Patgology Of The Stomach Flashcards Preview

Gastrointestinal > Patgology Of The Stomach > Flashcards

Flashcards in Patgology Of The Stomach Deck (19):
1

What are the inflammatory disorders of the stomach?

°Acute gastritis
irritant chem injury
Severe burns
Shock
Severe trauma
Head injury


°Chronic gastritis
Autoimmune
Bacterial
Chemical (chronically ingest non-steroidal anti-inflammatory drugs, alcohol)

°Rare ones
Lymphomatic
Eosinophilic
Granulomatous

2

*What is autoimmune chronic gastritis?

Anti- parietal and anti- intrinsic factor antibodied produced which disturb stomach
Increased risk of malignancy and SACDC
Pernicacious anaemia, macrocytic due to vit B12 deficiency
*breaks down in spinal cord can lead to disabilities

3

What is H. Pylori associated Chronic Gastritis?

H. Pylori cam live within the gastric mucosa, destroys the epithelial cells.
Causes duodenal and gastric ulcer, gastric cancer and gastric lymphoma

4

What happens in chemical gastritis?

It involves direct injury to mucus layer by fat solvents. It breaks the cell membrane, hemce the cell breaks down and dies.

Marked epithelial regen,. Hyperplasia, congestion and little inflammation

Red stomach with lots of spots of inflammation

5

What is peptic ulceration?

It is a complication of imflammation.
Discontinuation of flat epithelial surface plus production of more acid. Hence the acid and gastric juices (pepsin) gets exposed to more deeped tissues and is therefore more toxic.

Long standing, deep and chronic

6

Areas predisposed to developing peptic ulcer

Upper part of duodenum, oesophageal-gastric junction, stomach (jnctn of body and antrum)

7

Pathogenesis of chronic duodenal ulcers

Increased attack (increased acid secretion, bacteria) and failure of defense (inability to cope with too much acid pdtn due to inability of epithelium to produce mucus)

In case of H. Pylori infection, it increases acid pdtn even more. Hence more corrosion, dysplasia and hyperplasia

8

Morphology of peptic ucers

Clear cut, pinched out, boundaries clear
Layered appearance
Increased collagen and scarring = stricture
Floor of ...

9

Complications of peptic ulcers

Perforation
Proliferation
Haemorrhage
Stenosis
Intractable pain

10

What are the gastric tumours?

Benign polyps(heaps of cells like mushrooms, easily removed) :-
Hyperplastic polyps
Cystic fundic gland polyps

Malignant tumours:

Carcinomas
Lymphomas
Gastrointestinal stromal tumours (GISTs)

11

Epidemiology of gastric adenocarcinoma

High in developing countries (due to increased H. Pylori infection)

High in Japan(smoked fish), china, columbia and finland

12

Pathogenesis of gastric adenocarcinoma

Hy. Pylori infection - chronic gastritis - intestinal metaplasia/ atrophy - dysplasia - carcinoma

13

What are other premalignant conditions ass with gastric adenocarcinoma

Pernicioyd anaemia
Partial gastrectomy
...
..

14

What are the subtypes of gastric adenocarcinoma

Intestinal - well defined tumor, exophytic/ polypoid (raised rolled edges and the cancer lies in the centre - with pus, blood)
Diffuse type - spread out all over the place

15

Histology of gastric adenocarcinoma

Forms glands, rossettes of it

16

Diffuse gastric adenocarcinoma

Thickening of the entire stomach wall : linitis plastica, signet ring type

Less prognosis than intestinal type

17

Which has better prognosis: intestinal or diffuse

Intestinal

18

How does gastric adenocarcinoma kill you?

By spreading and diffusing into other organs, via lymphoid or tissue itself

19

What is gastric lymphona/ maltoma?

Derived from mucosa ass lymphoid tissue (MALT)
Lymphoid tissue accumulated within the stomach in response to inflammation and then it transforms.
Associated with H. Pylori
**the lymphoid cells destroy stomach cells