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