Pathology Flashcards
(25 cards)
Parietal Cells; where are they and what do they produce?
Fundus and corpus, HCL and intrinsic factor
Chief Cells; where are they and what do they produce?
Fundus and corpus, pepsinogen
G-Cells, where are they and what do they produce?
Antrum, gastrin
What endocrine hormones are produced in the stomach?
Gastrin, Histamine, serotonin, somatostatin
Acute Gastritis; causes
Alcohol Smoking NSAIDs Steroids Corrosives Uremia Stress Infection
How would acute gastritis appear?
Thickened mucosa
Punctuate dark spots (from hemorrhage)
Erosions (deficits in mucosa, but does not penetrate to muscular mucosa)
Characteristic of chronic gastritis?
Mucosal changes, leading to mucosal atrophy and epithelial metaplasia.
Dysplasia may occur, predisposing to carcinoma.
The main types of chronic gastritis?
Helicobacter-associated
Auto-immune
Chemical/reflux
Name for a gastrin secreting tumor
Zollinger Ellison
Curling ulcer
Curling ulcer (stress ulcer) is an acute gastric erosion resulting as a complication from severe burns when reduced plasma volume leads to ischemia and cell necrosis of the gastric mucosa.
Cushing Ulcer
A Cushing ulcer is a peptic ulcer associated with elevated intracranial pressure.
The mechanism is due to stimulation of vagal nuclei as a result of increased intracranial pressure. The end result is increased secretion of gastric acid with eventual ulceration of the gastric mucosa.
Helicobacter Associated chronic gastritis; where does it colonize, what age does it effect, and what is the mechanism of destruction?
H. Pylori colonizes the corpus, antrum, and duodenum. It infects people of all ages.
It produces urease, which generates ammonia and protease.
Autoimmune chronic gastritis; who does it effect, what cells are attacked and in what part of the stomach, what are the consequences, and what are some comorbidities?
It is seen mostly in the elderly.
Autoantibodies attack parietal cells in the funds and corpus. Impairs intrinsic factor production, thereby causing megaloblastic anemia.
Seen with other autoimmune disorders; Hashimoto’s thyroiditis, Addison’s. Increases likelihood of gastric carcinoma.
5 sites of PUD
Esophagus Stomach (lesser curve most common) Duodenum (1st part, D1, most common) Meckels diverticulum (due to ectopic gastric mucosa) Gastric bypass
Risk factors/aetiology of PUD
H. pylori (90% duodenal, 70%gastric) Smoking Alcohol Drugs (NSAIDs, steroids) Diet Trauma/shock (Curling and Cushing ulcers) Family history Blood group (A for GU, O for DU)
Characteristics of acute gastric ulcers
Usually caused by shock/trauma/burns
Small in size < 1 mm
Can be single or multiple
Can bleed profusely but heals without scaring.
Investigations for PUD (3)
Endoscopy
Barium swallow radiography
gastrin levels
Triple therapy
One week course.
PPI 2x daily
Clarithromycin 2x daily
Amoxicillin 2x daily
Or methronizadole in place of penicillin
Symptomatic difference between gastric and duodenal ulcers
Gastric ulcer pain occurs AFTER eating, therefor weight loss.
Duodenal ulcer pain is relieved by eating, therefor weight gain. And often come on at night.
Symptoms of PUD
Epigraphic pain; guarding, tenderness, rigidity.
Can have nausea, vomiting, back pain.
Duodenal and gastric ulcer hemmorage locations and arteries
GU; lesser curve, left gastric artery.
DU; posterior wall, gastroduodenal artery.
Symptom and diagnosis of perforated duodenal ulcer
Shoulder pain, due to irritation of phrenic nerve.
Free air under diaphragm in CXR.
What is the acronym for retroperitoneal organs?
SADPUCKER
Causes of acute pancreatitis?
I GET SMASHED
Idiopathic Gallstones (majority) Ethanol Trauma Steroids Mumps Autoimmune disease Scorpion sting Hypercalcemia/triglyceridemia ERCP Drugs
