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33 Cards in this Set
- Front
- Back
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major cause of massive hematemesis
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acute gastritis
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how get acute gastritis
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NSAID
alcohol |
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morphology of acute gastritis
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The presence of PMNs above the BM (w/in surface epithelial & glandular layer ) is abnormal & signifies active inflammation)
-erosion |
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presentation of chronic gastritis
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ASx
*no ulcers! (vs. PUD) |
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Et of chronic gastritis
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1. Autoimmune
-Autoantibodies to components of parietal cells (i.e. H+,K+ ATPase & IF) -affects body-fundus -->achlorhydria (no gastric acid production) -->can pernicious anemia 2. H pylori infxn-more common -affects antrum -normal gastrin levels -hypochlorhydria<--parietal cell damage |
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Morph of chronic gastritis
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lymphocytes & plasma cells present in the lamina propria
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complication of chronic gastritis
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PUD
gastric carcinoma carcinoid tumor (autoimmune gastritis) |
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et of H. pylori
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crowding, poor sanitation
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H. pylori can cause:
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chronic gastritis, PUD gastric carcinoma
gastric MALT lymphoma |
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pathogenesis of H. pylori infxn
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H. pylori lies in the superficial mucus layer & among the microvilli of epi cells
(H. pylori does NOT invade the mucosa) ~ Cannot colonize areas w/ intestinal |
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Desc gastritis caused by H pylori
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2 patterns of H. pylori induced gastritis:
Antral-type gastritis: high acid incr risk for duodenal ulcer (PUD) low IL-1β production Pangastritis: low acid, incr risk for adenocarcinoma, high IL-1β production |
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epigastric gnawing
pain worse at night & 1-3 hrs after meal painr eleived by food and alkali |
PUD
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et of PUD
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H pylori
chronic NSAID |
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pathologenesis of PUD
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H pylori:
1. Although H.pylori does not invade, it induces an intense inflammatory response (incr production of pro-inflammatory cytokines)--chronically inflamed mucosa is more susecptible to acid injury 2. (urease, phospholipases, proteases, LPS) 3. H. pylori enhances gastric acid secretion & impairs duodenal bicarb |
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"punched out ulcer"
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PUD
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how distinguish PUD ulcer from Gastric CA-intestinal type? (both have ulcer in duodenum)
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PUD:
"punched out ulcer" smooth and clean base just 1 ulcer Gastric carcinoma-intestinal type not well demarcated heaped up borders >1 ulcer |
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morphology of PUD
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4 layers: "NIGS" (superficial--base of ulcer-- to deep)
1. Necrotic debris 2. Inflam (PMNs) 3. Granulation tissue w/mononuclear infiltrate 4. Scar |
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in whom do we find gastric ulcers?
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(gastric ulcers=stress ulcers)
critically ill pt |
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gastric ulcers are a complication of what?
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NSAIDs
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where are ulcers in stress ulcers?
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anywhere in stomach (vs. PUD: lesser curvature of stomach)
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where are ulcers in PUD?
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#1 duodenum
#2 antrum & lesser curvature of stomach |
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what can cause multiple stomach ulcers?
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gastric ulcer
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what determines clinical outcome of PUD?
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ab to correct underlying condition (remember, pt pop is critically ill pts)
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giant rugal folds
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hypertrophic gastropathy AKA Menetrier Dz
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cerebriform enlarged rugal folds
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hypertrophic gastropathy AKA Menetrier Dz
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what inc risk of gastric polyps?
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chronic gastritis
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what are the types of gastric polyps
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hyperplastic (non-neo)
adenomatous (neo) |
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supraclavicular node
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gastric CA
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Virchow node
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gastric CA
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linitis plastica
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=leather bottle
in gastric CA |
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Krukenberg tumor
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=metastasis to bilateral ovaries
in gastric CA |
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gastric lymphoma
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most are MALT, B cell
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where is MC site of extra-nodal lymphoma
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stomach
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