EXAM #1: PATHOLOGY OF THE STOMACH Flashcards Preview

Gastrointestinal System > EXAM #1: PATHOLOGY OF THE STOMACH > Flashcards

Flashcards in EXAM #1: PATHOLOGY OF THE STOMACH Deck (59)
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1

What is the definition of gastritis?

Acidic damage causing superficial inflammation of the gastric mucosa

2

What is the underlying cause of acute gastritis?

Imbalance of mucosal defenses and acidic environment

3

What are the three major mucosal defenses?

1) Mucin layer
2) Bicarbonate secretion
3) Normal blood supply

****Normal blood supply delivers nutrients and removes acid*****

4

What wall layer does acute gastritis NOT penetrate through?

Muscularis mucosa

5

What causes acute gastritis?

1) NSAIDs (esp Aspirin) b/c of decreased PGE2
2) Alcohol
3) Chemotherapy
4) Increased ICP-->vagal stimulation that increases acid production
5) Severe burns-->hypovolemia causing decreased blood flow
6) Shock-->decreased blood flow

6

Describe the morphology of mild acute gastritis.

- Hyperemia and edema
- Neutrophils above BM

7

Describe the morphology of severe acute gastritis.

Erosion of entire mucosal thickness and hemorrhage

8

What are the clinical features of acute gastritis?

Hematemesis*
Melena

*Especially in alcoholics

9

What is the definition of chronic gastritis? What does chronic gastritis lead to?

Chronic inflammatory changes of the gastric mucosa leading to:
- Mucosal atrophy
- Intestinal metaplasia

10

What at patients with chronic gastritis at risk for?

Progression to gastric carcinoma

11

What is the most common cause of Chronic Gastritis?

H. pylori

12

What are the characteristics of H. pylori?

Gram negative
Bacillus
S-shaped

13

Is H. pylori motile or non-motile?

Motile--contains a flagella

14

What enzyme allows H. pylori to survive in the gastric mucosa?

Urease

15

What allows H. pylori to bind to the epithelial surface of the stomach? What is the most common site of infection?

- Adhesins
- Antrum

16

What factors associated with H. pylori induce the production of cytokines?

CagA
VacA

****These are proinflammatory peptides associated with some strains of H. pylori****

17

There are divergent responses to H. pylori infection. When H. pylori causes disease, what is the most common outcome?

- Increased acid
- Increased gastrin

Leading to DUODENAL ULCER disease

18

What is the less common scenario that occurs with H. pylori infection?

- Decreased acid
- Increased gastrin

Leading to a high risk of GASTRIC CARCINOMA

19

What is autoimmune gastritis?

Gastritis that results from autoantibodies to parietal and IF cells

20

What are the consequences of IF antibodies?

Pernicious anemia and megaloblastic anemia (B12 deficiency)

21

What cancer are patients with autoimmune gastritis most at risk for?

Gastric carcinoma

22

What does achlorhydia distinguish between?

Autoimmune gastritis can lead to achlorhydia, H. pylori does NOT

23

Which primary cause of Chronic Gastritis can lead to Lymphoma and PUD?

H. pylori

24

Which primary cause of Chronic Gastritis can lead to Endocrine tumors?

Autoimmune gastritis

25

Structurally, what is the definition of an ulcer?

Involvement/ disruption of the muscularis mucosa

26

What are is the classic presentation of a gastric ulcer?

Epigastric pain that is worse with eating

27

How do you diagnose a gastric PUD?

1) Imaging
2) Endoscopy

Note that you need endoscopy for gastric ulcer, but NOT duodenal--these are NEVER cancerous

28

What is the most common cause of duodenal ulcers?

H. pylori (70%)

29

What are the proinflammatory cytokines induced by H. pylori will activate and recruit neutrophils?

IL-8

****Note that this is especially seen with CagA and VacA****

30

How does H.pylori induced gastric acid secretion effect the duodenum?

Increased gastric acid secretion leads to decreases duodenal bicarbonate (protection)