Patho - Stomach Diseases

Question 1

Complication of Acute gastritis

Answer 1

«acute ulcer»

Question 2

Causes of acute gastritis

Answer 2

1) NSAIDs e.g : aspirin
2) ALCHOL
3) SMOKING
4) Stress ulcer
5) Old age

Question 3

Microscopic picture of acute gastritis

Answer 3

1. Mild acute gastritis
2. Acute erosive hemorrhagic gastritis :
   Severe mucosal damage
3. Acute peptic ulcer :

-curling’s ulcer: Associated with severe burns or trauma.
-cushing ulcer: Associated with trauma to C.N.S

Question 4

Congenital anomalies of stomach

Answer 4

1. Diaphragmatic hernia
2. Congenital pyloric stenosis

Question 5

What is Congenital pyloric stenosis

Answer 5

Hypertrophy of pyloric sphincter

Question 6

Start of Congenital pyloric stenosis

Answer 6

Appear in 3rd wk of life by regurge & vomiting

Question 7

Types of Chronic gastritis

Answer 7

1) Helicobacter pylori gastritis

2) Autoimmune gastritic (ch. Atrophic gastritis)

3) Reactive gastritis

Question 8

Causative organism of Helicobacter pylori gastritis

Answer 8

H. pylori

Question 9

Helicobacter pylori gastritis affect which part of stomach ?

Answer 9

antrum

Question 10

Microscopic picture of Helicobacter pylori gastritis

Answer 10

PNL infiltrate

Question 11

Complications of Helicobacter pylori gastritis

Answer 11

. Peptic ulcer
. Gastric carcinoma
. MALT lymphoma

Question 12

Autoimmune gastritic affect which part of stomach ?

Answer 12

fundus

Question 13

Autoimmune gastritic genetically is

Answer 13

Autosomal dominant

Question 14

Autoimmune gastritic associated with

Answer 14

1) Abs against parietal cells
2) Achlorhydria
3) pernicious anemia
4) Intestinal metaplasia

Question 15

Reactive gastritis called

Answer 15

Gastropathy

Question 16

Causes of Reactive gastritis

Answer 16

chemicals, drugs, radiation

Question 17

In active chronic gastritis background filled with

Answer 17

Neutrophil ( PNLs)

Question 18

Chronic infiltration cells in chronic gastritis extend to ……

Answer 18

Extend down to mascularis mucosa and replace glands

Question 19

Differentiate between Helicobacter pylori gastritis & Autoimmune gastritic

Answer 19

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Question 20

Benign tumors of stomach

Answer 20

1- Gastric adenoma
2- Gastric polyps

Question 21

Gastric adenoma Arise in the background of

Answer 21

chronic gastritis

Question 22

In Gastric adenoma Risk of malignant change increases in polyps ………….

Answer 22

greater than 2 cm

Question 23

In Gastric polyps there is risk of dysplasia if

Answer 23

> 1.5 cm

Question 24

Gastric polyps affect stomach in ……….. & genetically it is ………….

Answer 24

• fundus
• Hereditary

Question 25

Cause of Carcinoma of stomach

Answer 25

Mutation in CDH 1 gene

Question 26

Sites of Carcinoma of stomach

Answer 26

pyloric antrum & lesser curvature

Question 27

Prognosis of Carcinoma of stomach

Answer 27

•Depth of invasion •Extent of nodal and distant metastasis

Question 28

Gross of Carcinoma of stomach

Answer 28

1) Fungating or exophytic 2) Malignant ulcer 3) Infiltrating Localized: •In the pylorus & pyloric antrum Diffuse: •The entire stomach wall is thickened up , Coat converting the stomach into thick, rigid, short, tube called «Leather bottle stomach or linitis plastica»

Question 29

Microscopic picture of Carcinoma of stomach

Answer 29

Schedule page 22

Question 30

Predisposing factors of Carcinoma of stomach

Answer 30

1. Adenoma 2. Atrophic gastritis 3. After gastrectomy 4. (A) blood group

Question 31

Effects of Carcinoma of stomach

Answer 31

•hematemesis •Pyloric obstruction > cachexia

Question 32

Spread of Carcinoma of stomach

Answer 32

- direct - lymphatic: To Virchow LN «left supraclavicular» - Transcoelomic : to ovary (Krukenberg tumor)

Question 33

Carcinoid tumor associated with

Answer 33

endocrine cell hyperplasia

Question 34

Prognosis of GIT carcinoids

Answer 34

» Foregut carcinoids ( stomach and duodenum)———> rarely metastasize » Midgut tumours (jejunum and ileum) ———> aggressive » Hindgut tumours ( appendix) ———> benign

Question 35

Clinical picture of Carcinoid tumor

Answer 35

•Cutaneous flushing and sweating •Asthmatic wheezing & bronchospasm •Right sided cardiac valvular fibrosis •Cramping, abdominal pain and diarrhea

Question 36

Cause of Gastrointestinal stromal tumour

Answer 36

Mutation in c-kit gene

Question 37

Prognosis of Gastrointestinal stromal tumour (GIST) :

Answer 37

•Gastri GISTs being less aggressive than those arising in the small intestine. •Recurrence or metastasis is rare for gastric GISTs under 5 cm but common for tumors larger than 10 cm

Question 38

Clinical picture of Peptic ulcer

Answer 38

1- Epigastric burn or aching pain 2- Nausea, vomiting, bloating انتفاخ

Question 39

Sites of peptic ulcer :

Answer 39

1) Duodenum (1ry part) 2) Duodenum,stomach or jejunum (Zollinger Ellison $) 3) Meckel›s diverticulum with ectopic gastric mucosa

Question 40

Complication of peptic ulcer

Answer 40

Cicatricial contraction: -Hour – glass stomach

Question 41

Gross of peptic ulcer

Answer 41

- two ulcer can exists (particularly in duodenum) (kissing ulcer) - in gastric ulcer the surrounding mucosa flattened & atrophic

Question 42

Layers of peptic ulcer

Answer 42

(1) Fibrinoid necrosis (2) Acute nonspecific infiltration : with PNL (3) Granulation tissue formation (4) Fibrosis (5) BV •(A) EAO •(V) Thrombosis