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Block 10 Week 4 > Usera > GI Path > Flashcards

Usera > GI Path Flashcards

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1
Q

what are the 4 anatomical regions of the stomach?

A

cardia
fundus
body
pylorus

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2
Q

what lines the surface & pits of the entire stomach?

A

mucous cells

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3
Q

what cells are only found in the body & fundus?

A

chief & parietal cells

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4
Q

what are the 3 types of epithelial cells in the stomach?

A

mucous cells
chief cells
parietal cells

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5
Q

what endocrine cell is found in the body & fundus?

A

ECL

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6
Q

what endocrine cells are found in the antrum?

A

G
D
Enterochromaffin

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7
Q

what do ECL cells secrete?

A

histamine

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8
Q

what do G cells secrete?

A

gastrin

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9
Q

what do D cells secrete?

A

somatostatin

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10
Q

what do enterochromaffin cells secrete?

A

serotonin

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11
Q

what are the layers in gastric histology?

A

mucosa
submucosa
muscularis propria
(just like the esophagus)

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12
Q

what are the glands like in the fundus & body?

A

straight tubular glands that synthesize gastric juice

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13
Q

what are parietal cells?

A

eosinophilic

secrete intrinsic factor (vitamin B12)

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14
Q

what are chief cells?

A

basophilic

secrete pepsin

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15
Q

what are the glands like in the antrum & cardia?

A

branched & coiled

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16
Q

how much of the mucosa do the gastric pits of the antrum & cardia occupy?

A

half the thickness of the mucosa

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17
Q

what lines the glands of the antrum & cardia?

A

mucus-secreting cells

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18
Q

T/F: a small number of parietal cells are present in the cardia/antrum

A

TRUE

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19
Q

why is there potential for damage to the mucosa?

A

bc the gastric lumen has an acidic pH

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20
Q

what is the pH of the gastric lumen?

A

1

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21
Q

what are the 3 ways that the mucosa is protected from the pH of the gastric lumen?

A
  1. mucin
  2. mucus layer > neutral fluid layer
  3. vascular supply
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22
Q

how does mucin protect the mucosa from acidic pH?

A

foveolar cells secrete mucin > prevents food from touching the epithelium

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23
Q

how does the mucus layer protect the mucosa from acidic pH?

A

forms a neutral pH layer of fluid over the epithelium

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24
Q

how does the vascular supply help protect the mucosa from acidic pH?

A

delivers O2, bicarb, & nutrients > washes away acid that has diffused into the lamina propria

