Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
58 Cards in this Set
- Front
- Back
|
Define ectopic gastric mucosa
|
Congenital. ectopic (=abnormal) acid production with mucosal damage
|
|
|
Define Diaphragmatic hernia
|
Congenital. abdominal viscera herniates into thoracic cavity due to incomplete diaphragm formation
|
|
|
Define Omphalocele
|
Congenital. Incomplete closure of muscular abd. wall with herniation of abd. viscera into ventral membranous sac
|
|
|
Define Gastroschisis
|
Congenital. Abd. wall defect involving all layers (not just muscular like with omphalocele)
|
|
|
Define Pyloric stenosis
|
Congenital OR Acquired. Projectile vomit, palpable mass, Tx. = Pyloromyotomy (=incise/split pyloric muscle)
|
|
|
You feel a palpable mass around the opening of the stomach to small intestines. Pt has been projectile vomiting for 3 days. What other genetic conditions is this assoc. with?
|
We're thinking pyloric stenosis.
Assoc. with Trisomy 18 (=third copy of material from chromo 18) Turner Syndrome (female doesn't have xx chromos) |
|
|
Which is typically more severe, acute or chronic gastritis?
|
Acute
|
|
|
What are some usual causes of acute gastritis?
|
Drugs or stress
|
|
|
What is a complication of chronic gastritis?
|
epi dysplasia and Peptic Ulcer Disease
|
|
|
Define Gastritis
|
Mucosal inflamm with or without erosions/ulcerations hemorrhage
Imbalance between degradative and protective processes Altered mucosa |
|
|
How do ulcers develop with gastritis?
|
With continual damage to mucosa of stomach, eventually the damage can wear down mucosa and we can get an ulcer
|
|
|
How do we grade chronic gastritis?
|
[Location will be included]
TO GRADE: Type of inflamm - active, chronic, other Presence/absence of H. pylori Presence of glandular atrophy, intestinal metaplasia |
|
|
Whats the cause of acute gastritis?
|
Gastric hyperacidity
|
|
|
What will we see in the mucosa of stomach with acute gastritis?
|
Neutrophils
|
|
|
Pt has been on aspirin and corticosteroids for a while. What can we say about their mucus production and gastritis?
|
DEC. mucus production leading to acute gastritis
|
|
|
Pt has been on NSAIDS for a while. What can we say about their prostaglandins and gastritis?
|
DEC. Prostaglandins leading to acute gastritis
|
|
|
Pt was in a car accident where they suffered severe burns. What type of ulcer will they have?
|
Curling ulcer ie acute gastritis so give them something to dec. these ulcers
|
|
|
Pt suffered severe CNS trauma. What type of ulcer will they have>?
|
Cushing ulcer ie acute gastritis so give them something to dec. these ulcers
|
|
|
Type B chronic gastritis is caused by what?
|
ENVIRONMENATAL (type A = Autoimmune)
H. pyloir Multipfocal Reactive |
|
|
The location of the gastritis is Antral stomach. Is the cause of the gastritis Autoimmune or Environmental
|
Environmental, specifically H. pylori
|
|
|
The location of the gastritis is Body/Fundus of stomach. Is the cause of the gastritis Autoimmune or Environmental
|
Autoimmune
|
|
|
Pt presents with pernicious anemia (B12 def.) and auto-Abs against IF. Type A or Type B gastritis?
|
Type A
|
|
|
When H. pylori causes chronic gastritis, what can it lead to?
|
inc. acid production and thus Peptic ulcer disease, MALT or Lymphoma
|
|
|
Long H. Pylori gastritis will eventually lead to what?
|
Multi-focal gastritis ie LOTS of the stomach involved, not just Antral stomach like with H. pylori
|
|
|
Whats the result of multi-focal gastritis?
|
DEC. acid production (vs. H. pylori gastritis = inc. acid production) --> Hypochlorhydria as parietal cells LOST --> MALT Lymphoma
|
|
|
When a pt takes NSAIDS for a long time and develops chronic gastritis, what will we see in the tissue?
|
sparse inflammatory infiltrate with reactive foveolar hyperplasia and regenerative glandular change (this means nothing to me....)
|
|
|
What genes are related to the inflamm response of multi-focal gastritis?
|
IL-1beta and TNF
|
|
|
Pathogenesis of Type A Autoimmune gastritis?
|
Auto-Abs directed against parietal cells and IF
= DEC. gastric secretion, notably HCl and IF |
|
|
How do we get Pernicious anemia with autoimmune gastritis?
