GI-stomach & small bowel (3) Flashcards Preview

Unit 6: Pathology > GI-stomach & small bowel (3) > Flashcards

Flashcards in GI-stomach & small bowel (3) Deck (41):
1

where in the stomach does chronic autoimmune gastritis occur?

body & fundus

2

are there antibodies seen in chronic autoimmune gastritis? is this what causes damage?

there can be antibodies against parietal cells and or intrinsic factor which can be used for diagnosis but this is NOT what causes the damage- damage is type IV hypersensitivity that is cell mediated

3

what are some clinical features in chronic autoimmune gastritis

-atrophy of mucosa
-knocking out ability to produce acid-achlorhydria
-increased gastrin levels and antral G cell hyperplasia (because of loss of negative feedback)
-megaloblastic anemia (lack of IF)

4

what is the more common type of chronic gastritis

chronic H pylori gastritis

5

how does H pylori weaken mucosal defenses?

secretes ureases and proteases and cause inflammation

6

where in the stomach is the most common site of chronic H pylori gastritis

antrum

7

what is the treatment for chronic H pylori gastritis

triple therapy
will resolve gastritis, ulcer and will reverse the intestinal metaplasia

8

where is peptic ulcer disease usually

90% in the proximal duodenum or distal stomach (10%)

9

what is the usual cause of a duodenal ulcer

H pylori (rarely ZE syndrome)

10

you have epigastric pain that IMPROVES with meals, where is the ulcer?

duodenum

11

how does a duodenal ulcer appear on endoscopy?

ulcer with hypertrophy of brunner glands

12

what are some causes of a gastric ulcer

H pylori (70%)
NSAIDs (20%)

13

do gastric ulcers get better or worse with food

WORSE

14

where are the gastric ulcers usually located? what is a risk that is associated with this?

on lesser curvature of antrum. associated with rise of bleeding from left gastric artery if the ulcer ruptures

15

you have an ulcer than is PUNCHED OUT
benign or malignant

benign

16

what are some other features of a benign gastric ulcer

small, punched out, margins next to it are NOT piling up, flat and normal

17

what are some features of a malignant ulcer?

irregularly shaped (NOT punched out), much larger, and there will be piling up of the mucosa at the edge of ulcer

18

what are the 2 types of gastric carcinoma

intestinal and diffuse type

19

how does the intestinal type of gastric carcinoma appear?

large, irregular ulcer with heaped up margins
usually involves the lesser curvature of the antrum

20

how does the diffuse type of gastric carcinoma appear?

signet ring cells that diffusely infiltrate the gastric wall
results in the cancer PLUS a reaction to the cancer (desmoplasia)

21

what type of cell is the following describing:
"nucleus is pushed off the to the edge due to mucus production"
when are these cells seen?

signet ring cell
see in diffuse type gastric carcinoma

22

what is desmoplasia (seen in diffuse type gastric carcinoma)

reactive response of the stroma (mainly just fibrosis and blood vessels). appears white
results in the thickening of the stomach wall

23

diffuse or intestinal type, which is associated with H pylori infection?

intestinal type

24

where does gastric carcinoma like to spread (which node)?

virchow's nodes (left supraclavicular)

25

what are 2 skin manifestations that can be seen with gastric carcinoma

acanthosis nigricans
lesser trelet sign

26

what gastric carcinoma likes to go to the periumbilical region (sister mary joseph nodule)?

intestinal type

27

what gastric carcinoma is associated with krukenburg tumors?

diffuse type
will see signet cells in the ovaries

28

what disorder is duodenal atresia associated with?

down syndrome

29

how does duodenal atresia appear on barium swallow?

double bubble sign (2 separate areas of distension)

30

is the vomiting in duodenal atresia billous or non billous

billous

31

is meckel diverticulum true or false diverticulum?

true (outpouching of all 3 layers of wall)

32

why does meckel diverticulum arise?

due to failure of vitelline duct to involute

33

you see meconium coming out of the baby's umbilicus? whats up

meckel diverticulum

34

what is the most common congenital anomaly of the GI tract?

meckel diverticulum

35

what condition?
"twisting of bowel on its mesentery"

volvulus

36

what is the most common location of a volvus in the elderly? the young?

elderly- sigmoid colon
young adults- cecum

37

what condition
"telescoping of proximal segment of bowel into the distal segment"

intussusception

38

person presents with current jelly stools

intussusception

39

intussusception usually needs a "leading edge" to drag the bowel on, in adults what usually is in? children?

children-lymphoid hyperplasia
adults-tumor

40

what is usually the cause of a transmural infarction in the bowel?

embolism/thrombosis of SMA or thrombosis of mesenteric vein

41

what are the 2 acquired pathways to lactose intolerance

1. as you age you become intolerant and once you are intolerant you are for the rest of your life
2. after an infection that destroys the enzyme you are temporarily intolerant until the bowel is repaired