M2010.01.04- Gi: The Stomach

Front 1

Describe cause and findings of:
1. congenital diaphragmatic hernia
2. congenital hypertrophic pyloric stenosis

Back 1

1. hole in diaphragm (usually on L side) allows abd contents to displace lungs & heart --> respiratory distress

2. thickened pylorus causes increased intragastric pressure and projectile non-bilious vomit

Front 2

Contrast erosions from ulcers in the GI tract

Back 2

erosion: loss of superficial epithelium

ulcer: crosses the muscularis into the submucosa

Front 3

List 5 causes of acute gastritis

Back 3

1. stress
2. NSAID Tx
3. EtOH
4. burns (Curlings ulcer)
5. brain injury (Cushings ulcer)

Front 4

Describe the etiology of Cushings ulcers*

Back 4

brain injury leads to increased vagal stim, causes increased gastric acid production

Hint 4

*Cushion the brain

Front 5

Describe the etiology of Curlings ulcers*

Back 5

burns cause a loss of plasma vol and sloughing of gastric mucosa

Hint 5

*Burned by the Curling iron

Front 6

Causes of 2 types of chronic gastritis and which part of the stomach is affected*

Back 6

H. pylori: antrum, increased acid production & disrupted protective mechs (ulcers)

Autoimmune rxn against parietal cells & IF: hits body

Hint 6

AB pairing:
Bacterium affects Antrum

AutoAbs/Anemia/Achlorhydia affects Body

Front 7

Contrast ulcers found in peptic ulcer dz and acute gastritis

Back 7

PUDz: solitary ulcers, located anywhere that's exposed to acid/peptic juices

Acute gastritis: acute, multiple erosions through out gastric mucosa

Front 8

Contrast the ulcers of peptic ulcer dz and excavated lesions of gastric carcinoma

Back 8

PUDz: "punched out" ulcers w/ clean margins

gastric carcinoma: raised/irregular margins

Front 9

General cause of peptic ulcer dz

Back 9

imbalance b/t:
degrading (acid, enzymes)
protective (bicarb, PGI2, blood flow)

with: injury or impaired defenses

Front 10

Describe the findings and malignant potential of:
1. hyperplastic gastric polyps
2. adenomatous gastric polyps

Back 10

1. hyperplastic epithelium, increased inflammatory cells & smM; no malignant potential

2. proliferative dysplastic epithelium; increased malignant potential

Front 11

Describe the extent of gastric adenocarcinoma in:
1. early phase
2. late phase

Back 11

1. only mucosa & submucosa

2. into the muscularis

Front 12

The most common malignant gastric neoplasm

Back 12

adenocarcinoma

Front 13

Describe the 4 gross pathologies in gastric adenocarcinoma

Back 13

1. exophytic

2. flat/depressed

3. excavated

4. linitis plastica (thickened, leathery)

Front 14

With gastric adenocarcinoma, describe:
1. Virchow's node
2. Krukenberg's tumor
3. Sister Mary Joseph's nodule

Back 14

1. involvement of L supraclavicular node by stomach mets

2. B/L mets to ovaries

3. spread to soft tissue to tissue around umbilicus

Front 15

Name & describe 2 hypertrophic gastropathies

Back 15

1. Menetrier dz- enlarged rugal folds, increased risk of adenocarcinoma

2. Zollinger Ellison- gastrin secreting tumor, parietal cell hyperplasia

Front 16

List 2 environmental factors that can promote development of gastric adenocarcinoma

Back 16

1. diet (nitrates, smoked/salted foods)

2. low socioeconomic status

Front 17

1. What is the origin of carcinoid tumors?
2. Most common location
3. Most important prognostic factor at this location

Back 17

1. endocrine cells

2. GI tract

3. location (fore/mid/hindgut)

Front 18

Benign & Malignant neoplasms of smM origin

Back 18

benign: leiomyoma

malignant: leiomyosarcoma

Front 19

1. Origin of GI stromal tumors (GIST)
2. 2 histological appearances
3. Molecular abNL and effect

Back 19

1. from interstitial cells of Cajal (pacemakers for peristalsis)

2. epitheleoid or spindle

3. CD117 (C-kit) mutation causes Tyr kinase activity, cell proliferation & apoptosis resistance