased gastric acid secretion

Question 17

What symptoms may be seen with Type A Chronic Gastritis?

Answer 17

Pernicious anemia - LOW B12

= Glossitis and CNS issues

Question 18

Type B Chronic Gastritis location and damage?

Answer 18

Antrum of stomach

= Patchy mucosal damage

Question 19

Type B Chronic Gastritis acid production?

Answer 19

Normal - increased

Type A = decreased

Question 20

Main cell types with Type A and B Chronic Gastritis?

Answer 20

Type A - lymphocytes and macrophages

Type B - Neutrophils

Question 21

Pathogenesis for stress ulcers?

Answer 21

Local ischemia!

Question 22

What do the stress ulcers look like?

Answer 22

Multiple, round with brown/black base anywhere in the stomach

Question 23

How should you treat stress ulcers?

Answer 23

Treat underlying condition

Question 24

Curlings and Cushings stress ulcers

Answer 24

Curlings = associated with extensive burns
Cushings = brain/trauma and lesions

Question 25

2 Non-stress ulcers?

Answer 25

GAVE

Dieulafoy lesion

Question 26

Dieulafoy lesion

Answer 26

Abnormal artery at the lesser curvature of the stomach

= recurrent gastric bleeding

Question 27

Penetrating ulcers will cause?

Answer 27

Referred pain

Question 28

How do ulcers look with PUD?

Answer 28

SINGLE ulcer - punched out appearance

Question 29

3 Complications of PUD?

Answer 29

Bleeding
Perforation
Obstruction