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Pathophysiology > GI: The Stomach > Flashcards

Flashcards in GI: The Stomach Deck (38)
1

What cells of the stomach secrete mucin?

foveolar cells

2

What is the name of the congenital defect with persistent herniation of bowel into umbilical cord?

omphalocele

3

What is the name of the congenital defect that causes malformation of abdominal wall, exposing abdominal contents?

gastroschisis

4

Describe pyloric stenosis

congenital hypertrophy of smooth muscle of pylorus (more common in males) doesn't allow food to pass stomach (projectile vomiting)

5

What is the big physical exam finding in pyloric stenosis?

olive like mass (representing the hypertrophied pylorus)

6

Name the 4 symptoms associated with gastritis

nausea
vomiting
epigastric pain
hematemesis

7

What causes gastritis?

lots of things - can be associated with anything that increases time of stomach emptying

(also NSAIDs, smoking, alcohol, gastric hyperactivity, etc)

8

What is the most common cause of chronic gastritis?

H. pylori infection

9

What are some causes of acute gastritis?

impairment of protective system via NSAIDs, ingestion, direct injury

10

You see ___________ infiltrate with acute gastritis

neutrophilic

11

What are the treatments for acute gastritis?

1) remove offending agent
2) pharmacologic acid blockade

12

What is the most common cause of chronic gastritis?

H. pylori

13

What are the four modes of virulence for H. pylori?

1) flagella
2) secretion of urease
3) adhesins
4) toxins

14

H. pylori leads to increased risk of ___________ and ____________

gastric adenocarcinoma
MALT

15

How is H. pylori diagnosed?

1) biopsy
2) antibody testing (IgM and IgG)
3) fecal detetion
4) urea breath test

16

How is H. pylori chronic gastritis treated?

PPIs and antibiotics for 10-14 days

17

Autoimmune chronic gastritis targets which two things?

1) parietal cells (defective gastric acid secretion - achlorhydria)
2) intrinsic factor (pernicious anemia)

18

food __________ pain with duodenal ulcers

DECREASES

19

pain becomes __________ with food intake for gastric ulcers

GREATER

20

What are some particularly at risk patients for acute peptic ulcers?

mechanical ventilation
severe burns
trauma
severe sepsis
intracranial injury
coagulopathy

21

What is the treatment for acute peptic ulcer disease?

PPI or H2 blockers

22

Chronic peptic ulcer disease is caused by _________________

gastric hyperacidity

(zollinger ellison due to too much gastrin secreted by tumor)

23

Where do most carcinoid tumors form

40% in small intestine

24

What determines carcinoid tumor prognosis?

location

midgut = most aggressive

25

What are the symptoms of carcinoid tumors?

determined by hormones produced (because tumors form from neuroendocrine organs (like G-cells in stomach)

26

What is the name of a mesenchymal neoplasm of interstitial cells of cajal?

Gastrointestinal stromal tumor (GIST)

27

Where do GIST tumors occur?

most in the stomach

28

What is the molecular bio feature of GIST tumors?

gain of function mutation in gene encoding tyrosine kinase c-KIT

29

How can GIST be treated?

surgically resected or use of imatinib (inhibits tyrosine kinase activity of c-KIT)

30

What 3 things can cause gastric adenocarcinoma?

1) H. pylori infection
2) EBV
3) mutations (one in Ecadherin)

31

What is the Lauren classification for gastric adenocarcinoma?

1) intestinal - bulky, glandular structures, exophytic mass/ulcerated tumors
2) diffuse - infiltrative growth, discohesive cells with large mucin vacuoles --> SIGNET RINGS)

32

Signet rings are associated with which GI abnormality?

gastric adenocarcinoma

33

What is the name of the left supraclavicular node when gastric adenocarcinomas metastasize?

virchow node

34

What is the name of the periumbilical region when gastric adenocarcinomas metastasize?

sister mary joseph nodule

35

What is the name of the tumor when gastric adenocarcinoma has metastasized to bilateral ovaries

Krukenberg tumor

36

Gastritis is the result of _________________________

impaired host defenses against acid exposure or direct injury

37

the most common cause of chronic gastritis AND chronic PUD is __________

H. pylori

38

autoimmune gastritis is due to autoantibodies to _____________ and _____________

parietal cells and intrinsic factor