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24 Cards in this Set
- Front
- Back
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Two types of diaphragmatic
hernia: |
Bochdalek hernia:
Involves an opening on the left side of the diaphragm. The stomach and intestines usually move up into the chest cavity. • Morgagni hernia (space of Larrey): Involves an opening on the right side of the diaphragm. The liver and intestines usually move up into the chest cavity. |
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Gastric gland hetero_____: gastric adenomyoma
Hamartoma of stomach composed of large ducts, Brunner’s glands, prominent smooth muscle bundles May produce peptic type ulcers in duodenum and bleeding |
Gastric gland heterotopia: gastric adenomyoma
Hamartoma of stomach composed of large ducts, Brunner’s glands, prominent smooth muscle bundles May produce peptic type ulcers in duodenum and bleeding |
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Heterotopic pancreas/pancreatic acinar metaplasia
Nodules of normal pancreatic tissue up to 1 cm in gastric or intestinal wall Prevalence 1-2%; incidental or presents as mass; in 4% of pediatric gastric biopsies Usually antrum or pylorus; when in pylorus, localized inflammation may cause obstruction Strongly associated with chronic gastritis and intestinal metaplasia, but not H. pylori infection At GE junction in children/young adults, but may also be congenital. 11 |
Heterotopic pancreas/pancreatic acinar metaplasia
Nodules of normal pancreatic tissue up to 1 cm in gastric or intestinal wall Prevalence 1-2%; incidental or presents as mass; in 4% of pediatric gastric biopsies Usually antrum or pylorus; when in pylorus, localized inflammation may cause obstruction Strongly associated with chronic gastritis and intestinal metaplasia, but not H. pylori infection At GE junction in children/young adults, but may also be congenital. 11 |
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Mucolipidosis type IV: autosomal recessive
_________ storage disease, causes severe neurologic abnormalities |
Mucolipidosis type IV: autosomal recessive
lysosomal storage disease, causes severe neurologic abnormalities |
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H. Pylori is not assoc with:
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Not associated with:
NSAID and NSAID-induced erosions and ulcers Postgastrectomy status (unless they had it pre-op) Pernicious anemia |
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H. pylori is Detectable in superficial mucus (noninvasive) by:
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Endoscopic biopsy or brushing
Identify microscopically CLO-test, incubate specimen, detects urease Urea breath test -inhale radioactive carbon labelled urea test for release of labeled carbon dioxide Specific IgG tested in saliva by an ELISA assay |
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Most cases of chronic gastritis are caused by
_____________. |
Most cases of chronic gastritis are caused by
heliobacter. |
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H.P: Bacterial factors
Epithelial injury is also caused by a ___________ toxin (VacA) _________ associated gene A (CagA) is a powerful stimulus for IL-_. H.P. enhances gastric acid secretion and impairs duodenal bicarbonate, reducing pH of duodenum. This favors gastric metaplasia of duodenum The antral gastric mucosa responds by __________ type metaplasia. |
H.P: Bacterial factors
Epithelial injury is also caused by a vacuolating toxin (VacA) Cytotoxic associated gene A (CagA) is a powerful stimulus for IL-8. H.P. enhances gastric acid secretion and impairs duodenal bicarbonate, reducing pH of duodenum. This favors gastric metaplasia of duodenum The antral gastric mucosa responds by intestinal type metaplasia. 20 |
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HP treatment
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Tetracycline better than amoxicillin [Chiba]
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2 types of Active gastritis, chronic
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superficial
follicular |
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________ _______ or chemical gastritis is now the
2nd most common gastric bx diagnosis in USA. |
Reflux gastritis or chemical gastritis is now the
2nd most common gastric bx diagnosis in USA. |
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Describe microcopic look of reactive gastropathy
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Mucosa shows edema, congestion, foveolar
hyperplasia with mucin depletion often producing a *corkscrew* appearance and paucity of inflx cells. |
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Which is associated with HP?
a) increased muucosal lymphocytes in LP, surface, foveolar epithelium. b) Lymphoid follicle with germinal centers of deep mucosa |
b) Lymphoid follicle with
germinal centers of deep mucosa |
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Ulcer Perforation or penetration can be fatal:
Gastric -> referred pain to ____ _____ quadrant, thorax, or back Duodenal ->____ or _____ upper quadrant |
Ulcer Perforation or penetration can be fatal:
Gastric -> referred pain to left upper quadrant, thorax, or back Duodenal ->back or right upper quadrant |
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Zollinger-Ellison syndrome
Multiple gastric and duodenal ulcers Gastrin-secreting tumor of islet D-cells Found in distal duodenum (even jejunum) *No _______ loss or peripheral _____ |
Zollinger-Ellison syndrome
Multiple gastric and duodenal ulcers Gastrin-secreting tumor of islet D-cells Found in distal duodenum (even jejunum) *No protein loss or peripheral edema |
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***********
Menetriers disease profound hyperplasia of surface mucous cells with accompanying glandular atrophy with antral sparing. _______ loss and peripheral edema. |
***********
Menetriers disease profound hyperplasia of surface mucous cells with accompanying glandular atrophy with antral sparing. Protein loss and peripheral edema. |
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***************
Gastric polyps 90% are hyperplastic, regenerative and nonheoplastic but 20-25% of hyperplastic polyps are associated with carcinomas when >_cm**********; usually multiple, most <1 cm and sessile but can be 2 cm and pedunculated |
***************
Gastric polyps 90% are hyperplastic, regenerative and nonheoplastic but 20-25% of hyperplastic polyps are associated with carcinomas when >2cm**********; usually multiple, most <1 cm and sessile but can be 2 cm and pedunculated |
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**************
Malignant tumors: 90-95% are adenocarcinoma; weak statistical link with incomplete __________ metaplasia (type III) |
**************
Malignant tumors: 90-95% are adenocarcinoma; weak statistical link with incomplete intestinal metaplasia (type III) |
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Dukes stages
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A, B, C, D
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Risk factors for adenocarcinoma
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prior gastrectomy >20 years old
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Proximal
Gastroesophageal junction and cardia - cardia type *** b. Distal -gastric body and antrum |
Proximal
Gastroesophageal junction and cardia - cardia type *** b. Distal -gastric body and antrum |
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Adverse prognostic factors
Duffuse gastric carcinoma |
>70 years
proximal stomach venous lymphatic invasion CEA > 10 ng/ml CA19-9 >37 g/ml *********Most powerful determinant of prognosis is the TNM pathologic stage: refer to Dukes staging |
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***********
50% eliminated by __________ treatment for H pylori |
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50% eliminated by antibiotic treatment for H pylori |
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95% of GIST stain with antibodies to c-KIT (CD___) and 70% CD34
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95% of GIST stain with antibodies to c-KIT (CD117) and 70% CD34
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