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Year2 GI Exam I > Path IV > Flashcards

Flashcards in Path IV Deck (59)
1

characteristics of autoimmune gastritis

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

2

Pathogenesis autoimmune gastritis

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)

3

autoimmune gastritis is assoc with what

increased risk gastric cancer and carcinoid tumros
assoc with hashimoto thyroiditis, graves, type I DM, addison, myasthenia gravis, vitiligo

4

how to differentiat H pylor assoc chronic gastritis or autoimmune

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!!!

5

sequelae of H pylor assoc gastritis

peptic ulcer, adenocarcinoma, MALT lymphoma

6

sequelae autoimmune gastritis

atrophy, pernicious anemia, adenocarcinoma, carcinoid tumor

7

uncommon forms of gastritis

reactive gastropathy
esosinphilic gastritis
lymphocytic gastritis- celiac
granulomatous gastritis

8

causes of granulomatous gastritis

crohn disease, mycobacteria, fungi, CMV and H pylori

9

What are peptic ulcers

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

10

where are most peptic ulcers

duodenum 4: 1 stomach

11

peptic ulcers are more common in male or femal

male

12

complicaitons of peptic ulcers

bleeding, perforation, obstruction

13

what do cancerous ulcers look like

have elevated margins

14

what will CXR show if have gastric perforation

free air under diaphragm

15

Tx for peptic ulcers

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

16

what is melena and what causes it

dark tarry stools
digestive enzymes act on blood and change its color

17

what is hematochezia and what causes it

usually GI bleed in colon because still bright red

18

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

slow bleeding or oozing

19

red blood and clots from NG tubes means what

active ongoing bleed

20

bile stained aspirate from NG tube

no active bleeding above treitz ligament

21

does clear NG aspirate meand there is no bleeding anywhere

no because GI bleed can be intermittant

22

procedure of choice to confirm bleeding site

upper GI endoscopy

23

what can be used to stop upper GI bleed

injection therapy with epinephrine or electro coagulation techniques

24

diseases that cause hypertrophic gastritis

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