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GI > Pathology- stomach > Flashcards

Pathology- stomach Flashcards

1
Q

where does the pyloric channel end

A

where the duodenum begins

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2
Q

what can cause acute gastritis

A

irritant chemical injury, severe burns, shock, severe trauma, head injury

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3
Q

what can cause chronic gastritis

A

ABC;

  • autoimmune
  • bacterial- H pylori
  • chemical- injury, NSAIDS, chronic reflux, alcohol
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4
Q

what are rare inflammatory disorders of the stomach

A

lymphocytic, eosinophillic, granulomatous

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5
Q

what are the inflammatory disorders of the stomach

A

acute and chronic gastritis, rare ones (lymphocytic. eosinophillic, granulomatous)

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6
Q

what is the pathology of autoimmune chronic gastritis

A

atrophy and intestinal metaplasia in body of stomach

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7
Q

why type of anaemia does autoimmune gastritis cause

A

pernicious anaemia, due to B 12 deficiency

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8
Q

how does autoimmune chronic gastritis affect nerves

A

causes SACDC- sub acute combined degeneration of the spinal chord

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9
Q

where is B12 absorbed

A

in the small intestine, bound to intrinsic factor

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10
Q

what is the most common type of chronic gastritis

A

H. pylori associated

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11
Q

what does H pylori look like on a gram stain

A

gram negative rod

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12
Q

how does H pylori affect the stomach

A

inhabits a niche between the epithelial cell surface and mucous barrier- excites early acute inflammatory response within gastric mucosa which destroys epithelial cells

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13
Q

what interleukin is essential in h pylori chronic gastritis

A

IL8

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14
Q

what produces anti pylori antibodies

A

lamina propria plasma cells

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15
Q

what does h pylori increase the risk of

A

duodenal ulcer, gastric ulcer, gastric carcinoma, gastric lympoma

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16
Q

what causes chemical gastritis

A

NSAIDs, alcohol, bile reflux (main 3)

direct injury to mucous layer by fat solvents

17
Q

what is the pathology of chemical gastritis

A

marked epithelial regeneration, hyperplasia, congestion and little inflammation

18
Q

what might chemical gastritis produce

A

erosions, ulcers

19
Q

what is peptic ulceration

A

a breach in the GI mucosa as a result of acid and pepsin attack

20
Q

what sites are predisposed to peptic ulcers

A

duodenum (1st part), stomach (junction of body and antrum), oesophago-gastric junction, stomal ulcers (jejunum mucosa)

21
Q

describe the synergism that causes chronic duodenal ulcers

A

excess acid in duodenum produces gastric metaplasia which leads to H. pylori infection (failure of mucosal defence), inflammation, epithelial damage and ulceration

22
Q

describe the morphology of peptic ulcers

A

2-10cm across, edges are clear cut and punched out

23
Q

what does a peptic ulcer look like microscopically

A

layers:

  • necrotic fibrinopurulent debris
  • inflamed granulation tissue
  • fibrotic scar tissue
24
Q

what issue does scarring in peptic ulcers cause

A

strictures

25
Q

what are the complications of peptic ulcers

A

perforation, penetration, haemorrhage, stenosis, intractable pain

26
Q

what are two benign gastric tumours

A

hyperplastic polyps,

cystic fundi gland polyps

27
Q

what are three malignant gastric tumours

A

carcinomas (adeno)
lymphomas
gastrointestinal stromal tumours

28
Q

what is the pathogensis of gasrtic adenocarcinoma

A
  • H. pylori infection
  • chronic gastritis
  • intestinal metaplasia/ atrophy
  • dysplasia
  • carcinoma
29
Q

what other premalignant conditions can cause gastric adenocarcinomas

A

pernicious anaemia, partial gastrectomy (surgery creates inflammation), HNPCC/ lynch syndrome, menetriers disease

30
Q

what are the two subtypes of gastric adebicarcinomas

A

intestinal- exophytic/polypoid mass

diffuse- expands/ infiltrates stomach wall

31
Q

describe the morphology of intestinal type gastric adenocarcinoma

A

rolled edges- malignant ulcers, epithelial edges brought up, cancer in centre

32
Q

what is the difference in morphology between benign and malignant peptic ulcers

A

benign is more punched out and lacks a raised rolled edge

33
Q

what forms in intestinal type adenocarcinoma

A

glands- clusters of malignant cells

34
Q

where is leatherbottel stomach seen

A

in diffuse gastric adenocarcinoma

35
Q

what type of gastric adenocarcinoma has signet rings

A

diffuse

36
Q

what has a better prognosis intestinal or diffuse

A

intestinal

37
Q

what is MALT

A

mucosa associated lymphoid tissue

38
Q

what is the pathogenesis of gastric lymphoma

A

Continuous inflammation induces an evolution into a clonal B-cell proliferation…low grade lymphoma

If unchecked evolves into a high grade B-cell lymphoma

associated with H pylori infection

GI (64 decks)

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