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28 Cards in this Set

  • Front
  • Back
Cells of the Stomach (4)
Mucous cells - mucus and pspsinogen II (cardia and antrum), pepsinogen I and II (body and fundus)

Parietal cells - H+ ions, intrinsic factor

Chief cells - pesinogen I and II

Endocrine cells - gastrin and histamine
Gastric mucosal protection
mucus secretion

bicarbonate secretion

tight intercellular junctions

epithelial cell restitution

mucosal blood flow - prevents back diffusion of acid

prostaglandin - augments mucus production, bicarb production, increased mucosal bood flow
congential abnormalities of the stomach
heterotopic rests

diaphragmatic hernia

congenital hypertrophic pyloric stenosis

acquired pyloric stenosis
congenital hypertrophic pyrloic stenosis
projectile vomiting 2nd-4th week of life

mass in RUQ with visable peristalsis

associated with trisomy 18, 21 esophageal atresa
Acute Gastritis
epigastric pain, nausea, vomit

hematemesis, malena

associated with asprin use

morphology: intraepithelial neutrophils, vascular congestion, edema, erosions with bleeding, peticheal hemorrhage
Chronic Gastritis
lymphocytes and plasma cells in lamina propria

eventual atrophy and intestinal metaplasia

assocated with H. Pylori, autoimmune destruction of parietal cells, toxic (alcohol), + others
Helicobacter Pylori

definitive cause of what?
g- curveilinear rod colonizes antrum

strongly associated with: gastritis, peptic ulcer disease, gastric carcinoma.

definitive cause of gastric MALT lymphoma
Autoimmune Gastritis

increased risk of what?
Cd4+ T cells and autoantibodies against to H/K ATPase, Gastrin Receptor, Intrinsic Factor

gland destruction -> mucosal atrophy and decreased acid production

can cause loss of intrinsic factor -> pernicious anemia

association with other autoimmune disease - hashimotos thyroiditis, addisons, type 1 DM

increased risk of gastric carcinoma and endocrine tumors
Lymphocytic Gastritis
40% association with celiac disease
Granulomatous Gastritis
association wtih crohns disease, sarcoidosis, TB, CMV
Reactive Gastropathy
chemical injury (NSAIDS, Bile reflux)
Eosinophilic Gastritis
Allergic reactions, collagen vascular disease, systemic sclerosis
Peptic Ulcer Disease (PUD)

damage through the alimentary tract mucosa that extends through the mucularis mucosa and into the submucosa

due to imbalance of damaging factors to defensive factors

location in decreasing freq: duodenum (most common), stomach, GE junction
Peptic Ulcer Disease (PUD)

burning epigastric pain worse at night and after meals, relieved by meals

perforation (most cause death)
Peptic Ulcer Disease (PUD)

vs malignancy (gross)
peptic ulcer has clean edges, punched out look with necrotic base

malignant tumor will have heaped up boarder
Acute Gastric Ulceration
also known as stress ulcers - patients with shock, severe trauma, intracranial injury, burns, sepsis

Curling ulcer - assocated with severe burns/trauma - proximal duodenum

Cushing ulcer - intercranial ulcer puts pressure on vagus nerve -> nerve stimulation -> increased acid secretion - gastric, duodenal, and esophageal ulcers - high incidence of perforation
Menetrier Disease
excessive TGFalpha causes hyperplasia of gastric surface mucous (hypertrophic gastropathy)


increased risk of gastric adenocarcinoma

common in males
Zollinger-Ellison Syndrome
due to gastrinoma which secretes gastrin

PUD, chronic diarrhea, hyperplasia of parietal cells and endocrine cells
Mucosal polyps

usually nonneoplastic - Fundic gland polyps

adenomatous polyps are premalignant
gastric adenocarcinoma
most common malignancy of the stomach (90%)

increased risk due to lack of refrigeration, smoked, cured and salted foods, smoking, H.Pylori

decreased risk with fresh vegetables
Gasttric Carcinoma

growth pattern
linitis plastica
location (dec freq): pyloris/antrum, cardia, body, fundus

lesser cuvature more than greater curvature

3 growth patterns
exophytic - protrudes into lumen
flat/depressed - no obvious mass
excavated/ulcerative - deep crater looks like PUD but has heaped up margins

Linitis Plastica - leather bottle look when a have extensive infiltration
Gastric Carcinoma

Intestinal type: neoplastic intestinal glands permeate gastric wall, grow in large groups

diffuse type - gastric mucous cells permeate the mucosa and wall as scattered cells or small cluster - form signet rings because mucus in cell pushes nucleus to edge
Gastric Lymphoma
almost all are B cell MALT lymphoma

assocated with chronic gastritis and H. Pylori infection

trisomy 3, t(11:18), t(1:11), t(14:18)
Gastrointestinal Stromal Tumors (GIST)
derived from interstitial cells of Cajal

95% positive for c-kit
70% positive for CD34

spindle and epithelial types
Carney's Triad


pulmonary chondroma or NF1
Gastric Neuroendocrine Tumors (Carcinoid Tumors)
from endocrine cells in oxyntic mucosa

likely due to too much gastrin (Zollinger Ellison, chronic gastritis)

location is most important factor:

foregut - rare metastasis
midgut - multiple and agressive
hindgut - more agressive

in submucosa

composed of mature fibroadipose tissue
metastatic cancer
rare in the stomach

most common source
systemic lymphoma, malanoma, breast, lung