Quiz 3 Stomach Flashcards Preview

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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

carcinoid tumor

neuro endocrine neoplasm
from enterochromaffin cells
serotonin producing
cells look like soccer balls