Gastritis

Question 1

sign of past ulcers in stomach?

Answer 1

radial scarring

Question 2

are there normally inflammatory cells in the lamina propria of the stomach?

Answer 2

No.

Question 3

2 ways that stomach protects itself from it’s own acid:

Answer 3

bicarbonate mucous ‘gel’ layer

hydrophobic monolayer

Question 4

5 things that damage stomach mucosal barrier:

Answer 4

H/Pylori
aspirin
NSAIDS
bile
alcohol

Question 5

What is the role of prostaglandins in stomach mucosal barrier? 4 things

Answer 5

inhibit acid secretion
stim bicarb, mucous
increase blood flow
modify inflam

Question 6

Acute gastritis lasts how long usually?

Answer 6

a few days

Question 7

How long does it take for stomach to heal? why?

Answer 7

24-48 hours due to constant regeneration

Question 8

does H pylori heal spontaneously after progressing to chronic?

Answer 8

Nope./

Question 9

Shock or sepsis can do what to stomach?

Answer 9

acute gastritis

Question 10

neutrophils with erosion?

Answer 10

not much bro.

Question 11

Chronic superficial gastritis bacterial infections you see more what?

Answer 11

plasma cells

eosinophils

Question 12

All people in ICU are put on what?

Answer 12

proton pump inhibitors

Question 13

When does an erosion become an ulcer?

Answer 13

once it goes below the muscularis mucosae

Question 14

defining feature of chronic ulcer?

Answer 14

fibrosis in the deep layers

Question 15

acute Ulcers in proximal duodenum from what?

Answer 15

severe burns/trauma

Question 16

acute Ulcers in gastric and duodenum from what? called what?

Answer 16

intracranial injury. Cushing ulcers.

Question 17

proximal duodenal ulcers are called what?

Answer 17

Curling ulcers

Question 18

if you get subactue gastric ulcer with erosion of artery, what clinical manifestation do you see?

Answer 18

haemetemesis

Question 19

What are the 3 main types of chronic gastritis?

Answer 19

autoimmune (rarer)
H.Pylori
Chemical

Question 20

What happens in Autoimmune gastritis?

Answer 20

destruction of acid secreting tubules of parietal cells

Question 21

No parietal cells also mean no intrinsic factor which means?

Answer 21

decreased B12 absorption and defiency

Question 22

What is spared in autoimmune gastritis?

Answer 22

antrum of stomach

Question 23

no parietal cells>hypergastriaemia>linear/nodular hyperplasia> increased risk of?

Answer 23

carcinoidosis

Question 24

How else can B12 be interfered with in autoimmune gastritis?

Answer 24

IF-Ab secretion complexes with B12 preventing absorption

Question 25

What are ECL cells?

Answer 25

neuroendocrine cells

Question 26

Chemical chronic gastritis caused by?

Answer 26

reflux of bile/alkaline | long term aspirin/NSAIDS

Question 27

What happens to mucosa in Chemical chronic gastritis?

Answer 27

disruption of mucus layer | epithelial desquamation

Question 28

what does epithelial desquamation mean in Chemical chronic gastritis?

Answer 28

foveolar hyperplasia with elongation of gastric pits | vasodilation and oedema

Question 29

erosions and ulcers in Chemical chronic gastritis?

Answer 29

yes

Question 30

H. pylori is linked to 2 things:

Answer 30

peptic ulcers | gastric cancers

Question 31

where do H. pylori find their niche?

Answer 31

below the mucus bicarb gel layer of stomach

Question 32

Why are H. pylori good at surviving in stomach?

Answer 32

motile have adhesins have urease

Question 33

Acute H. pylori infections bring what kind of immune response?

Answer 33

``` neutrophilic gastritis acute inflam (IL-8) ```

Question 34

What happens to parietal cells after Acute H. pylori infection?

Answer 34

transient hypochlorhydria up to 4 months

Question 35

What do antibodies do with Acute H. pylori infection?

Answer 35

helps but not curative

Question 36

high infection of Acute H. pylori infection means what 2 things?

Answer 36

low rate of clearance | persists for life when established

Question 37

H.Pylori in intercellular junctions?

Answer 37

yes when it's bad

Question 38

H.Pylori for cancer sequence

Answer 38

``` normal chronic gastritis atrophic gastritis intestinal metaplasia dysplasia adenocarcinoma ```

Question 39

in gastric cancer, there are no more specialized cells in walls of stomach, they are replaced by

Answer 39

lyphoid follicles with germinal centres

Question 40

in antrum predominant H.Pylori gastritis what happens to acid and results?

Answer 40

chronic inflam, polymorphs H. Pylori colonisation increased acid duodenal ulcer

Question 41

in pan-gastritis predominant H.Pylori gastritis what happens to acid and results?

Answer 41

reduced acid chronic inflam, intestinal metaplasia>adenocarcinoma gastric ulcer

Question 42

What is MALT?

Answer 42

mucosa associated lymphoid tissue

Question 43

When do you get B-cell lymphoma of MALT?

Answer 43

in H. Pylori chronic pangastritis

Question 44

92% of duodenal ulcer is caused by?

Answer 44

H-pylori

Question 45

25% of gastric ulcer is caused by?

Answer 45

NSAIDS

Question 46

where is the most common site of peptic ulcer?

Answer 46

D1 and antrum

Question 47

3 other common places for peptic ulcers?

Answer 47

1. oesophagus at squamocolumnar junction 2. gastroenterostomy stoma 3. Meckel's diverticulum if H-pylori infected

Question 48

4 layers of chornic peptic ulcer floor?

Answer 48

1. fibrin exudate 2. narrow zone of fibrinoid necrosis 3. granulation tissue 4. fibrosis: endarteritis/hypertrophied nerves

Question 49

4 complications of peptic ulcers

Answer 49

perforation (peritonitis/septicaemia) haemorrhage (haematemesis) penetration (into adjacent organ) stenosis (pyloric canal and obstruction)

Question 50

what happens to the muscosal folds with gastric carcinoma?

Answer 50

obliterated

Question 51

diffuse-type gastric carcinoma (linitis plastica) looks like?

Answer 51

stomach is sharply punched out, no glands for cells and is discohesive.

Question 52

Signet-ring cell carcinoma

Answer 52

form of gastric adenocarcinoma