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25
what happens when the protective mechanisms for resisting acidic pH fail?
acute & chronic gastritis
26
what is acute gastritis?
a transient mucosal inflammatory process
27
what are the clinical features of acute gastritis (6)?
1. asymptomatic 2. epigastric pain 3. Nausea 4. vomiting 5. hematemesis 6. melena
28
what are the 7 causes of acute gastritis?
1. NSAIDs 2. H. pylori infxn 3. aspirin 4. cigs 5. booze 6. gastric hyperacidity 7. duodenal-gastric reflux
29
what is the preferred term for acute gastritis?
active inflammation
30
the presence of WHAT TYPE of cell in the mucosa denotes active inflammation?
neutrophils!
31
what is acute gastritis erosion?
loss of superficial epithelium | limited to the LAMINA PROPRIA
32
what is acute gastritis ulceration?
loss of epithelium DEEPER THAN EROSION
33
what are the components of acute gastritis ulceration?
layer of necrosis ulceration granulation tissue
34
what are the types of acute gastritis ulceration?
1. stress ulcers 2. curling ulcers 3. cushing ulcers
35
what pts get stress ulcers?
pts w/ shock
36
where do curling ulcers occur?
proximal duodenum
37
what are curling ulcers a/w?
severe burns or trauma
38
where do cushing ulcers occur?
gastric duodenal esophageal
39
what pts get cushing ulcers?
pts w/ intracranial dz
40
what are the 3 clinical features of chronic gastritis?
1. nausea 2. vomiting 3. upper abd discomfort
41
what are the 5 causes of chronic gastritis?
1. H. pylori infxn 2. psychological stress 3. caffeine 4. booze 5. tobacco (i'm surprised i don't have one tbh)
42
what does H. pylori look like?
spiral shaped or curved bacilli
43
what is present in almost all pts w/ duodenal ulcers & most pts w/ gastric ulcers & chronic gastritis?
H. pylori
44
why do you get a condition a/w H. pylori?
result of an imbalance btwn gastroduodenal mucosal defenses & damaging forces that overcome the defenses
45
what does H. pylori normally affect?
antrum
46
what does H. pylori cause in the antrum?
antral gastritis w/ LOTS of acid pdtion
47
what happens if you get an H. pylori infxn in the fundus/body?
multifocal atrophic gastritis
48
what 3 things characterize multifocal atrophic gastritis?
1. DEC acid secretion 2. intestinal metaplasia 3. INC risk of gastric adenocarcinoma
49
what is the cellular infiltrate of chronic gastritis?
plasmacytic
50
what accounts for <10% of chronic gastritis?
autoimmune gastritis
51
what does autoimmune gastritis affect?
body/fundus of stomach
52
what is another name for autoimmune gastritis?
chronic atrophic gastritis
53
what are the 5 characteristics of autoimmune gastritis?
1. ab to parietal cells & IF 2. DEC serum pepsinogen I conc 3. antral endocrine cell hyperplasia 4. vitamin B12 def 5. achlorhydria
54
what is pernicious anemia?
vitamin B12 def
55
why do you get DEC serum pepsinogen I conc in autoimmune gastritis?
chief cell destruction
56
pts w/ autoimmune gastritis often have WHAT?
other autoimmune conditions | duh
57
what 3 things characterize reactive gastropathy?
1. foveolar hyperplasia 2. mucosal edema 3. glandular regenerative changes
58
what are the causes of reactive gastropathy (4)?
1. chemical injury 2. NSAIDs 3. bile reflux 4. mucosal trauma
59
what is eosinophilic gastritis?
dense infiltrates of eosinophils in the mucosa & muscularis
60
what are the causes of eosinophilic gastritis?
1. allergens 2. parasitic infxn 3. H. pylori 4. collagen vascular dz
61
what is lymphocytic gastritis a/w?
idiopathic | some a/w celiac
62
what can cause granulomatous gastritis (6 things)
1. Crohn's 2. sarcoidosis 3. mycobacteria 4. fungus 5. CMV 6. h. pylori
63
where can you get peptic ulcer dz?
any portion of the GI tract exposed to gastric acid
64
what is peptic ulcer dz most commonly a/w?
H. pylori & chronic gastritis
65
what is the cause of peptic ulcer dz?
same as the cause of chronic gastritis > the imbalance btwn mucosal defenses & damaging forces
66
what TYPES of conditions cause peptic ulcer dz?
things that inc gastric acidity
67
what 6 things cause peptic ulcer dz?
1. h. pylori infxn 2. parietal cell hyperplasia 3. zollinger-ellison syndrome 4. NSAIDs 5. cigs 6. high-dose steroids
68
what are polyps?
nodules or masses that protrude above the level of the surrounding mucosa
69
what can cause polyps (4 things)
1. epithelial or stromal hyperplasia 2. inflammation 3. ectopia 4. neoplasia
70
75% of gastric polyps are what type?
inflammatory/hyperplastic
71
what are inflammatory or hyperplastic polyps a/w?
chronic gastritis (reactive hyperplasia)
72
what kinds of pts get fundic gland polyps?
pts w/ familial adenomatous polyposis (FAP) or pts on proton pump inhibitors
73
when do adenomas appear?
in a background of chronic gastritis w/ atrophy & intestinal metaplasia
74
what pt population has an increased incidence of adenomas?
FAP pts
75
what is the most common carcinoma of the stomach?
adenocarcinoma
76
what is a histo finding of adenoma?
dysplastic nuclei
77
where do you most often get gastric adenocarcinomas?
antrum & lesser curvature
78
what are the 2 major histo types of adenocarcinoma?
1. intestinal type | 2. diffuse type (linitus plastica)
79
what does the histology of intestinal type adenocarcinoma look like?
columnar & disorganized
80
what does diffuse type adenocarcinoma look like on histo?
signet ring cells
81
primary lymphoma makes up what % of gastric malignancies?
only 5%
82
what kind of pts get lymphomas?
bone marrow & organ transplant pts
83
what is the most common type of lymphoma?
extra nodal marginal zone B-cell lymphoma
84
what are lymphomas in the gut called?
MALToma | lymphoma of mucosa-assoc lymphoid tissue
85
what is the 2nd most common type of lymphoma?
diffuse large B cell lymphoma
86
where do MALTomas arise?
sites of chronic inflammation, esp d/t h. pylori
87
how do you induce remission of a MALToma in most pts?
eradicate the infxn w/ abx
88
what 3 things are neuroendocrine tumors a/w?
1. endocrine cell hyperplasia 2. chronic atrophic gastritis 3. zollinger-ellison syndrome
89
neuroendocrine tumors can produce syndromes depending on what?
what hormone they produce
90
what did neuroendocrine tumors used to be called?
carcinoids
91
what is the most common mesenchymal tumor of the abdomen?
gastrointestinal stromal tumor
92
from what does a gastrointestinal stromal tumor arise?
interstitial cells of cajal

Block 10 Week 4 (9 decks)

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