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11 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Peptic ulcer defn |
Areas of degeneration & necrosis of git mucosa that is exposed to acid peptic secretions. Common in duodenum & stomach (4:1) |
Gastric fundus along lesser curvature impacted |
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Chronic peptic ulcer |
Gastric /duodenal Etilogy: h pylori infection, nsaids abuse; acid peptic secretions; gastrtitis; local irritants; dietary deficiencies; psychological;genetic; hormonal |
Abuse two things, infection by? Have more acid peptic secretions; if you don't eat well. Genes, env, hormones |
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Pathogenesis of peptic ulcers |
Two main factors- h pylori infection & exposure of mucosa to gastric acid & pepsin Duodenal ulcer- night; h pylori; rapid emptying of stomach Gastric: hyperacidity in atonic stomach, local irritants; loss of mucosal barrier ( like h pylori induced) |
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How does h pylori contribute to ulcers |
1) induces inflammation & release of pro inflammatory cytokines like IL 2, 6,8 2) liberates urease, protease, catalase, phospholipase 3) injury also initiated by cytotoxin ass gene protein(CagA) & vacuolating cytoxin induces cytokines.( VacA) |
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Gross c.peptic ulcer |
Predominantly along lesser curvature in region of pyloric antrum; punched out, solitary, round or oval, small. Benign ulcers- flat & surrounding mucosa converge towards it Malignant: large, raised, mucosa is rolled out. malignant ulcers are rare & bowel shaped |
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Microscopy of c ulcer |
Necrotic zone- ulcer floor. Fibronous exudate containing necrotic debris & leucocytes Superficial exudative: below the necrotic zone, made of tissue that show coagulative necrosis giving eosinopholic, smudgy appearance Granulation tissue zone: shows newly formed capillaries+ inflammatory cells Zone of cicatrization: merges into granulation tissue. Made of dense fibro collagenous scarover which granulation tissue rests. |
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Complications of chronic ulcer |
1) obstruction- a healed fibrous scar near the pyloric antrum can cause obstruction to outflow of food. hourglass deformity 2)hemmorhage- small Amt of blood due to erosion of vessels. Large amt can cause anemia. Coffee ground comitus or malaena 3)perforation: acute peritonitis, subphrenic abscess, air under diaphragm. 4) malignant transformation: rare |
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Carcinoid syndrome |
5 symptoms;5 secretory products Symptoms: flushing of skin of face; watery diarrhea; attacks of dyspnea; abdominal pain; right heart failure die to valve involvement Secretory products: 5HT,5 hydroxytryptamine, 5 hydroxyindoleacetic acid, histamine, bradykinin Carcinoid tumors that metastise cause this |
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Meckels diverticulum |
Remnant of vitellointestinal duct. Outpouching of ileum, 1cm above ileocaecal valve. Contains all three layers of intestinal wall in their orientation; congenital anomaly occurs in 2% population. Complications: hemorrhage, perforation, diverticulitis |
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Tropical sprue |
Partial villous atrophy Occurs in individuals living in or visiting tropical conuntties. EP- enyerotocin production by some strains of E coli which cause intestinal injury. Severe cases- macrocytic anemia, glossitis, emaciation |
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Typhoid ulcer |
Gross: terminal ileum; payers pafhches show ovoid typhoid ulcers. Base is black due to sloughed mucosa. margins raised due to oedema. NEVER FIBROSIS microscopically, hyperemia, ordema, cellular prol of histiocytes, lymphocytes, plasma cells. No neutrophils even though acute Mesentric lymph nodes- hemorrhagic lymphadenitis Liver- foci of necrosis Joknts- arthritis; nephritis.. |
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