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19 Cards in this Set
- Front
- Back
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What are the main cells of the gastric body?
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Parietal cells and chief cells
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What are the top and bottom compartments of the gastric body called?
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Top= foveolar compartment
Bottom= glandular compartment |
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What are the 3 types of gastritis?
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Acute (active) - neurtophils
Chronic - lymphocytes, plasma cells and macrophages Acute on chronic (active chronic) Inflammation of the gastric mucosa |
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What are the 3 common causes of gastritis?
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Autoimmunity (10% of chronic)
Auto antibodies to parts of parietal cells (H/K ATPase, gastrin receptor, I.F) Bacteria- H. Pylori (gastric epithelium, antrum most affected) Chemicals= reactive/ reflux gastritis (bile salts, alcohols, NSAIDs, aspirin, bisphosphates) |
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What are the 5 rare causes of gastritis?
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Granulomatous gastritis (crohn's/ TB)
Viral infection (CMV) Lymphocytic gastritis Eosinophilic gastritis Radiation |
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What are the 3 different types of duodenitis?
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Active acute
Chronic (more common) Acute on chronic Inflammation of the mucosa of the PROXIMAL duodenum |
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What are the 3 main causes of duodenitis?
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H. Pylori colonising gastric metaplasia
Hyperacidity (gastric metaplasia) Drugs- NSAIDs! |
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What are the courses of gastritis/ duodenitis?
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Resolution
Persistance Erosion (acute) Ulcers (invaded the muscularis mucosa) Dysplasia - neoplastic - premalignant Cancer- adenocarinomas/ lymphoma Atrophy and interstitial metaplasia |
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If left untreated, what can h.pylori and autoimmune gastritis cause?
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Adenocarcinoma
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What is gastric lymphoma associated with?
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Chronic gastritis and H. pylori (>80%)
50% resolve with treatment of H. pylori MALT lymphoma B cells - NHL Lymphoepithelial lesions |
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Where are acute peptic ulcers and what causes them?
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Stomach and duodenum
NSAIDs Severe physiological stress |
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What is zollinger Ellison syndrome?
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Tumour in the duodenum/ peripancreatic soft tissue/ pancreas
Produces gastrin resulting in hyperacidity |
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What are the different types of acute peptic ulcer?
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Curling ulcer- proximal duodenum- burns/ trauma
Cushing ulcers- stomach/ duodenum/ oesophagus (head injury, post op) Ischaemia - head injury = vagal stimulation = acid hypersecretion Stress ulcers |
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Where are chronic ulcers usually found?
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Sites exposed to acid/ peptic juices
1st part of the duodenum (75%) Stomach, usually antrum (25%) Gastro- oesophageal junction- reflux, hiatus hernia |
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Name the defensive forces against peptic ulcers? (5)
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Mucus
Bicarbonate Mucosal blood flow (removes acid and provides HCO3) Prostaglandins (production of HCO3) Epithelial regeneration |
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Name the 6 damaging stimuli to the epithelium?
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Acid
Peptic enzymes H.pylori (!!) NSAIDs - suppress prostaglandins Cigarettes - impair mucosal blood flow and healing Ischaemia |
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What are the 4 zones of a peptic ulcer? GINF
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Granulomatous tissue - angiogeneis and proliferation of fibroblats
Inflammatory (neutrophils) Necrotic tissue - fibrinoid debris Fibrosis |
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What are the complications of Peptic ulcers?
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Haematemeis/ GI bleed
Perforation with peritonitis Penetration of surrounding organs Obstruction via scarring = hour glass stomach Rarely causes cancer |
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What are 7 steps involved in a duodenal peptic ulcer?
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H. Pylori antral gastritis
Hypergastrinaemia (Increased gastrin produced) Hyperacidity Duodenitis Gastric metaplasia of duodenum Helicobacter colonization of duodenum Impaired duodenal mucosal defence Duodenal peptic ulcer |
