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18 Cards in this Set
- Front
- Back
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What is the most proximal region of the stomach?
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Cardia (nearest esophagus)
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The fundus is lined by _______.
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Parietal (acid) and chief cells (pepsin)
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The antrum is lined by _______.
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Muscous cells, G cells (gastrin)
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What is the most distal region of the stomach?
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Antrum (pylorus is more distal actually)
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Acute gastritis:
Prognosis Gross appearance Histologic appearance |
Transient, self-limiting
Resolves if stimulis removed! Gross appearance: hemorrhage, erosions, edema Histologic: Inflammn, nphils |
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Chronic gastritis:
Presentation Prognosis Histologic appearance |
Often asyx; pain, n/v
May lead to ulceration, atrophy, metaplasia (-->dysplasia-->carcinoma), lymphoma if h. pylori Histo: lots of lymphocytes, lots of plasma cells, +/- nphils |
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What is the most common cause of chronic gastritis?
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H. pylori
Can also have autoimmune, chemical/reactive (NSAIDs, bile reflux, EtOH) |
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H. pylori places patients at risk of developing ______.
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Lymphoma (MALT)
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This cause of gastritis affects the antrum.
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h. pylori
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This cause of gastritis affects the fundus.
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Autoimmune (parietal cells affected)
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Autoimmune chronic gastritis:
Presentation |
B12 deficiency (anti-parietal ab's, anti-IF ab's)
Achlorhydria |
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H. pylori gastritis vs Autoimmune gastritis:
Region of stomach affected Cells present under microscope Acid levels Effects |
HP:
Antrum See PMNs, plasma cells Acid slightly dec'd Find Abs x H. pylori Leads to peptic ulcer, adenoca (Low SES) Autoimmune: Affects body (fundis?) Lymphocyte predominance DEc'd acid Abs x parietal cells & IF Results in atrophy, adenoca, carcinoid, PERNICIOUS ANEMIA |
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Peptic ulcer disease:
Presentation Causes |
Dyspepsia, epigastric pain, MELENA, HEMATEMESIS, anemia
Causes: H pylori most common Hyperacidity (Z-E Syndrome) NSAIDs |
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Gastric Polyps:
Associated with? Subtypes |
90% are hyperplastic; assocd w/chronic gastritis (response to damage)
Some are fundic gland polyps--sporadic 5-10% are adenomas--neoplastic |
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Gastric Carcinoma:
Intestinal Type vs Diffuse Type: Populations affected Environmental Influences Changes in incidence |
Intestinal type:
Male > female, over 50 years age Strong assocn w/H pylori and environmental factors Incidence decreasing in USA Diffuse Type: male = female, younger pts No enviro influence Incidence unchanged (subset have familial gastric cancer--mutation in e-cadherin) |
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Intestinal type adenocarcinoma:
Risk Factors Region of stomach affected |
Low SES
Diet (nitrites, smoked, salted, and pickled foods; lack of fresh fruit/veggies) Chronic gastritis (helicobacter, autoimmune gastritis, s/p gastrectomy) 50% occur in antrum |
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Lymphoma of GI Tract:
Causes |
H. pylori (MALToma)
Immunodeficiency (High grade B cell lymphoma) Celiac Sprue (T-Cell lymphoma) |
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Gastrointestinal Stromal Tumor:
Pathophys Treatment |
Derived from cells of Cajal which express c-kit receptor
c-kip = receptor for stem cell GF (SCF) In GIST, mutant c-kit continuously pi'd in absence of SCF-->proliferation ALL GISTS HAVE MALIGNANT POTENTIAL Tx: Surgery and imatinib |