|
Dec. IF = Malabsorption of B12 = pernicious anemia
Megaloblastic anemia from B12 deficiency, too |
|
|
There is a strong assoc. of H. pylori chronic gastritis with what outcome?
|
Peptic Ulcer Disease ie ulcers in stomach
|
|
|
Define classic gastric PUD
|
pain 5-15 min after oral intake, relieved by fasting.
|
|
|
Define Duodenal PUD
|
pain may be relieved by eating, returns 1-2 hrs after eating, nocturnal pain, RUQ pain
|
|
|
Pts. pain is relieved by fasting. What type if PUD do they have?
|
Gastric PUD
|
|
|
Pt presents with H. pylori infection, NSAID use, smokes, cirrhosis of liver, has a 1st degree relative with PUD, and is half AA half hispanic. What are they at increased risk for?
|
PUD
|
|
|
With PUD, what are we worried about?
|
Bleeding, Fibrosis, Perforation
|
|
|
Define Hypertrophic Gastropathies
|
Marked accentuation of the gastric rugal folds
|
|
|
Will we see epi hyperplasia with Hypertrophic Gastropathies?
|
MINIMAL to NONE
|
|
|
Should you be worried about neoplasms if a pt has a hypertrophic gastropathy (Menetrier Disease or Zollinger-Ellison Syndrome)?
|
NO, epi proliferation is NOT neoplastic (bot NOTE that Menetrier disease is a neoplastic process)
|
|
|
Define Menetrier disease
|
Hyperplastic Hypersecretory gastropathy = glands in stomach secrete lots of TGF-alpha
= excessive secretion/action of TGF-alpha Diffuse Hyperplasia of the foveolar (mucus cell) epi in gastric fundus/body |
|
|
Pt suffers from post-prandial (=after a meal) pain, diarrhea, loss of plasma proteins, and edema. Their pain is relieves by antacids. Dx?
|
Menetrier disease
|
|
|
Pts with GERD and Menetrier disease are at increased risk of what?
|
Adenocarcinoma
GERD = adenocarcinoma of esophagus Menetrier disease = adenocarcinoma of stomach |
|
|
Define Zollinger-Ellison Syndrome
|
Gastrin-secreting tumor in stomach
|
|
|
Pathogenesis of Zollinger-Ellison syndrome?
|
Gastrin-secreting tumor = Inc. # parietal cells = Inc. HCL = Inc. peptic ulcers
|
|
|
Nodule felt in the left supraclavicular area. What type of stomach cancer did this metastasize from?
|
Gastric carcinoma
|
|
|
What are the two types of gastric adenocarcinomas?
|
Intestinal and Diffuse
|
|
|
Diffuse Adenocarcnoma of stomach will present with dec. activity of what?
|
E-cadherin = genetic mutation
|
|
|
Pt presents with "leather bottle stomach" or linitus plastica. What type of gastric cancer do they have?
|
Diffuse adenocarcinoma (makes sense...intestinal type adenocarcinoma wouldn't make the stomach leather-bottle like)
|
|
|
Pathologist notes "signet ring cells" on path report. WITHOUT PEEKING what type of gastric cancer does pt have? (seriously, don't peek)
|
Adenocarcinoma
|
|
|
You note a metastasized gastric carcinoma present in the subcu periumbilical area. Whats the name of this gastric tumor?
|
Sister Mary Joseph Nodule
(to remember: Jesus was born of imaculate conception, and this tumor marks the spot!) |
|
|
You note a metastasized gastric carcinoma present in the ovaries. What do we call this?
|
Krukenberg tumor
|
|
|
The GI tract is the number one location for what type of tumors
|
Neuroendocrine tumors, a type of carcinoid tumor
|
|
|
Gastric neuroendocrine tumors are assoc. with what condition?
|
Zollinger-Ellison
|
|
|
What is the biggest determiant of the prognosis of a gastric tumor?
|
location
Foregut = good Midgut = aggressive and multiple Hindgut = benign, small |
|
|
Where do you NOT want your gastric tumor to be if you had one?
|
midgut
|
|
|
Most MALT lymphomas of stomach arise because of what?
|
H. pylori
|
|
|
How does H. pylori stimulate MALT lymphomas in stomach?
|
H. pylori = Trigger NFK-B = cell growth/survival = MALT
|
|
|
Whats the most common mesenchymal abdominal tumor?
|
GIST, Gastrointestinal Stromal Tumor
|
|
|
We see spindled cells change to round cells in the stomach and c-kit and PDGFRA genetic changes. Dx?
|
GIST, Gastrointestinal Stromal Tumor
|
