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27 Cards in this Set
- Front
- Back
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what is the difference between sliding and rolling hiatal hernia?
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sliding is a bell shaped protrusion
rolling is a paraesophageal protrusion that may cause obstruction or strangulation |
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what is the difference between odynophagia and dysphagia
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odyno is painful swallowing, dys is difficulty swallowing
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what are 3 types of esophagitis?
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-corrosive
-infective -reflux (GERD) |
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what are some predisposing conditions for GERD
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-vomiting
-ulcers -hiatal hernia -supine positions -increased abdominal pressure (pregnancy) -decreased LES tone |
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what does Barrett's metaplasia arise as a complication from
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GERD
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what are 3 histological features of reflux
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-expanded basal zone
-vascular dilation -inflammatory cells (lymphos, eosinos, neutros) |
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what are 4 complications of reflux
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-peptic ulcers
-strictures -glandular metaplasia -adenocarcinoma |
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what is Barrett's esophagus?
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abnormal change (metaplasia) in lower esophagus, increased goblet cells, adenocarcinoma risk factor
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esophageal adenocarcinoma features
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-malignant neoplasm of glandular epithelium
-~50% esophageal carcinomas -arises in distal Barrett's esophagus -agressive w/poor prognosis |
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esophageal squamous cell carcinoma risk factors
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-diet carcinogens
-nutritional deficiency -alcohol -tobacco -high in NW China, Iran, S.A. |
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esophageal sq. cell carc. epidemiology
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much higher in males, african-americans
alcohol & tobacco |
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what are 2 causes of chronic gastritis?
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h. pylori
autoimmune |
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what are the features of h pylori
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gram (-) bacillus
urease producing resides in mucous layer of gastric epi. infects antrum oral-fecal route |
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what 3 conditions can h pylori cause
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-peptic ulcer disease
-gastric adenocarcinoma -gastric lymphoma |
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what are 4 mechanisms of stomach protection
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-secretion of mucus and bicarbonate
-rapid epithelial generation -elaboration of prostaglandins (NSAIDs prevent this) -strong mucosal bloodflow |
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what are 4 major etiologies of acute gastritis
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-drugs/chemicals
-physical stress -infection -radiation |
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what is the difference between an ulcer and an erosion
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erosion is superficial, can regenerate
ulcer penetrates muscularis mucosa, cant be repaired/is replaced by fibrotic tissue |
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what are histologic features of chronic gastritis
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-lymphocytes and plasma cells
-active- neutros present -progressive destruction of epithelium -atrophy ass. w./intestinal metaplasia |
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how often is h pylori found in duodenal ulcers? stomach
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nearly all duodenal, 50% stomach
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what % of pts w h pylori develop ulcers?
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10-20%
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what do high AST/ALT levels indicate
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injury or necrosis of liver
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what do alkaline phospatase levels indicate
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impaired bile flow
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which rxns increase h2o solubility and destroy activity of the compound
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conjugation rxns
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what rxns increase h2o solubility and dont destroy compound activity
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oxidation rxn
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what is a major function of hepatic sinusoids
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uptake of lipophilic molecules via albumin carriers
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what can high levels of ammonia in the blood cause?
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hepatic encephalopathy
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what is cholestasis
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impairment of bile flow
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