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Year2 GI Exam I > Path IV > Flashcards

Path IV Flashcards

1
Q

characteristics of autoimmune gastritis

A

Ab to parietal cells and IF that can be detected in serum and gastric secretions

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2
Q

Pathogenesis autoimmune gastritis

A

CD4 T cells against parietal cell components like H/K ATPase
chief cells get destroyed too
reduced serum pepsinogen
antral/fundic hyperplasia
Vit B12 def
defective gastric acid secretion (achlorhydria)

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3
Q

autoimmune gastritis is assoc with what

A

increased risk gastric cancer and carcinoid tumros

assoc with hashimoto thyroiditis, graves, type I DM, addison, myasthenia gravis, vitiligo

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4
Q

how to differentiat H pylor assoc chronic gastritis or autoimmune

A

HP antrum / AI is in body of stomach!!!!
HP neutrophils plasma cells/ AI lymphocytes and macrophages
HP acid increased / AI acid decreased
HP gastrin norm or dec / AI gastrin increased
HP hyperplastic inflammatory polyps / AI neuroendocrine hyperplasia!!!

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5
Q

sequelae of H pylor assoc gastritis

A

peptic ulcer, adenocarcinoma, MALT lymphoma

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6
Q

sequelae autoimmune gastritis

A

atrophy, pernicious anemia, adenocarcinoma, carcinoid tumor

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7
Q

uncommon forms of gastritis

A

reactive gastropathy
esosinphilic gastritis
lymphocytic gastritis- celiac
granulomatous gastritis

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8
Q

causes of granulomatous gastritis

A

crohn disease, mycobacteria, fungi, CMV and H pylori

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9
Q

What are peptic ulcers

A

chronic, usually solitary lesions that occur in any part of GI tract exposed to aggressive acid/peptide juices
go through muscularis mucosae

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10
Q

where are most peptic ulcers

A

duodenum 4: 1 stomach

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11
Q

peptic ulcers are more common in male or femal

A

male

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12
Q

complicaitons of peptic ulcers

A

bleeding, perforation, obstruction

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13
Q

what do cancerous ulcers look like

A

have elevated margins

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14
Q

what will CXR show if have gastric perforation

A

free air under diaphragm

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15
Q

Tx for peptic ulcers

A

Antibiotics for H pylori
PPI
remove offending agent (NSAID)
surgery if massive bleed/perforated (antrectomy, vagotomy)

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16
Q

what is melena and what causes it

A

dark tarry stools

digestive enzymes act on blood and change its color

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17
Q

what is hematochezia and what causes it

A

usually GI bleed in colon because still bright red

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18
Q

what does it mean if blood appears like coffee grounds coming out of NG tube

A

slow bleeding or oozing

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19
Q

red blood and clots from NG tubes means what

A

active ongoing bleed

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20
Q

bile stained aspirate from NG tube

A

no active bleeding above treitz ligament

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21
Q

does clear NG aspirate meand there is no bleeding anywhere

A

no because GI bleed can be intermittant

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22
Q

procedure of choice to confirm bleeding site

A

upper GI endoscopy

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23
Q

what can be used to stop upper GI bleed

A

injection therapy with epinephrine or electro coagulation techniques

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24
Q

diseases that cause hypertrophic gastritis

A

menetrier and zollinger ellison

25
gross structure of hypertrophic gastropathy
thickened cerebriform gastric folds
26
two important points of hypertrophic gastropathy
may mimic carcinoma or lymphoma | could have severe PUD
27
what is cause of menetrier disease
excessive secretion of transofrming growth factor alpha
28
Tx mentrier disease in children
goes away on own usually
29
Sx menetrier disease in children
weight loss, diarrhea, peripheral edema
30
cause Z-E syndrome
gastrin secreting tumore: gastrinoma
31
Sx Z-E syndrome
chronic diarrhea, multiple peptic ulcers
32
what cell # is greatly increased in Z-E syndrome
parietal cells
33
Tx for Z-E syndrome
block acid production | find and remove the tumor
34
majority of gastric polyps are what
inflammatory and hyperplastic <1cm
35
fundic gland polyps are found in what population
F>M PPI related because of increased gastrin
36
gastric ademoa greater than 2 cm is assoc with what
carcinoma
37
polyp with corkscrew shaped foveolar glands
gastric hyperplastic polyp
38
3rd most common cause cancer death worldwide
stomach
39
stoamch carcinoma is associated with
H pylori | >90% originate from glandular epithelial cells of the stomach (adenocarcinoma)
40
population affected by gastric cancer
55 y.o M>F | aggressive
41
Describe intestinal type stomach carcinoma
``` M>F assoc with prior H pylor infection TLR4, APC/WNT pathyway, p53 gatric antrum/pylorus lesser curvature>greater ```
42
describe diffuse type (signet ring) stomach carcinoma
``` no decline increasing incidence M=F no association with H pylori or precursor lesion CDH1/E cadherin mutations, p53 dismal 5 yr survival occurs throughout stomach ```
43
what cancers involve mutation sin APC/WNT pathway
intestinal type gastric cancer and colon CA
44
what mutation is assoc with diffuse gastric carcinoma
mutation in tumor suppressor CDH1 | also mutation in lobular CA of breast
45
stomach carcinoma is classified by
depth of invasion macroscopic growth pattern histologic subtype
46
what is important for prognosis of stomach carcinoma
depth of invasion and lymph node status
47
where is sister mary joseph nodule irish node? virchows node?
sister mary joseph is belly buton virchow is neck/supraclavicular irish is axillary node
48
what is linitis plastica
extreme form of flat or depressed advanced gastric carcinoma
49
signet ring cells
diffuse gastric carcinoma
50
what is name for mesenchymal tumores of stomach
gastro intestinal stromal tumor
51
most common site extra nodal lymphoma
stomach
52
2 types gastric lymphoma
indolent extra nodal marginal zone B cell lymphoma (MALToma, H pylori related) diffuse large B cell lymphoma (high grade)
53
translocations assoc with gastric MALToma | and net effect?
t11;18 q21;q21 and t1;14p22;q23 and t14;18 q32;q21 | all result in activation of NFkbeta that promotes B cell growth and survival
54
lymphoepithelial lesions with neoplastic lymphocytes in gastric glands dx?
gastric MALT lymphoma
55
markers for gastric MALT B cell lymphoma
CD19 and 20+ | monoclonal light chains
56
2nd most common gastric lymphoma
DLBCL
57
GIST mesenchymal tumors arise from what
interstitial cells of Cajal, pacemakers
58
most common abdominal mesenchymal tumor? | mutations?
GIST tyrosine kinase c-kit CD117 mutations some are PDGFRA mutations
59
Tx GIST | appearance histo?
imatinib-ckit | spindle cell feature

Year2 GI Exam I (18 decks)

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