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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
Q

gross structure of hypertrophic gastropathy

A

thickened cerebriform gastric folds

26
Q

two important points of hypertrophic gastropathy

A

may mimic carcinoma or lymphoma

could have severe PUD

27
Q

what is cause of menetrier disease

A

excessive secretion of transofrming growth factor alpha

28
Q

Tx mentrier disease in children

A

goes away on own usually

29
Q

Sx menetrier disease in children

A

weight loss, diarrhea, peripheral edema

30
Q

cause Z-E syndrome

A

gastrin secreting tumore: gastrinoma

31
Q

Sx Z-E syndrome

A

chronic diarrhea, multiple peptic ulcers

32
Q

what cell # is greatly increased in Z-E syndrome

A

parietal cells

33
Q

Tx for Z-E syndrome

A

block acid production

find and remove the tumor

34
Q

majority of gastric polyps are what

A

inflammatory and hyperplastic <1cm

35
Q

fundic gland polyps are found in what population

A

F>M PPI related because of increased gastrin

36
Q

gastric ademoa greater than 2 cm is assoc with what

A

carcinoma

37
Q

polyp with corkscrew shaped foveolar glands

A

gastric hyperplastic polyp

38
Q

3rd most common cause cancer death worldwide

A

stomach

39
Q

stoamch carcinoma is associated with

A

H pylori

>90% originate from glandular epithelial cells of the stomach (adenocarcinoma)

40
Q

population affected by gastric cancer

A

55 y.o M>F

aggressive

41
Q

Describe intestinal type stomach carcinoma

A 
M>F
assoc with prior H pylor infection
TLR4, APC/WNT pathyway, p53
gatric antrum/pylorus
lesser curvature>greater
42
Q

describe diffuse type (signet ring) stomach carcinoma

A 
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
Q

what cancers involve mutation sin APC/WNT pathway

A

intestinal type gastric cancer and colon CA

44
Q

what mutation is assoc with diffuse gastric carcinoma

A

mutation in tumor suppressor CDH1

also mutation in lobular CA of breast

45
Q

stomach carcinoma is classified by

A

depth of invasion
macroscopic growth pattern
histologic subtype

46
Q

what is important for prognosis of stomach carcinoma

A

depth of invasion and lymph node status

47
Q

where is sister mary joseph nodule
irish node?
virchows node?

A

sister mary joseph is belly buton
virchow is neck/supraclavicular
irish is axillary node

48
Q

what is linitis plastica

A

extreme form of flat or depressed advanced gastric carcinoma

49
Q

signet ring cells

A

diffuse gastric carcinoma

50
Q

what is name for mesenchymal tumores of stomach

A

gastro intestinal stromal tumor

51
Q

most common site extra nodal lymphoma

A

stomach

52
Q

2 types gastric lymphoma

A

indolent extra nodal marginal zone B cell lymphoma (MALToma, H pylori related)
diffuse large B cell lymphoma (high grade)

53
Q

translocations assoc with gastric MALToma

and net effect?

A

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
Q

lymphoepithelial lesions with neoplastic lymphocytes in gastric glands
dx?

A

gastric MALT lymphoma

55
Q

markers for gastric MALT B cell lymphoma

A

CD19 and 20+

monoclonal light chains

56
Q

2nd most common gastric lymphoma

A

DLBCL

57
Q

GIST mesenchymal tumors arise from what

A

interstitial cells of Cajal, pacemakers

58
Q

most common abdominal mesenchymal tumor?

mutations?

A

GIST
tyrosine kinase c-kit CD117 mutations
some are PDGFRA mutations

59
Q

Tx GIST

appearance histo?

A

imatinib-ckit

spindle cell feature

Year2 GI Exam I (18 decks)

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