Flashcards in Quiz 3 Stomach Deck (40):
1
Congenital diaphragmatic hernia
anatomical defect
see air above diaphragm on x-ray
2
congenital hypertrophic pyloric stenosis
- pyloris thickened
- mucosal hyperplasia
- elongated branched distorted pits
- abundant edematous lamina propria
- hypertrophy of smooth muscle of pylorus, causing thickening of the wall and decreased lumen size
- gastric peristalsis increased so backup of food and vomitting
- 2-3 weeks after birth
3
What causes gastric varices
hep b or c, alcohol, cirrhosis
4
gastric volvulus
twisted causing obstruction so everything proximal gets stuck
5
what causes gastric volvulus?
- fibrous adhesions
- laxity of ligamentous structures that hold things in place
6
where is most common volvulus?
sigmoid
7
what causes gastritis?
h. pylori, alcohol, drugs, infections
8
Hist of atrophic gastritis
- nuetrophils, white cells in lamina propria
- intestinal metaplasia
- loss of gastric glands
9
what type of ulcer is h. pylori most associated with?
duodenal peptic ulcers
10
h. pylori
rod shaped (spirochetes)
lives in mucus
gm-
flagellated
releases urease to get into
11
What is most sensitive and most specific test for h. pylori?
- which is best for ease and accuracy?
serology (ELISA)
carbon breath test (urea broken down to CO2)
12
H pylori is found in pt with?
duodenal ulceration (90%)
gastric ulceration (70%)
gastric cancer (60%)
gastritis
PUD
13
what causes peptic ulcers?
h pylori
stress
nsaids
14
how do you differentiate benign ulcers from malignant ulcers?
benign: smooth, regular, round edges, with flat smooth base, no blood
malignant: irregular, heaped borders, nodular, irregular mass that can be ulcerated and protrudes from lumen of stomach, fungating
15
What is number one cause of gastritis and PUD?
h. pylori
16
what is most common type of ulcer?
duodenal (2X)
- usually benign
17
Potential complications of PUD
GI bleeding
perforation of gastric or duodenal wall
scarring can lead to gastric outlet obstruction
ulcer into cancer
18
What is worse area for ulcer?
posterior and inferior because near aorta and pancreas
19
what is treatment for ulcers?
2 antibiotics and pepto bismo
20
how do you detect a peptic ulcer perforation?
free air under diaphragm in x-ray
21
what is referred to as an olive?
enlarged pyloric muscle in hypertrophic pyloric stenosis
22
what is triad in zollinger-ellison syndrome
- gastric acid hypersecrtion
- severe peptic ulceration
- non-beta cell islet tumor or pancreas (gastrinoma)
23
what does a gastrinoma do?
produces increased gastrin causing increased hydrochloric acid
24
Multiple endocrine neoplasia type 1 (MEN 1) is associated with what?
ZE
25
where are ZE primary tumors located?
pancreas (usually here)
duodenum
abdominal lymph nodes
26
Menetriers disease
- hyperplastic hypersecretory gastropathy
- enlarged gastric folds (rugae)
- giant stomach cells, thickened rugae, main polypoid
- increased mucin
- achlorhidria (decreased acid)
- can't absorb protein
27
what causes childhood menetriers
CMV or h pylori
28
what causes adult form of menetriers
over expression of protein, transforming growth factor alpha (TGF- alpha)
29
atrophic gastritis
- chronic inflammation of stomach mucosa leading to loss of gastric glandular cells and replacement by fibrous tissue and numerous goblet cells
- decreased gastric glands
- decreased acid production
30
what causes atrophic gastritis?
h. pylori or autoimmune
31
if autoimmune cause of atrophic gastritis, what are the ab against? What does this lead to?
gastric parietal cells which release Intrinsic factor. This leads to pernicious anemia due to non absorption of B12
32
what are autoimmune atrophic gastritis patients more likely to develop?
achlorhydria and gastric carcinoma
33
autoimmune metaplastic atrophic gastritis
immune response directed towards parietal cells and intrinsic factor
34
hypocholrhydria due to decreased parietal cells can lead to what?
carcinoid tumors
35
what are early signs of neoplasia?
- increased nucleus to cytoplasm ratio
- increased size of nuclei
- more mitotic bodies
36
gastric adenocarcinoma
neoplastic glands
better prognosis
same cellular changes seen in all caner
signet ring (nucleus pushed against wall)
37
linitis plastica
leather bottle stomach
originates in glandular tissue
have to remove stomach
38
MALT (mucosal associated lymphoid tumor)
GI lining only
sheets in wave pattern
most frequent stomach malignancy after adenocarcinoma
39
gastric leiomyoma
smooth muscle tumor
most common in esophagus
40