Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Robbins Pathology GI (Chptr 16,17,18,19) > Clinical-Stomach Disorders > Flashcards

Clinical-Stomach Disorders Flashcards

1
Q

What is Portal hypertension gastropathy

A

Congestion of the capillaries and venules of the gastric mucosal and submucosal layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can be given in the case of portal hypertensive gastropathy to reduce recurrent bleeding

A

Propranolol or nadolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common clinical manifestation of erosive gastritis

A

Upper GI bleeding, resulting in hematemesis, “coffee ground” emesis, or bloody aspirate during nasogastric suction
*Usually not hemodynamically significant bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

During hemorrhagic gastritis, what is the method of diagnosis and what is the state of inflammation

A

Upper endoscopy, which will not show significant inflammation on histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the location of Type A gastritis

A

Body predominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In Type A gastritis, what are the autoimmune mechanisms associated with

A
  • achlorhydria
  • pernicious anemia
  • gastric cancer risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What antibodies are present in the majority of type A gastritis

A

Antibodies to parietal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the process of Achlorhydria

A
  • Hypergastrinemia due to loss of regulation on G cells

- Hyperplasia of ECF cells (due to increased gastrin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can achlorydia lead to

A

Small multi centric carcinoid tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What population is more common for pernicious anemia gastritis

A

Females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the effects of pernicious anemia gastritis

A
  • Megablastic anemia (due to decrease IF secretion and B12 absorption)
  • Autoimmune destruction of gastric fundic mucosa
  • Increased risk for gastric adenocarcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the cause of Type A gastritis

A

Rare autoimmune disorder involving the fundic glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the location and cause of type B gastritis

A

Antral dominated infection with H. Pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

H pylori is associated with an increased risk of which condition

A

Gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the characteristic morphology associated with Menetrier disease

A

Giant thickened gastric folds in the body of the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the symptoms of Menetrier disease

A

-Chronic protein loss, leading to anasarca (general swelling throughout the body)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does peptic ulcer disease most commonly occur

A

Duodenal bulb and stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the typical descriptions given by the patient for peptic ulcer disease

A
  • gnawing
  • dull
  • aching
  • “hunger like”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the signs of peptic ulcer bleeding

A

“Coffee grounds” emesis

  • hematemesis
  • melena
  • hematochezia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the rule of thumb for exclusion of nasogastric lavage fluid without blood with regards to active bleeding of a duodenal ulcer

A

Does not rule it out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the prevalence of H pylori in duodenal bleeds, and what is the cause

A

70-90% and due to increased gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the prevalence of H. Pylori in gastric ulcers and what is the cause

A

Infection of the gastric body decreased acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the factors that can cause ulcers and are not H pylor related

A

NSAIDs, corticosteroids, anticoagulants, smoking

24
Q

What are the tests that can be preformed to test for H. Pylori

A

Urea breath test

Fecal antigen test

25
Q

What is the protocol for being able to test for H. Pylori without a false negative

A

Stop the PPI for 14 days, as well as 4 weeks after completing antibiotic treatment

26
Q

What is the stain used to see H pylori

A

Warthin-Starry silver stain

27
Q

What is the complication with an ulcer in the posterior wall of the duodenum or stomach

A

Perforation into the pancreas, liver, or biliary tree

28
Q

What is the treatment for an active GI bleed due to ulcer

A

-Continuous infusion with PPI via IV starting with a bolus

29
Q

What are some complication of surgery for peptic ulcer disease

A
  • Obstruction
  • Bile reflex gastritis
  • Bezoar (GI mass)
  • anemia
  • malabsorption
  • osteomalacia
30
Q

How does H pylori cause a duodenal ulcer

A

-Causes the hyper secretion of gastric acid, which stimulated the antral G cells and increased activity of parietal cells

31
Q

How does H pylori cause a gastric ulcer

A

In the lesser curvature of the antrum, but infects the cells celled, causing a decrease in the protective mechanisms

32
Q

What is the clinical feature with regards to timing in duodenal ulcers

A

Gets better with food

33
Q

What is the clinical feature with regards to timing in a gastric ulcer

A

Gets worse with food

34
Q

What is the process of treatment for gastric ulcers

A

Eradication of H. Pylori

Followed up with EGD to rule out malignancy

35
Q

What are the histological findings in gastric adenoma

A

Signet ring cells

Linitis plastica

36
Q

What are the physical exam findings that are consistent with gastric adenocarcinomas

A

Virchow sentinel node (left supraclavicular node)

Krukenberg tumor

37
Q

What are the clinical findings that may lead to the diagnosis of Zollinger-Ellison (ZE syndrome)

A

Ulcer disease is:

  • Severe
  • Refractory to therapy
  • diarrhea, yet NGT section stops it
38
Q

What is the common location of a gastrinoma

A

Aka ZE tumor

  • Duodenum (45%)
  • Pancreas (Pancreatic)
39
Q

Which condition is Zollinger Ellison associated with

A

MEN-1

40
Q

What are the conditions commonly seen in MEN1

A

Gastrinoma, hyperPTH (and calcium), pituitary neoplasms

41
Q

What finding on endoscopy would suggest diagnosis of Zollinger Ellison

A

Large mucosal folds

42
Q

Which diagnosis can be made with a positive secretin test

A

Zollinger ellison, because it is the only gastrinoma that will respond

43
Q

What is the level of gastrin that must present for the diagnosis of Zollinger-ellison

A

> 1000 ng/L

44
Q

What are the levels in the blood that are checked for Zollinger ellison syndrome

A
  • Serum PTH
  • Prolactin
  • LH-FSH
  • GH
45
Q

In patients with MEN1, what is the usual prognosis of Zollinger Ellison

A

Not good, as they are usually multifocal and unresectable

46
Q

What is the endocrine cause of gastroparesis

A

Diabetes mellitus

47
Q

What are the 3 general conditions that can cause gastroparesis

A

Endocrine
Neurological
Postsurgical

48
Q

What is the ideal method for assessing gastric emptying

A

Gastric scinigrapy with a low fat solid meal

49
Q

What is the condition of gastric paresis

A

Chronic condition of intermittent, waxing and waning symptoms and signs of gastric obstruction in the absence of mechanical lesions

50
Q

What is the treatment of gastroparesis

A

No specific therapy, but acute cases can be helped with NG suction and IV fluids

51
Q

What is the recommended meal for those patients with gastroparesis

A

-Low in fiber, milk, gas forming, and fat

52
Q

Which agents in gastroparesis should be avoided

A

-Opiods and others that reduce GI motility

53
Q

In the treatment of gastroparesis with metocloparmide, what is the risk of tar dive dyskinesia

A

Less than 1% and defined as involuntary motions such as eye blinking and smacking of the lips

54
Q

What is the characteristic of food or foreign body impaction

A

Inability to swallow liquids, including their own saliva

55
Q

What is the condition of postvagotmy

A

Aka dumping syndrome
-rapid food passage into the small intestine, leading to distention as a result of the osmotic flow into the lumen, resulting in reactive hypoglycemia

Robbins Pathology GI (Chptr 16,17,18,19) (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions