Pathology - stomach

Question 1

what are two types of gastritis

Answer 1

acute- erosive

chornic - non erosive

Question 2

what causes acute gastritis?

Answer 2

disruption of the mucosal barrier - inflammation

Question 3

what type of patient would display acute gastritis

Answer 3

OHics
chronic NSAID users
burn victims
brain injury victims

Question 4

how do NSAIDs lead to the development of gastritis?

Answer 4

decrease PGE2 - decrease mucosal barrier

Question 5

what are curling ulcers?

Answer 5

burn victims - acute gastritis

Question 6

how do burns lead to ulcers?

Answer 6

decrased plasma volume - sloughing of gastric mucosa

Question 7

what are cushing ulcers?

Answer 7

brain injury - acute gastritis

Question 8

how does a brain injury lead to an ulcer?

Answer 8

increased vagal stimulation - increased Ach - increased H secretion

Question 9

what type of patient typical for acute gastritis

Answer 9

OHis and patients taking daily NSAIDs (ie rheumatoid arthritis)

Question 10

type A chronic gastritis due to:

Answer 10

autoimmune disorders
pernicious anaemia
abs to parietal cells
achlorhydria

Question 11

what part of the stomach does type A chronic gastritis hit?

Answer 11

fundus and body

Question 12

what part of the stomach does type B chronic gastritis hit?

Answer 12

antrum

Question 13

what causes type B chronic gastritis?

Answer 13

H pylor infection

Question 14

what type of cancer does type B chronic gastritis increase the risk of?

Answer 14

MALToma

Question 15

autoimmune disease
abs to parietal cells
pernicious anaemia
achlorhydria

Answer 15

type A chronic gastritis

body and fundus of stomach

Question 16

what is achlorhydria?n

Answer 16

no Cl in gastric secretions

Question 17

hypertrophies ruga
excess mucos production
protein loss
parietal cell atrophy

Answer 17

menetrier disease

Question 18

describe how menetrier disease looks on CT?

Answer 18

rugaue are so hypertrophied that they look like brain gyri

Question 19

describe menetrier disease

Answer 19

gastric hyperPLASIA of mucosa leads to hyperTROPHY of rugae, increased mucous production, protein loss and atrophy or parietal cells – decreased acid production

Question 20

who cares about menetrier disease

Answer 20

precancerous

Question 21

describe the s and sxs of stomach disorders

Answer 21

hematemesis: most common due to PUD, can be from varices or acute gastritis
melena: hb exposed to acid turns black – bleed proximal to fourth part of the duodenum

Question 22

what surrounds the fourth part of the duodenum?

Answer 22

the ligament of trietz

Question 23

what does H pylori infection cause?

Answer 23

type B chronic gastritis
duodenal > gastric ulcers
gastric adenocarcinoma
MALToma

Question 24

what types of gastric cancer exist

Answer 24

adenocarcinoma
lymphoid
carcinoid (rare)

Question 25

where is most common site of carcinoid tumour in the git?

Answer 25

small intestine

Question 26

what needs to happen for a carcinoid tumour to present as carcinoid syndrome?

Answer 26

mets to the liver

Question 27

describe prognosis of stomach cancer

Answer 27

early aggressive local spread with node/liver metastases

Question 28

where does stomach cancer met to?

Answer 28

liver and nodes

Question 29

weight loss early satiety acanthosis nigricans

Answer 29

stomach cancer

Question 30

what causes intestinal form of gastric cancer?

Answer 30

``` H pylori dietary nitrosamines/smoked foods tobacco achlorhydria chronic gastritis ```

Question 31

where is intestinal gastric cancer most common?

Answer 31

japan

Question 32

incident of gastric cancer in USA?

Answer 32

decreasing

Question 33

where does intestinal gastric cancer occur in stomach?

Answer 33

lesser curvature

Question 34

what does intestinal gastric cancer look like?

Answer 34

ulcer with RAISED MARGINS

Question 35

H pylori and diffuse stomach cancer?

Answer 35

not related

Question 36

H pylori and intestinal stomach cancer?

Answer 36

related

Question 37

histopathos of diffuse stomach cancer please

Answer 37

SIGNET RING CELLS

Question 38

what is a signet ring cell?

Answer 38

diffuse stomach cancer | mucin filled cells with peripheral nuclei

Question 39

describe gross presentation fo diffuse stomach cancer

Answer 39

linitus plastic: wall is grossly thickened and leathery as signet celsl invade

Question 40

``` cachexia weight loss epigastric pain vomiting and melena acanthosis nigricans seborrhoeic keratosis ```

Answer 40

stomach cancer

Question 41

what is Leser-Trelat sign?

Answer 41

multiple outcroppings of seborrheic keratosis associated with gastric cancer

Question 42

name the lumps and bumps you'd see in gastric cancer

Answer 42

``` virchows node (also esophageal, cervical, pancreatic) sister mary joseph nodule SEBORRHEIC KERATOSIS acanthosis nigricans krukenberg tu;mour ```

Question 43

what is vrichows node

Answer 43

gastric cancer, pancreatic, esophageal, cervical cancers involvement of left supraclvicular node by mets from stomach

Question 44

what is sister mary joseph nodule

Answer 44

subcutaneous periumbilical metastasis with gastric cancer

Question 45

what is a krkenberg tumor

Answer 45

bilateral mets to ovaries hematogenous spread abundant mucin secreting signet ring cells

Question 46

bilateral ovaries with abundant mucin secreting signet ring cells

Answer 46

krukenberg tumour | gastric cancer

Question 47

which PUD: weight loss

Answer 47

pain with food - gastric

Question 48

which PUS: weight gain

Answer 48

duodenal - pain relived by food

Question 49

which PUD is associated with H pylori infection?

Answer 49

H pylori - intestinal gastric cancer, type B chronic gastricits, MALToma gastric - 70% duodeonal - 100%

Question 50

mechanism of gastric ulcer pelase

Answer 50

decreased mucosal protection against gastric acid

Question 51

mechanism of duodenal ulcer pelase

Answer 51

decreased mucosal protection OR increased gastric acid secretion

Question 52

risk fo carcinoma with gastric ulcer

Answer 52

some

Question 53

risk of carcinoma with duodenal ulcer

Answer 53

negligible

Question 54

which type of ulcer needs to be biopsied?

Answer 54

gastric not duodenal

Question 55

what happens in duodenal histology in duodenal ulcers

Answer 55

hypertrophy of brunner glands

Question 56

what type of ulcers associated with zollinger Ellison syndrome

Answer 56

duodenal

Question 57

what are complciatiosn of ulcers?

Answer 57

hemorrhage | perforation

Question 58

what type of PUD associated with hemorrhage

Answer 58

gastric | duodenal

Question 59

anterior ro posterior for hemorrhages associaedted with PUD?

Answer 59

posterior

Question 60

list vessels to worry about in hemorrhage of PUD

Answer 60

gastric - left gastric | duodenal - gastroduodenal

Question 61

which PUD worry about in perforation?

Answer 61

duodenal

Question 62

describe what youd see if duodenal PUD perforates?

Answer 62

may see free air under diaphragm with referred pain to shoulder via phrenic nerve

Question 63

anterior or posterior for perforation of PUD

Answer 63

anterior

Question 64

free air under diaphragm H pylori infection referred pain to the shoulder

Answer 64

perforation of duodenal PUD