GI Tract II-Usera

Question 1

What are the four anatomical regions of the stomach?

Answer 1

• cardia
• fundus
• body
• pylorus

Question 2

The stomach epithelial cells have (blank) cells lining surface and pits of the entire stomach.
(blank and blank) cells are located in the body and fundus

Answer 2

Mucous cells

Chief and parietal cells

Question 3

What are the endocrine cells found in the body and fundus of the stomach?

Answer 3

ECL-aid in production of gastric acid via the release of histamine.

Question 4

What endocrine cells are found in the antrum?

Answer 4

• G (gastrin)
• D (somatostatin)
• Enterochromaffin (serotonin)

Question 5

Where are these found:

straight tubular glands that synthesize gastric juice

Answer 5

Fundus body

Question 6

What are the straight tubular glands found in the fundus/body lined by? What do they glands contain?

Answer 6

surface mucous cells and gastric pits

parietal and chief cells

Question 7

Parietal cells are (blank) and secrete (blank)

Answer 7

eosinophilic
intrinsic factor (vit B12)

Question 8

Chief cells are (Blank) and secrete (blank)

Answer 8

basophilic

pepsin

Question 9

What do they glands look like in the cardia/antrum?

Answer 9

branched and coiled and the gastric pits occupy half the thickness of the mucosa

Question 10

What are the glands lined by in the cardia/antrum? Do you find parietal cells in the antrum/cardia?

Answer 10

• mucus-secreting cells

- small number

Question 11

The gastric lumen has an acidic pH of (blank), therefore there is potential for damage to the mucosa

Answer 11

1

Question 12

What are the mechanisms for protection of the gastric lumen due to the acidic pH?

Answer 12

• Mucin secreted from foveolar cells that prevents food from touching the epithelium
• Mucus layer promotes the formation of a (neutral pH) layer of fluid over the epithelium
• Rich vascular supply deliver O2, bicarb and nutrients and washes away acid that has back diffused into the LP

Question 13

Acute and chronic gastritis occurs where this a breakdown of (blank)

Answer 13

protective mechanims

Question 14

What is acute gastritis?

What are the clinical features?

Answer 14

transient mucosal inflammatory process

• asymptomatic
• epigastric pain
• N/V
• Hematemesis
• Melena

Question 15

What are the causes of acute gastritis?

Answer 15

Nonsteroidal anti-inflammatory drugs (NSAIDs)
H. pylori infection
Aspirin
Cigarettes
Alcohol
Gastric hyperacidity
Duodenal-gastric reflux

Question 16

(Blank) inflammation is the preferred term for acute gastritis

Answer 16

active

Question 17

In acute gastritis, the presence of (bank) within the mucosa denotes active inflammation

Answer 17

neutrophils

Question 18

In acute gastric ulcers, there is erosion and ulceration. In an erosion what happens?

Answer 18

-loss of superficial epithelium, defect limited to the LP

Question 19

What is an ulceration?

Answer 19

Loss of epithelium deeper than an erosion. Includes a layer of necrosis, inflammation and granulation tissue

Question 20

What are the types of acute gastric ulcers?

Answer 20

Stress ulcers
Curling ulcers
Cushing ulcers

Question 21

What kind of ulcers do patients with shock get?

Answer 21

Stress ulcers

Question 22

What kind of ulcers occur in the proximal duodenum and are associated with severe burns or trauma?

Answer 22

Curling ulcers

Question 23

What kind of ulcers occur in the gastric, duodenuml, or esophagus in patients with intracranial disease?

Answer 23

Cushing ulcers

Question 24

What are the clinical features of chronic gastritis?

What are the causes?

Answer 24

• N/V
• upper abdominal discomfort

H. pylori
psychological stress
caffeine
alcohol
tobacco

Question 25

What is this: a spiral shaped or curved bacilli present in almost all patients w/ duodenal ulcers and the majority of pnts with gastric ulcers and chronic gastritis (90%)

Answer 25

H. pylori

Question 26

H pylori normally affects the (blank) and causes gastritis here with high (blank) production

Answer 26

antrum | acid production

Question 27

In patients w/ H. pylori of the fundus/body, creates a condition called (blank) that is charactered by (blank x 3)

Answer 27

multifocal atrophic gastritis reduced acid secretion intestinal metaplasia increased risk of gastric adenocarcinoma

Question 28

Autoimmune gastritis accounts for (blank)% of chronic gastritis. What is another name for autoimmune gastritis?

