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Pathoma GI > 10.4 Stomach > Flashcards

10.4 Stomach Flashcards

1
Q

Congenital malformation of the anterior abdominal wall leading to exposure of abdominal contents (NOT covered by peritoneum)

A

Gastroschisis

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2
Q

Persistent hernia of bowel into umbilical cord due to failure of herniated intestines to return to the body vacuity during development; contents are covered by peritoneum and amnion of umbilical cord

A

Omphalocele

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3
Q

Congenital hypertrophy of pyloric smooth muscle; more common in males; presents 2 weeks after birth

A

Pyloric stenosis

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4
Q

Pyloric stenosis presents two weeks after birth with:

A
  1. projectile non bilious vomiting
  2. visible peristalsis
  3. olive like mass in the abdomen
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5
Q

pyloric stenosis treatment

A

myotomy

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6
Q

3 stomach defenses against acid

A
  1. mucin layer produced by foveolar cells
  2. bicarb secretion by surface epithelium
  3. normal blood supply (provides nutrients and picks up leaked acid)
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7
Q

Why does severe burn –> acute gastritis (curling ulcer)?

A

Curling ulcer - hypovolemia –> decreased blood supply

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8
Q

why do NSAIDS –> acute gastritis?

A

Decreased PGs –> decreased BF, mucus, bicarb… other stuff! look up!

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9
Q

why does increased intracranial pressure –> acute gastritis (cushing ulcer)?

A

increased stimulation of vagus nerve –> increased ACh –> stimulates parietal cell to produce more HCl

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10
Q

6 risk factors for acute gastritis

A
  1. Severe burn
  2. NSAIDs
  3. Heavy alcohol consumption
  4. Chemotherapy
  5. Increased ICP
  6. Shock
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11
Q

what do you call loss of superficial epithelium in stomach?

A

erosion

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12
Q

what do you call loss of mucosal layer (and a bit of submucosa) in stomach?

A

ulcer

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13
Q

what are the two types of chronic gastritis?

A

chronic autoimmune and chronic H pylori

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14
Q

where are parietal cells located?

A

body and fundus

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15
Q

chronic AI gastritis pathogenesis mediated by

A

T cells (type IV hSR)

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16
Q

chronic AI gastritis is associated with antibodies against

A

parietal cells and/or intrinsic factor (but it’s the T cells causing the real damage!)

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17
Q

3 clinical features of chronic AI gastritis

A
  1. atrophy of mucosa with intestinal metaplasia
  2. achlorhydria with increased gastrin levels and antral G-cell hyperplasia
  3. Megaloblastic (pernicious) anemia due to lack of IF
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18
Q

Chronic AI gastritis increases risk for

A

gastric adenocarcinoma (intestinal type)

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19
Q

What H pylori proteins (along with inflammation) weaken mucosal defenses ?

A

ureases and proteases

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20
Q

most common site for H pylori gastritis

A

antrum

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21
Q

H pylori gastritis presentation

A

epigastric abdominal pain

22
Q

H pylori gastritis increases risk for three things

A
  1. peptic ulcer disease
  2. gastric adenocarcinoma (intestinal type)
  3. MALT lymphoma
23
Q

H pylori gastritis treatment

A

triple therapy!

  • PPI
  • clarithromycin
  • amoxicillin
24
Q

confirm H pylori eradication with?

A

negative urea breath test, lack of stool antigen

25
Q

most common location for solitary mucosal peptic ulcer

A

proximal duodenum

26
Q

Causes of duodenal ulcer

A

H pylori (95%) or ZES (5%)

27
Q

Epigastric pain that improves with meals

A

duodenal ulcer

28
Q

diagnostic endoscopic biopsy of duodenal ulcer shows ulcer (duh) with hypertrophy of

A

Brunner glands

29
Q

Submucosal glands in duodenum above the hepatopancreatic sphincter (Sphincter of Oddi) that produce a mucus-rich alkaline secretion

A

Brunner glands

30
Q

where do duodenal ulcers most commonly arise?

A

anterior duodenum

31
Q

artery behind posterior duodenum?

A

gastroduodenal

32
Q

posterior duodenal ulcer rupture may lead to

A

bleeding from gastroduodenal artery or acute pancreatitis

33
Q

gastric ulcer causes

A

H pylori (75%), NSAIDs, bile reeflux

34
Q

Epigastric pain that worsens with meals

A

gastic ulcer

35
Q

most common location for gastric ulcer

A

less curvature of antrum

36
Q

artery next to lesser curvature of antrum

A

left gastric artery

37
Q

gastric ulcers can be caused by what type of carcinoma?

A

gastric carcinoma (intestinal subtype)

38
Q

three characteristics that would make you think a gastric ulcer was benign

A
  • small ()

- surrounded by radiating folds of mucosa

39
Q

malignant gastric ulcer appearance

A

large and irregular with heaped up margins

40
Q

malignant proliferation of surface epithelial cells in stomach

A

gastric adenocarcinoma

41
Q

two types of gastric adenocarcinoma

A

intestinal & diffuse types

42
Q

Gastric carcinoma that presents as a large, irregular ulcer with heaped up margins; most commonly involves the lesser curvature of the antrum

A

intestinal type (more common)

43
Q

3 risk factors for intestinal type of gastric carcinoma

A
  1. intestinal metaplasia (H pylori or AI gastritis)
  2. nitrosamines in smoked foods (Japan)
  3. blood type A
44
Q

Gastric carcinoma that is characterized by signet ring cells; desmoplasia results in thickening of stomach wall lining (linitis plastica)

A

diffuse type

45
Q

presents late with weight loss, abdominal pain, anemia, early satiety; rarely acanthosis nigricans or Leser-Trelat sing

A

Gastric carcinoma

46
Q

Pt presents with dozens of seborrheic keratoses all of a sudden

A

Leser-Trélat sign (gastric carcinoma)

47
Q

Gastic cancer can spread to the left supraclavicular node, which is also called

A

Virchow node

48
Q

distant metastasis of gastric cancer most commonly involves

A

liver

49
Q

name for intestinal-type gastric cancer mets to periumbilical region

A

Sister Mary Joseph nodule

50
Q

name for diffuse-type gastric cancer mets to bilateral ovaries

A

Krukenberg tumor

Pathoma GI (8 decks)

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