Systems path 2 exam 1 - Stomach pathologies and abnormalities (pg 78-108)

vomiting blood

hematemesis (coffee grounds)

black tarry stool

melena

MC stomach infection

h. pylori

inflammation of gastric mucosa

gastritis

what type of gastritis has a sudden onset, is transient, and is characterized by an influx of neutrophils causing inflammation

acute

What condition results in hemorrhage due to erosion/ulceration from acute gastritis?

acute erosive hemorrhagic gastritis

causes of acute gastritis

NSAIDs, alcohol, smoking, food, stress

symptoms associated with acute gastritis

epigastric pain, n/v, anorexia, hematemesis (alcoholics), melena

where does acute gastritis occur?

gastric mucosa

meds to treat acute gastritis

PPIs, H2 receptor antagonist ( to decrease gastric acidity)

small, shallow ulcerations in stomach or duodenum (peptic)

stress-related mucosal disease (acute gastric ulceration)

causes of stress-related mucosal disease

physiologic stress, high doses of NSAIDs, intracranial disease

symptoms of stress-related mucosal disease

n/v, coffee ground hematemesis

acute gastric ulcer caused by physiologic stress (shock, sepsis, or trauma)

stress ulcer

acute gastric ulcer associated with severe burns or trauma, found in proximal duodenum

curling ulcers

gastric, duodenal, esophagus ulcers associated with intracranial injury, operations or tumors

Cushing ulcers

there is a high incidence of ________ associated with Cushing ulcers

perforation

less intense, prolonged gastritis which causes atrophy of gastric mucosa -> decrease secretions

chronic gastritis

signs and symptoms of chronic gastritis

nausea and upper abdominal "discomfort"

causes of chronic gastritis

h. pylori (mc), age, stressors

consequences of chronic gastritis

PUD, gastric adenocarcinoma

70-90% of all cases of chronic gastritis are positive for _________ infection

h. pylori

is h. pylori gastritis mostly asymptomatic or symptomatic?

asymptomatic

h. pylori infection causes the release of ________ which neutralizes acid

urease

H. pylori gastritis can lead to what types of cancers?

gastric adenocarcinoma, MALT lymphoma

H pylori-associated atrophic gastritis is frequently asymptomatic but individuals with this disease are at increased risk of developing what?

gastric carcinoma

patients with chronic atrophic gastritis develop low gastric acid output and hypergastremia which may lead to _______ and _______

ECL cell hyperplasia and carcinoid tumors

ongoing infection of h. pylori along with PPI drugs

chronic atrophic gastritis

what is autoimmune gastritis caused by?

Ab against parietal cells and I.F.

who is most likely to get autoimmune gastritis?

elderly (60), females, chronic gastritis cases

during autoimmune gastritis, parietal cells no longer produce _____ and ____

HCl and I.F.

autoimmune gastritis presents with features of ______

anemia

autoimmune gastritis complicates erythropoiesis which causes what?

pernicious anemia (consequence of IF loss)

during autoimmune gastritis, acid loss leads to ______ _______ anemia that precedes _______ ________ anemia by 20 years

iron deficiency anemia ; B-12 deficient pernicious anemia

open sore or raw area in lining of stomach or intestine

peptic ulcer

ulcer in the stomach

gastric ulcer

ulcer in the first part of the small intestine

duodenal ulcer

causes of peptic ulcer disease

increased acidity (ulcerogenic), NSAIDs, H pylori (most cases)

Gastrin-secreting tumor associated with ulcers and MEN1

Zollinger-Ellison syndrome

vascularized tissue that forms as chronic inflammation evolves

granulation tissue

signs/symptoms of peptic ulcer disease

n/v, heartburn, weight loss, bloating, cachexia, fatigue, epigastric pain

epigastric pain due to peptic ulcer disease occurs during what time of the day?

night or 1-3 hours postprandial

classic presentation of duodenal peptic ulcer disease

postprandial relief (pain returns in 1-3 Horus)

classic presentation of gastric peptic ulcer disease

immediately worse postprandial

shared features of duodenal and gastric peptic ulcer disease

eating influences pain, relieved by alkaline substances, worse at night

mass projection from mucosa

polyp

MC type of gastric polyp (75%) which is inflammatory or regenerative and caused by age (50-60) / H. pylori

hyperplastic polyp

gastric polyp which is caused by PPI use or FAP

fundic gland polyp

gastric polyp which is dysplastic, found MC in males and associated with increased age

gastric adenomas

1/3 of gastric adenomas become...

gastric adenocarcinomas

visual examination of the esophagus, stomach, and duodenum

esophagogastroduodenoscopy (upper endoscopy)

MC stomach cancer, usually from dysplastic adenomas (polyps)

adenocarcinoma

causes/risks associated with developing stomach cancer

males, age 55, chronic inflammation, Japan

symptoms of stomach cancer (when advanced)

gastritis, altered bowels, nausea/anorexia, weight loss, hemorrhage, anemia

sign which represents an enlargement of a left-sided supraclavicular lymph node

trosier sign

histology of stomach cancer

signet ring cells

Hypertrophy of the pyloric muscle causing narrowing of pyloric sphincter

pyloric stenosis

what type of pyloric stenosis is associated with fibrous scar tissue and is diagnosed later in life?

acquired

what type of pyloric stenosis is due to a developmental abnormality?

congenital

signs/symptoms of pyloric stenosis

hyper peristalsis, projectile vomiting, dehydration, irritability, fail to gain weight

risks associated with developing pyloric stenosis

caucasians, male, turner syndrome

treatment for pyloric stenosis

pyloromyotomy

what type of mass is pathognomonic to pyloric stenosis?

palpable epigastric olive-shaped mass