Answer 28

<10% | -chronic atrophic gastritis

Question 29

What does autoimmune gastritis affect?

Answer 29

the body/fundus of the stomach

Question 30

What is autoimmune gastritis characterized by?

Answer 30

- antibodies to parietal cells and intrinsic factor - reduced serum pepsinogen I concentration (due to chilef cell destruction) - antral endocrine cell hyperplasia (G cells with hypergastrinemia) - Vit b12 deficiency (pernicious anemia) - achloryhydria

Question 31

What is this: foveolar hyperplasia, mucosal edema and glandular regenerative changes What are the causes?

Answer 31

Reactive gastropathy Chemical injury, NSAIDs, bile reflux, mucosal trauma

Question 32

What is this: Dense infiltrates of eosinophils in the mucosa and muscularis What are the causes?

Answer 32

Eosinophilic gastritis allergens, parasitic infection, H. pylori, collagen vascular disease

Question 33

(blank) is usually idiopathic but some are associated with celiac disease.

Answer 33

Lymphocytic gastritis

Question 34

What is associated with granulomatous gastritis?

Answer 34

``` Crohn’s disease Sarcoidosis Mycobacteria Fungi CMV H. pylori ```

Question 35

(blank) occurs in any portion of the GI tract exposed to gastric acid. It is most offten associated with (blank and blank).

Answer 35

PUD | H. pylori gastritis and chronic gastritis

Question 36

What is PUD due to?

Answer 36

imbalance of mucosal defenses and damaging forces

Question 37

PUD is seen in conditions that increase gastric acidity such as?

Answer 37

``` H. pylori infection Parietal cell hyperplasia Zollinger-Ellison syndrome NSAIDs Cigarette smoking High-dose steroids ```

Question 38

What is this: Nodules or masses that protrude above the level of the surrounding mucosa May result due to (blank x 4)

Answer 38

polyps Epithelial or stromal hyperplasia Inflammation Ectopia Neoplasia

Question 39

What makes up 75% of gastric polyps? It develops in association with (blank)

Answer 39

``` Inflammatory/hyperplastic polyps chronic gastritis (reactive hyperplasia) ```

Question 40

A fundic gland polyp occurs sporadically in those with (blank) and seen in patients on (blank)

Answer 40

Familial adenomatous polyposis (FAP) | PPIs

Question 41

What is this: occur in the background of chronic gastritis with atrophy and intestinal metaplasia. Increased incidence in (blank)

Answer 41

adenoma FAP

Question 42

What is the most common carcinoma of the stomach (90%)? Where does it occur most often in the stomach? What are the 2 major histologic types?

Answer 42

adenocarcinoma - antrum and the lesser curvature - intestinal type and diffuse type (linitus plastica)

Question 43

(blank) is 5% of gastric malignancies. | Where do they arise from and in whom?

Answer 43

primary lymphoma | bone marrow and organ transplant patients

Question 44

What is the most common type of lymphoma? In the gut they are called lymphomas of (blank) The second most common type is (blank)

Answer 44

extra nodal marginal zone B-cell lymphoma MALT Diffuse large B-cell lymphoma

Question 45

(blank) arise at sites of chronic inflammation (H. pylori). How do you treat it?

Answer 45

MALToma antibiotics

Question 46

(blank) are formerly called carcinoids and may produce a syndrome depending on the hormone being produced

Answer 46

Neuroendocrine tumors

Question 47

Neuroendocrine tumors may be associated with (blank x 3)

Answer 47

- endocrine cell hyperplasia - chronic atrophic gastritis - zollinger-ellison syndrome

Question 48

What is the most common mesenchymal tumor of the abdomen? what do they arise from

Answer 48

GI stromal tumor | interstitial cell of cajal